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Individual
KYLE WHITE
Active
Individual
KYLE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61705
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA61705
PHYSICIAN ASSISTANT BOARD OF CALIFORNIA
CA
Enumeration date
12/20/2021
Last updated
10/07/2022
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