Provider Demographics
NPI:1154531697
Name:KISILEWICZ, PAUL FRANK (DPM)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:FRANK
Last Name:KISILEWICZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:2382 LOCH WAY
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762
Mailing Address - Country:US
Mailing Address - Phone:916-933-6869
Mailing Address - Fax:
Practice Address - Street 1:7237 E SOUTHGATE DR STE B
Practice Address - Street 2:7237 EAST SOUTHGATE DRIVE SUITE B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2637
Practice Address - Country:US
Practice Address - Phone:916-392-3330
Practice Address - Fax:916-392-6622
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE3739213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery