Provider Demographics
NPI:1487943080
Name:KELLEY, ASHLEY (MD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KELLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 CALIFORNIA ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5424
Mailing Address - Country:US
Mailing Address - Phone:800-997-6196
Mailing Address - Fax:415-504-1367
Practice Address - Street 1:1 CALIFORNIA ST STE 2300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-5424
Practice Address - Country:US
Practice Address - Phone:800-997-6196
Practice Address - Fax:415-504-1367
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101262686207R00000X
NC2017-01894207R00000X
ARE-10996207R00000X
MO2022004737207R00000X
IN01087383A207R00000X
DCMD045783207R00000X
SC51523207R00000X
MN70810207R00000X
NH18671207R00000X
TXT4948207R00000X
TN56480207R00000X
FLME 123 110207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine