Provider Demographics
NPI:1215931233
Name:METROS, KEVIN LEE (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:LEE
Last Name:METROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:332 S JUNIPER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4941
Mailing Address - Country:US
Mailing Address - Phone:760-291-6621
Mailing Address - Fax:760-737-3430
Practice Address - Street 1:225 E 2ND AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4212
Practice Address - Country:US
Practice Address - Phone:866-228-2236
Practice Address - Fax:760-737-3430
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2015-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG71444207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G7144400Medicaid
CACB223099OtherMEDICARE PTAN
E22627Medicare UPIN