Provider Demographics
NPI:1386063618
Name:MCCLEVE, DAVID KAYLE (PA-C)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:KAYLE
Last Name:MCCLEVE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16297
Mailing Address - Street 2:#203
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-2297
Mailing Address - Country:US
Mailing Address - Phone:310-446-4400
Mailing Address - Fax:310-446-4408
Practice Address - Street 1:500 N RAINBOW BLVD
Practice Address - Street 2:#203
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-1082
Practice Address - Country:US
Practice Address - Phone:702-259-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1526363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant