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General NPI Number Information
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NPI Number | 1235607318
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Entity Type | Individual
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Provider Name | KELSEY ANNE MCCALL O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 36 W YOKUTS AVE
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City | STOCKTON
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State | CA
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Zip | 95207-5735
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Country | US
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Telephone | 209-465-5933
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Fax |
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Provider Business Mailing Address
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Address Line | 441 S HAM LN STE B
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City | LODI
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State | CA
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Zip | 95242-3525
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Country | US
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Telephone | 209-247-4964
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 34359TLG
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License Number State | CA
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