Healthcare Provider Details

I. General information

NPI: 1093210783
Provider Name (Legal Business Name): KELLY MELANA MCCARTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DANIEL BURNHAM CT STE 110C
SAN FRANCISCO CA
94109-0456
US

IV. Provider business mailing address

1 DANIEL BURNHAM CT STE 110C
SAN FRANCISCO CA
94109-0456
US

V. Phone/Fax

Practice location:
  • Phone: 415-964-5618
  • Fax: 415-964-5619
Mailing address:
  • Phone: 415-964-5618
  • Fax: 415-964-5619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA202148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: