| Kyle White, | |
|
5565 Grossmont Center Dr, La Mesa, CA 91942-3020 | |
| (619) 464-3353 | |
| Not Available |
| Full Name | Kyle White |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 4 Years |
| Location | 5565 Grossmont Center Dr, La Mesa, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922768860 | NPI | - | NPPES |
| PA61705 | Other | CA | PHYSICIAN ASSISTANT BOARD OF CALIFORNIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA61705 (California) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Grossmont Hospital | La mesa, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ear Nose And Throat Associates Of San Diego A Medical Corp | 0345290094 | 11 |
| Entity Name | Ear Nose and Throat Associates of San Diego a Medical Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811992761 PECOS PAC ID: 0345290094 Enrollment ID: O20050131000231 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle White, 6511 Easton Rd, New Lothrop, MI 48460-9716 Ph: (810) 247-3892 | Kyle White, 5565 Grossmont Center Dr, La Mesa, CA 91942-3020 Ph: (619) 464-3353 |
Mrs. Amy Elizabeth Vu, P.A.-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5555 Grossmont Center Dr, La Mesa, CA 91942 Phone: 619-740-6000 |
Julia A. Caputo, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5525 Grossmont Center Dr, La Mesa, CA 91942 Phone: 858-499-2706 |
Dana Ashli Derissi, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5555 Grossmont Center Dr, La Mesa, CA 91942 Phone: 619-740-4071 |
Jasveen Dhillon, MS, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4561 Dickey Dr, La Mesa, CA 91941 Phone: 619-328-3025 |
Joelle Nicole Negley, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 8851 Center Dr, Suite 505, La Mesa, CA 91942 Phone: 619-461-3880 Fax: 619-461-3895 |
Michael Otte, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 6136 Lake Murray Blvd, La Mesa, CA 91942 Phone: 714-389-5700 |
Brittany Slaughter, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5555 Grossmont Center Dr, La Mesa, CA 91942 Phone: 619-740-4401 |