| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KEVIN RYAN EITEL | 1811583263 | 2020-12-18 |
Kevin Ryan Eitel is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1811583263. Registration indicates Kevin Ryan Eitel is a provider of services with a specialization in Emergency Medicine (Allopathic & Osteopathic Physicians, Emergency Medicine) (All Other Specialties & Provider Types, ) (Emergency Medicine, Allopathic & Osteopathic Physicians) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Kevin Ryan Eitel PA-C |
| Practice Office Address | 325 SHARON PARK DR STE F3 MENLO PARK, CA US |
| Practice Office Telephone | 8886636331 |
| Mailing Address | 1669 LAUREL ST SAN CARLOS, CA 940705216 US |
| Business Telephone | 6508886733 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1005 Van Ness Ave | San Francisco, CA 941096913 | 4152339901 / 8334640177 |
| Code | Practice | License No State |
|---|---|---|
| 207P00000X | Emergency Medicine Allopathic & Osteopathic Physicians Emergency Medicine All Other Specialties & Provider Types Emergency Medicine Allopathic & Osteopathic Physicians | PA58942
CA |
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 58942
CA |