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General NPI Number Information
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NPI Number | 1376488577
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Entity Type | Organization
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Legal Business Name | KELKER PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 1550 E WASHINGTON ST
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City | COLTON
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State | CA
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Zip | 92324-4624
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Country | US
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Telephone | 310-810-6554
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Fax | 310-810-6554
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Provider Business Mailing Address
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Address Line | 1550 E WASHINGTON ST
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City | COLTON
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State | CA
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Zip | 92324-4624
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Country | US
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Telephone | 310-810-6554
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Fax | 310-810-6554
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Authorized Official
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Title or Position | CEO
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Name | TARIQ KELKER
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Credential | MD
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Telephone | 310-810-6554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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License Number State |
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