DR. KYLE ALAN MCCULLOUGH (NPI# 1043743479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043743479 |
| Entity Type | Individual |
| Full Name | DR. KYLE ALAN MCCULLOUGH |
| Credential | MD |
| Practice Address |
155 N Fresno St Fresno CA 93701 |
| Mailing Address |
155 N Fresno St Fresno CA 93701-2302 |
| Practice Telephone | 5594595196 |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2018-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 157372 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023620242 | Kyle P Mccullough | Behavior Technician | 238 S Meridian Rd, Youngstown, OH 44509-2925 | 2020-08-19 |
| Street Address |
155 N FRESNO ST |
| City | FRESNO |
| State | CA |
| Zip Code | 93701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295735538 | Michael David Cawdery | Emergency Medicine | 155 N Fresno St, Ucsf-fresno Dept of Emergency Medicine, Fresno, CA 93701-2302 | 2005-07-28 |
| 1770184608 | Lemuel Vince Rivera | Student in an Organized Health Care Education/Training Program | 155 N Fresno St, Fresno, CA 93701-2302 | 2020-11-06 |
| 1902406457 | Reyoot Love Berry | Student in an Organized Health Care Education/Training Program | 155 N Fresno St, Fresno, CA 93701-2302 | 2020-10-26 |
| 1033718507 | Marcus Cummins | Student in an Organized Health Care Education/Training Program | 155 N Fresno St, Fresno, CA 93701-2302 | 2020-10-25 |
| 1902415052 | Ani Tokat M.d., Inc. | Psychiatry & Neurology | 155 N Fresno St, Fresno, CA 93701 | 2020-07-24 |
| 1558979393 | Jacqueline Leon | Student in an Organized Health Care Education/Training Program | 155 N Fresno St, Fresno, CA 93701-2302 | 2020-07-17 |
| 1407464373 | Tyler Wilson | Student in an Organized Health Care Education/Training Program | 155 N Fresno St, Fresno, CA 93701-2302 | 2020-07-16 |
| 1336767573 | Uzoma Dmitri Ezeuko | Student in an Organized Health Care Education/Training Program | 155 N Fresno St, Fresno, CA 93701-2302 | 2020-07-13 |
| 1578188421 | Emmanuel Wing-live Leung | Student in an Organized Health Care Education/Training Program | 155 N Fresno St, Fresno, CA 93701 | 2020-06-16 |
| 1396374997 | Nathan Dreyfus | Student in an Organized Health Care Education/Training Program | 155 N Fresno St, Fresno, CA 93701-2302 | 2020-04-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740244 | Tamara Sue Stanic | Registered Nurse | 215 N. Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-29 |
| 1144849829 | Katelyn Nicole Van Leir | Student in an Organized Health Care Education/Training Program | Surabian Dental Care Center - Suite 2500, 290 N. Wayte Lane, Fresno, CA 93701 | 2020-04-13 |
| 1003445693 | Michelle Edwardson | Registered Nurse | 215 North Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-06 |
| 1184253924 | Patricia Calderon | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-03 |
| 1922637032 | Leticia Lopez | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-02 |
| 1275026585 | Yesenia Gonzalez | Nurse Practitioner | 311 Abby Street, Fresno, CA 93701 | 2018-06-11 |
| 1710474606 | Amanda Juarez | Dietitian, Registered | 215 N Fresno, Suite 370, Fresno, CA 93701 | 2018-04-17 |
| 1235650391 | Plastic Surgery Partners of Fresno Inc | Plastic Surgery | 215 N Fresno St, Ste 490, Fresno, CA 93701 | 2017-06-29 |
| 1205369790 | Amy Alagh | Student in an Organized Health Care Education/Training Program | 155 N Fresno Street, Fresno, CA 93701 | 2017-04-11 |
| 1922462159 | Henry Matthew Dunn | Student in an Organized Health Care Education/Training Program | Ucsf Fresno, 155 N. Fresno St., Department of Orthopaedic Surgery, Fresno, CA 93701 | 2016-04-13 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457583155 | Tienchin Ho | Surgery | 1341 E Santa Ana Ave, Fresno, CA 93704-3435 | 2009-08-13 |
| 1063642866 | Juergen P. Krauthammer, Md, Inc | Surgery | 6057 N 1st St Ste 105, Fresno, CA 93710-5468 | 2009-07-15 |
| 1992961270 | John Chih-chieh Lin | Surgery | 7575 N Cedar Ave Ste 101, Fresno, CA 93720-2693 | 2008-08-06 |
| 1417118159 | Ibironke Vivian Adelaja | Surgery | 2335 E Kashian Ln Ste 220, Fresno, CA 93701-2211 | 2008-06-24 |
| 1790950137 | Herbert E. Gladen, M.d., Inc. | Surgery | 2351 W Loma Linda Ave, Fresno, CA 93711-0417 | 2008-04-28 |
| 1932370335 | Camille Avina Miller | Surgery | 2823 North Fresno Street, Dept of Surgery, 1st Floor, Fresno, CA 93721 | 2008-03-13 |
| 1578731428 | Kalwant S Dhillon | Surgery | 4425 W Ashlan Ave Ste 106, Fresno, CA 93722-7017 | 2008-02-13 |
| 1255519583 | Jennifer Louise Hubbard | Surgery | 2823 N Fresno St, Fresno, CA 93701 | 2008-02-08 |
| 1386825164 | Ana Luisa De La Sierra | Surgery | 5388 W Donner Ave, Fresno, CA 93722-3765 | 2007-11-20 |
| 1629278031 | Paul Frazier Frye | Surgery | 3075 W Silverhill Ln, Fresno, CA 93711-1176 | 2007-07-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.