Haley, Kevin David

Haley, Kevin David is an individual health care provider with primary practice located at 5405 Alton Pkwy Suite 5-A-300, Irvine CA 92604-3717. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Haley, Kevin David can be contacted via phone (949) 654-4444.

Contact Information

Primary practice address
5405 Alton Pkwy Suite 5-A-300 Irvine CA 92604-3717
Phone: (949) 654-4444
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA12297 California

Profile Details

NPI number 1730235383
LBN Legal business name Haley, Kevin David
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2007
Last updated Jun 6th, 2012 - about 12 years ago

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 1730235383 NPPES
California MEDICAID PA12297

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