MEDICARE: KELLY HOLZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	A191421	CA
2	207P00000X	Emergency Medicine Physician	HS000239L	PA

General Provider Information

NPI Number	:	1568828275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY HOLZ MD

Provider Business Mailing Address
First Line	:	3401 N BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23625 HOLMAN HWY
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-5902
Country	:	US
Telephone Number	:	831-624-5311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2016
Last Update Date	:	02/09/2026

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Directions to “ KELLY HOLZ MD” Practice Location

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