Provider Demographics
NPI:1558301390
Name:KINEL, CHRISTOPHER JOSEPH (MD)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:KINEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIAN
Other - Middle Name:JOSEPH
Other - Last Name:KINEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8880 W SUNSET RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5004
Mailing Address - Country:US
Mailing Address - Phone:702-798-8570
Mailing Address - Fax:702-798-8518
Practice Address - Street 1:8880 W SUNSET RD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5004
Practice Address - Country:US
Practice Address - Phone:702-798-8570
Practice Address - Fax:702-798-8518
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10728207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100502841Medicaid
NVV38541Medicare PIN