Individual
DR. KYLE PONTIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1700 ADAMS AVE STE 214, COSTA MESA, CA 92626-4865
(714) 957-1973
(714) 957-1922
Mailing address
PO BOX 80951, RANCHO SANTA MARGARITA, CA 92688-0951
(714) 957-1973
(714) 957-1922
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
14186
CA
Other
Enumeration date
02/13/2007
Last updated
09/09/2019
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