Organization
KYLE B. POTTS, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE B. POTTS M.D. (OWNER)
(559) 738-0450
Entity
Organization
Contact information
Practice address
805 W ACEQUIA AVE, SUITE 2-A, VISALIA, CA 93291-6162
(559) 738-0450
(559) 738-0460
Mailing address
805 W ACEQUIA AVE, SUITE 2-A, VISALIA, CA 93291-6162
(559) 738-0450
(559) 738-0460
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
G64819
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265651756
—
CA
01
—
WG64819A
MEDICARE ID
CA
Enumeration date
04/24/2007
Last updated
03/16/2011
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