Healthcare Provider Details

I. General information

NPI: 1932527611
Provider Name (Legal Business Name): KYLE ARTHUR STRODTBECK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3745 W CHAPMAN AVE
ORANGE CA
92868-1605
US

IV. Provider business mailing address

2211 E ORANGEWOOD AVE UNIT 103
ANAHEIM CA
92806-6164
US

V. Phone/Fax

Practice location:
  • Phone: 714-770-8409
  • Fax:
Mailing address:
  • Phone: 216-990-9909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA152362
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: