Phillip Kissel MD, a Professional Corporation

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

G53048 Issued in CA

Legal business name

PHILLIP KISSEL MD, A PROFESSIONAL CORPORATION

Practice address

699 California Blvd Ste a
San Luis Obispo, CA 93401-2507

Phone

(805) 544-4455

NPI assigned

Aug 31, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Phillip Kissel, M.DNPI 1306877030

Title

Owner

Phone

(805) 544-4455

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip Kissel, M.D.

  • Neurological Surgery Physician
  • San Luis Obispo, CA
  • NPI 1306877030
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1962514927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 CALIFORNIA BLVD STE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 CALIFORNIA BLVD STE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012507",
            "telephone_number": "805-544-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP KISSEL MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "KISSEL",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-544-4455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G53048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G530480",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSE",
            "identifier": "G53048",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Peterson
• Mishelle Petit
• James Petrik, D.D.S.
• Pharmarx Pharmaceutical Inc
• Pharmerica Drug Systems LLC
• Phillip M. Colbert, MD,, a Medical Corporation
• Carol Lynn Phillips, D.D.S.
• Kimberly Phillips, NP
• Luke Phillips, PT
• Tina Danielle Phipps

• Neurological Surgery Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.