Individual ProviderKelle DurruaGeneral PracticeAllopathic & Osteopathic PhysiciansPractice Address34800 Bob Wilson Dr, San Diego, CA 92134-1098(760) 707-4761PECOS EnrollmentBased on the most recent information from CMS, provider Kelle Durrua does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1821854746Provider TypeIndividualFull NameDurrua, KelleGenderFemaleSole ProprietorNoEnumeration Date2/27/2024Last Updated7/31/2025Contact InformationPractice LocationPractice Address34800 Bob Wilson Dr, San Diego, CA 92134-1098Phone(760) 707-4761FaxUnlisted FaxMailing LocationMailing Address34800 Bob Wilson Dr, San Diego, CA 92134-1098PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208D00000XPrimaryDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicense0102209487Virginia