1811384787 NPI number — KYLE WESTLUND HEBER M.D.

Table of content: KYLE WESTLUND HEBER M.D. (NPI 1811384787)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811384787 NPI number — KYLE WESTLUND HEBER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEBER
Provider First Name:
KYLE
Provider Middle Name:
WESTLUND
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811384787
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1139
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93302-1139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-371-2796
Provider Business Mailing Address Fax Number:
661-438-1746

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3008 SILLECT AVE STE 240
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93308-6326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-616-9300
Provider Business Practice Location Address Fax Number:
661-616-9301
Provider Enumeration Date:
04/18/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  A152989 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)