Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E3739 | CA |
NPI | 1154531697 |
---|---|
Provider Name | Mr. Paul Frank Kisilewicz |
First Address | El Dorado Hills, CA 95762 |
Second Address | Sacramento, CA 95823-2637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 26/01/2017 |