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General NPI Number Information
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NPI Number | 1043772585
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Entity Type | Individual
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Provider Name | MOLLY E. KELLY MD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2019
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Last Update Date | 07/01/2023
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Provider Practice Location Address
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Address Line | 505 PARNASSUS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2204
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Country | US
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Telephone | 415-476-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 513 PARNASSUS AVE # 111
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2205
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Country | US
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Telephone | 415-476-0753
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MDRE.ML.60949111
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD61189076
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 185399
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD61189076
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 185399
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License Number State | CA
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