Provider Demographics
NPI:1083605141
Name:KYLE, DOUGLAS W (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:W
Last Name:KYLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:300 TAMAL PLAZA
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925
Mailing Address - Country:US
Mailing Address - Phone:415-924-1010
Mailing Address - Fax:415-924-1016
Practice Address - Street 1:300 TAMAL PLAZA
Practice Address - Street 2:SUITE 120
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925
Practice Address - Country:US
Practice Address - Phone:415-924-1010
Practice Address - Fax:415-924-1016
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA18851111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic