Individual
DR. PHILLIP KISSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
699 CALIFORNIA BLVD STE A, SAN LUIS OBISPO, CA 93401-2507
(805) 544-4455
(805) 544-5815
Mailing address
699 CALIFORNIA BLVD STE A, SAN LUIS OBISPO, CA 93401-2507
(805) 544-4455
(805) 544-5815
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
G53048
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G530480
—
CA
Enumeration date
07/05/2006
Last updated
07/09/2007
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