John Kelleher M.D. Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

A107765 Issued in CA

Legal business name

JOHN KELLEHER M.D. INC.

Practice address

9171 Wilshire Blvd Ste 680
Beverly Hills, CA 90210-5542

Phone

(310) 721-0744

Fax

(310) 359-8062

NPI assigned

Mar 17, 2017

Last updated

Mar 17, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Kelleher III, M.D.

Title

Owner

Phone

(310) 721-0744

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1467993824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9171 WILSHIRE BLVD STE 680",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105542",
            "telephone_number": "310-721-0744",
            "fax_number": "310-359-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9171 WILSHIRE BLVD STE 680",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105542",
            "telephone_number": "310-721-0744",
            "fax_number": "310-359-8062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN KELLEHER M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "KELLEHER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-721-0744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A107765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.