Individual
KIP D LYCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
168 N BRENT ST, STE 404, VENTURA, CA 93003
(805) 641-6525
(805) 641-6530
Mailing address
168 N BRENT ST, STE 404, VENTURA, CA 93003
(805) 641-6525
(805) 641-6530
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G062357
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP1005
RR MEDICARE
—
Enumeration date
07/04/2006
Last updated
07/14/2023
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