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General NPI Number Information
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NPI Number | 1902375744
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Entity Type | Individual
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Provider Name | SAN MICHAEL KYTE PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/22/2018
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 4902 E SHEA BLVD STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-4184
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Country | US
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Telephone | 480-214-4468
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Fax | 480-607-6883
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Provider Business Mailing Address
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Address Line | 6633 E GREENWAY PKWY APT 2138
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-2053
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Country | US
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Telephone | 586-405-4511
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-08571
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 7920
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License Number State | AZ
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