Provider Demographics
NPI:1649483884
Name:KELLING, JONATHAN GEOFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:GEOFFREY
Last Name:KELLING
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 1:38860 SKY CANYON DR BLDG A
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2540
Mailing Address - Country:US
Mailing Address - Phone:951-375-7972
Mailing Address - Fax:877-657-8718
Practice Address - Street 1:38860 SKY CANYON DR BLDG A
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2540
Practice Address - Country:US
Practice Address - Phone:951-375-7972
Practice Address - Fax:877-657-8718
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97287208VP0000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine