Healthcare Provider Details

I. General information

NPI: 1669800405
Provider Name (Legal Business Name): CORBY S. KESSLER, M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2013
Last Update Date: 10/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 TRANCAS ST STE 1B
NAPA CA
94558-2942
US

IV. Provider business mailing address

935 TRANCAS ST STE 1B
NAPA CA
94558-2942
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 Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberG76902
License Number StateCA

VIII. Authorized Official

Name: MICHELE M CASTAGNOLA
Title or Position: OFFICE MANAGER
Credential:
Phone: 707-255-6115