Individual
KYLE OTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MPH
Contact information
Practice address
5400 W HILLSDALE AVE, VISALIA, CA 93291-8222
(559) 738-7500
Mailing address
5601 COFFEE RD APT 922, BAKERSFIELD, CA 93308-9468
(808) 779-0642
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
A144748
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/24/2015
Last updated
08/19/2021
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