Provider Demographics
NPI:1962746305
Name:KELBAN, LAURIE A (DVM)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:A
Last Name:KELBAN
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 E SAN BERNARDINO RD
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1641
Mailing Address - Country:US
Mailing Address - Phone:626-331-5374
Mailing Address - Fax:626-967-8512
Practice Address - Street 1:302 E SAN BERNARDINO RD
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1641
Practice Address - Country:US
Practice Address - Phone:626-331-5374
Practice Address - Fax:626-967-8512
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10427174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian