=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003711748
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KELLY L REED M.D. PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2026
-----------------------------------------------------
Last Update Date | 10/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26607 CARMEL CENTER PL STE 104
-----------------------------------------------------
City | CARMEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93923-8652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-293-4343
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26607 CARMEL CENTER PL STE 104
-----------------------------------------------------
City | CARMEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93923-8652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER / CEO
-----------------------------------------------------
Name | KELLY REED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 360-293-4343
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------