Provider Demographics
NPI:1326433350
Name:ALMODOVAR, KYLE MEJIA (DO)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:MEJIA
Last Name:ALMODOVAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:6733 N WILLOW AVE STE 107
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5953
Practice Address - Country:US
Practice Address - Phone:559-435-4700
Practice Address - Fax:559-298-7951
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2021-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A15120208M00000X, 207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine