KYLE JOSEPH GOLENO PA-C NPI 1083667851

NPI Information

NPI: 1083667851
Provider Name: KYLE JOSEPH GOLENO, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
2290 SACRAMENTO ST
VALLEJO, CA
ZIP 94590
Phone: (707) 643-5785
Get Directions

Kyle Joseph Goleno, PA-C is a surgical physician assistant in Vallejo, CA. Kyle Joseph Goleno, PA-C NPI is 1083667851. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2290 SACRAMENTO ST
VALLEJO, CA
ZIP 94590-929
Phone: (707) 643-5785
Fax: (707) 643-8810

The NPI 1083667851 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 5/14/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	PA16376	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0PA163760	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
2	ZZZ97788Z	OTHER	CALIFORNIA	MEDICARE PTAN
3	P87671	MEDICARE UPIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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