| Dr Stephen Michael Kelly, OD | |
|
851 Cherry Ave, Bayhill Center #25, San Bruno, CA 94066-2900 | |
| (650) 873-2020 | |
| (650) 873-5251 |
| Full Name | Dr Stephen Michael Kelly |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 851 Cherry Ave, San Bruno, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770652349 | NPI | - | NPPES |
| SD0067170 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OPT 6717 TPA (California) | Primary |
| Provider Name | Mid Peninsula Eye Physicians & Surgeons Medical Group |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1407924889 PECOS PAC ID: 2163573437 Enrollment ID: O20090625000691 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Stephen Michael Kelly, OD 2631 Sherwood Dr, San Bruno, CA 94066-1729 Ph: (650) 873-2020 | Dr Stephen Michael Kelly, OD 851 Cherry Ave, Bayhill Center #25, San Bruno, CA 94066-2900 Ph: (650) 873-2020 |
San Bruno Eye Care Center Optometrist Medicare: Medicare Enrolled Practice Location: 931 San Bruno Ave W Rm 4, San Bruno, CA 94066 Phone: 650-588-7701 Fax: 650-588-7797 | |
Jennifer Chen, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 476 San Mateo Ave, San Bruno, CA 94066 Phone: 650-589-4130 | |
Dr. Christina Vigil, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1178 El Camino Real, San Bruno, CA 94066 Phone: 650-553-8867 Fax: 650-871-5919 | |
Dr. Thomas A Aller, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 711 Kains Ave, San Bruno, CA 94066 Phone: 650-871-1816 Fax: 650-871-0164 | |
Dr. Thomas Aller Optometrist, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 648 Jenevein Ave, San Bruno, CA 94066 Phone: 650-871-1816 Fax: 650-871-0164 | |
Dr. Sherryl Lynne Quong, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 476 San Mateo Ave, San Bruno, CA 94066 Phone: 650-589-4130 Fax: 650-589-6549 | |
Elizabeth F Chen, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1178 El Camino Real, Space 265, San Bruno, CA 94066 Phone: 650-583-8024 |