MEDICARE: KAYLA MARIE WHITE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	A209098	CA

General Provider Information

NPI Number	:	1770167413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA MARIE WHITE MD

Provider Business Mailing Address
First Line	:	2351 ERWIN RD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-4699
Country	:	US
Telephone Number	:	919-681-3937
Fax Number	:

Provider Business Practice Location Address
First Line	:	1403 N TUSTIN AVE STE 399
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-8691
Country	:	US
Telephone Number	:	714-884-3961
Fax Number	:	714-884-3458

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2021
Last Update Date	:	06/09/2026

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