Individual
KRISTOFER KISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
119 W SULPHUR ST, STE. B-2, LAKE ELSINORE, CA 92530-3703
(951) 454-2673
(951) 344-1749
Mailing address
119 W SULPHUR ST, STE. B-2, LAKE ELSINORE, CA 92530-3703
(951) 454-2673
(951) 344-1749
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201418017
WORKCOMP
CA
Enumeration date
04/28/2011
Last updated
05/18/2015
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