Individual
DR. KYLE JERRY MICHAELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-5011
(707) 423-7496
Mailing address
466 PEACOCK WAY, VACAVILLE, CA 95688-8783
(707) 631-8476
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A93950
CA
Other
Enumeration date
09/09/2005
Last updated
10/06/2008
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