Provider Demographics
NPI:1134122633
Name:KAYSER, DENISE (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:KAYSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 E UNION HILLS DR STE 115
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3388
Mailing Address - Country:US
Mailing Address - Phone:602-368-3448
Mailing Address - Fax:
Practice Address - Street 1:3536 MENDOCINO AVE
Practice Address - Street 2:STE 380
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3612
Practice Address - Country:US
Practice Address - Phone:707-575-5353
Practice Address - Fax:707-523-7733
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66761207W00000X, 207WX0107X
AZ64149207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00058640OtherMEDICARE RAILROAD
CAA66761OtherSTATE MEDICAL LICENSE
CAH48439Medicare UPIN