Healthcare Provider Details

I. General information

NPI: 1891371993
Provider Name (Legal Business Name): KYLE NORTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2021
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4405 MANCHESTER AVE STE 101
ENCINITAS CA
92024-4940
US

IV. Provider business mailing address

14141 OLD EL CAMINO REAL UNIT 26
SAN DIEGO CA
92130-3294
US

V. Phone/Fax

Practice location:
  • Phone: 760-650-4040
  • Fax: 760-650-4057
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA180113
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: