Kirt Lee Edly is a Surgical in Rancho Mirage, California. Kirt Lee Edly practices all healthcare services and medical treatments related to Surgical. The NPI Number for Kirt Lee Edly is 1053575746. The last update date is 2023-04-05.
Kirt Lee Edly's current location address is Po Box 1730, Rancho Mirage, California. You can contact this provider via phone number 7605682684 and fax number 7603415832. The mailing address for Kirt Lee Edly is Po Box 1730, Rancho Mirage, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kirt Lee Edly |
|---|---|
| Address | Po Box 1730, Rancho Mirage, California |
| Phone Number | 7605682684 |
| Fax Number | 7603415832 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1053575746 |
|---|---|
| Provider Enumeration Date | 2008-07-11 |
| Last Updated Date | 2023-04-05 |
Provider Mailing Address Detail
| Address | Po Box 1730 |
|---|---|
| City | Rancho Mirage |
| State | California (CA) |
| Post Code | 922701058 |
| Phone Number | 7605682684 |
| Fax Number | 7603415832 |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | PA21381 |
|
Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PA21381 | CA | CALIFORNIA LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Kirt Lee Edly by the Centers for Medicare & Medicaid Services?
The Kirt Lee Edly has been issued the NPI (National Provider Identifier) 1053575746, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Kirt Lee Edly's facilities are situated?
The facilities of Kirt Lee Edly are physically located at the following address: Po Box 1730, Rancho Mirage, CA, 922701058.
What is the Kirt Lee Edly's area of specialization and corresponding taxonomy classification?
The Kirt Lee Edly's specialty field is Surgical, and it falls under the taxonomy code 363As0400X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1053575746 to Kirt Lee Edly?
The Centers for Medicare & Medicaid Services assigned the 1053575746 to Kirt Lee Edly on 2008-07-11.
When was the Kirt Lee Edly's information last updated?
The Kirt Lee Edly's information was last updated on 2023-04-05.
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