Organization · NPI-2

Kelker Management Corp

Surgery · Pomona, CA

NPI number1902394737
StatusActive
Last updated in NPPESOct 23, 2019

Details

NPI
1902394737
Entity type
Organization (NPI-2)
Legal business name
Kelker Management Corp
Organization subpart
No
Enumeration date
Apr 26, 2018
Last updated
Oct 23, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery125913CAYes

Practice location

160 E Artesia St Ste 310
Pomona, CA 91767-2922

Phone 174-330-1844

Mailing address

Po Box 17062
Anaheim, CA 92817-7062

Phone 714-330-1844

Authorized official

Tariq Kelker
MD/Ceo
7143301844

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