Healthcare Provider Details

I. General information

NPI: 1629606595
Provider Name (Legal Business Name): MORGAN ELIZABETH KELLY MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH ST FL HALL4
SAN FRANCISCO CA
94143-2549
US

IV. Provider business mailing address

550 16TH STREET MISSION HALL, 4TH FLOOR
SAN FRANCISCO CA
94143
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-5001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: