Healthcare Provider Details

I. General information

NPI: 1366161812
Provider Name (Legal Business Name): KYLE ERNEST STREHLOW RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9888 GENESEE AVE
LA JOLLA CA
92037-1205
US

IV. Provider business mailing address

510 1ST AVE UNIT 901
SAN DIEGO CA
92101-6779
US

V. Phone/Fax

Practice location:
  • Phone: 858-834-1798
  • Fax:
Mailing address:
  • Phone: 916-410-3053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95039666
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95199620
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: