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NPI Code Detail

MEDICARE: WILLIAM KIRBY D.O.

MEDICARE:   WILLIAM  KIRBY  D.O.
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
1207N00000XDermatology Physician20A8225CA

General Provider Information

NPI Number : 1841375474
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM KIRBY D.O.
Provider Business Mailing Address
First Line : 1312 HERMOSA AVE
Second Line :
City : HERMOSA BEACH
State : CA
Zip : 90254-3532
Country : US
Telephone Number : 888-631-7773
Fax Number : 310-861-8221
Provider Business Practice Location Address
First Line : 1312 HERMOSA AVE
Second Line :
City : HERMOSA BEACH
State : CA
Zip : 90254-3532
Country : US
Telephone Number : 888-631-7773
Fax Number : 310-861-8221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 01/21/2016

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Directions to “ WILLIAM KIRBY D.O.” Practice Location

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