Individual
DR. KEVIN MARK DEITEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2221 WANKEL WAY, OXNARD, CA 93030-0192
(805) 988-9366
(805) 483-3747
Mailing address
1203 FLYNN RD UNIT 160, CAMARILLO, CA 93012-6203
(805) 804-4168
(805) 830-1177
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
G85673
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G85673
MEDICAL LICENSE
CA
01
—
H35473
UPIN
CA
Enumeration date
06/01/2005
Last updated
07/14/2025
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