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General NPI Number Information
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NPI Number | 1013043314
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Entity Type | Individual
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Provider Name | LEAH MORTON KELLEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 1350 S ELISEO DR SUITE 210
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City | GREENBRAE
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State | CA
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Zip | 94904-2011
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Country | US
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Telephone | 415-925-5035
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Fax | 415-462-7035
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Provider Business Mailing Address
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Address Line | 1350 S ELISEO DR SUITE 210
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City | GREENBRAE
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State | CA
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Zip | 94904-2011
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Country | US
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Telephone | 415-925-5035
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Fax | 415-462-7035
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A89531
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A89531
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | A89531
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License Number State | CA
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