| Anthony Kelada Psychiatry Inc | |
|
991 Reserve Dr Ste B Roseville CA 95678-1350 | |
| (916) 789-8811 | |
| (916) 789-8809 |
| Full Name | Anthony Kelada Psychiatry Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 991 Reserve Dr Ste B, Roseville, California |
| Authorized Official Name and Position | Anthony Kelada (PRESIDENT) |
| Authorized Official Contact | 9162182277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Kelada Psychiatry Inc 991 Reserve Dr Ste B Roseville CA 95678-1350 Ph: (916) 789-8811 | Anthony Kelada Psychiatry Inc 991 Reserve Dr Ste B Roseville CA 95678-1350 Ph: (916) 789-8811 |
| NPI Number | 1679120836 |
|---|---|
| Provider Enumeration Date | 08/22/2019 |
| Last Update Date | 01/08/2020 |
| Certification Date | 01/08/2020 |
| Medicare PECOS PAC ID | 9032547468 |
|---|---|
| Medicare Enrollment ID | O20200319000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679120836 | NPI | - | NPPES |
| 1659790624 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Anthony Kelada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659790624 PECOS PAC ID: 8123362753 Enrollment ID: I20181207001053 |
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