Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A151079 | CA |
NPI | 1013364256 |
---|---|
Provider Name | Dr. Kristina Kyle |
First Address | Loma Linda, CA 92354-2804 |
Second Address | Loma Linda, CA 92354-2804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2016 |
Last Update Date | 26/08/2019 |