Basic Information
| Provider Information | |||||||||
| NPI: | 1255574067 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARSEE | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | EARL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2081 PALOS VERDES DR N | ||||||||
| Address2: | KAISER PERMANENTE PSYCHIATRY | ||||||||
| City: | LOMITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907173701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103256542 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2081 PALOS VERDES DR N | ||||||||
| Address2: | KAISER PERMANENTE PSYCHIATRY | ||||||||
| City: | LOMITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907173701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103256542 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2009 | ||||||||
| LastUpdateDate: | 12/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD160661 | OR | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2084P0800X | A129290 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.