Healthcare Provider Details

I. General information

NPI: 1215870506
Provider Name (Legal Business Name): KYLE FOSTER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 S CIMARRON RD STE 100
LAS VEGAS NV
89113-2181
US

IV. Provider business mailing address

6655 S CIMARRON RD STE 100
LAS VEGAS NV
89113-2181
US

V. Phone/Fax

Practice location:
  • Phone: 702-853-3564
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberSL2632
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: