Provider Demographics
NPI:1821019753
Name:KELSO, CHRISTINE GEAREN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:GEAREN
Last Name:KELSO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:CATHARINE
Other - Last Name:GEAREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:6860 AVENIDA ENCINAS
Mailing Address - Street 2:KAISER PERMANENTE
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3201
Mailing Address - Country:US
Mailing Address - Phone:800-290-5000
Mailing Address - Fax:
Practice Address - Street 1:6860 AVENIDA ENCINAS
Practice Address - Street 2:KAISER PERMANENTE
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-3201
Practice Address - Country:US
Practice Address - Phone:800-290-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17120208M00000X
ORMD26717208M00000X
CAA99718207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist