Provider Demographics
NPI:1316213382
Name:DAVIS, KELLY FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:FRANCES
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:FRANCES
Other - Last Name:CHAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1310 W STEWART DR STE 508
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3856
Mailing Address - Country:US
Mailing Address - Phone:714-633-2111
Mailing Address - Fax:844-387-7625
Practice Address - Street 1:1310 W STEWART DR STE 508
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3856
Practice Address - Country:US
Practice Address - Phone:714-633-2111
Practice Address - Fax:844-387-7625
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120241207XX0005X, 208000000X, 2080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics