Healthcare Provider Details

I. General information

NPI: 1043223381
Provider Name (Legal Business Name): CORBY S. KESSLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 TRANCAS ST STE 1B
NAPA CA
94558-2932
US

IV. Provider business mailing address

935 TRANCAS ST STE 1B
NAPA CA
94558-2932
US

V. Phone/Fax

Practice location:
  • Phone: 707-255-6115
  • Fax: 707-255-6613
Mailing address:
  • Phone: 707-255-6115
  • Fax: 707-255-6613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberG76902
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License NumberG76902
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberG76902
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: