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General NPI Number Information
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NPI Number | 1649665613
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Entity Type | Individual
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Provider Name | KYLE THOMAS RAGINS M.D.,M.B.A.
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Gender | Male
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 7515 VAN NUYS BLVD OFC 573
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City | VAN NUYS
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State | CA
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Zip | 91405-1949
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Country | US
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Telephone | 818-627-3062
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Fax |
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Provider Business Mailing Address
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Address Line | 7515 VAN NUYS BLVD OFC 573
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City | VAN NUYS
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State | CA
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Zip | 91405-1949
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Country | US
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Telephone | 818-267-3062
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A145214
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License Number State | CA
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