Provider Demographics
NPI:1063631000
Name:KELLOGG, DONALD RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RAY
Last Name:KELLOGG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 CORRAL DE TIERRA RD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93908-8917
Mailing Address - Country:US
Mailing Address - Phone:831-484-2300
Mailing Address - Fax:
Practice Address - Street 1:303 CORRAL DE TIERRA RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93908-8917
Practice Address - Country:US
Practice Address - Phone:831-484-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG14205174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist