Provider Demographics
NPI:1861459851
Name:KISELSTEIN, ALAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:H
Last Name:KISELSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:PROBST PROFESSIONAL BLDG 312
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-346-7872
Mailing Address - Fax:760-779-9110
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:PROBST PROFESSIONAL BLDG 312
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-346-7872
Practice Address - Fax:760-779-9110
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG19125174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA40533Medicare UPIN