Belasco, Kevin Tate

Belasco, Kevin Tate is an individual health care provider with primary practice located at 1501 Superior Ave Ste 115 , Newport Beach CA 92663-3606. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Belasco, Kevin Tate can be contacted via phone (949) 640-7546.

Contact Information

Primary practice address
1501 Superior Ave Ste 115 Newport Beach CA 92663-3606
Phone: (949) 640-7546
Fax: (949) 640-7547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 51343021 Wisconsin
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 20A12076 California
Allopathic & Osteopathic Physicians / Dermatology 207N00000X DO1741 Nevada

Profile Details

NPI number 1578736724
LBN Legal business name Belasco, Kevin Tate
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2008
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578736724 NPPES
Wisconsin Other 001417140 MEDICARE
Wisconsin Other P00690402 MEDICARE
Wisconsin Other 51343-021 MEDICARE
Wisconsin MEDICAID 1578736724 MEDICARE

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