KYLE GREEN PA-C NPI 1194246041

NPI Information

  • NPI: 1194246041
  • Provider Name: KYLE GREEN, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 22431 ANTONIO PKWY # B160-613
    RANCHO SANTA MARGARITA, CA
    ZIP 92688
  • Phone: (855) 727-2251

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NPI Details

Kyle Green, PA-C is a surgical physician assistant in Rancho Santa Margarita, CA with 8 years of experience. Kyle Green, PA-C NPI is 1194246041. 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:

22431 ANTONIO PKWY # B160-613
RANCHO SANTA MARGARITA, CA
ZIP 92688-804
Phone: (855) 727-2251
Fax: (855) 727-2251

The NPI 1194246041 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 6/30/2017 and was last updated on 11/10/2022.

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
1363A00000XPhysician AssistantNo
2363AS0400XPhysician AssistantSurgicalYes

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
158474OTHERCALIFORNIAPHYSICIAN ASSISTANT

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: 11/21/2025

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