Basic Information
| Provider Information | |||||||||
| NPI: | 1992937304 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STUART B KINCAID MD, FACS, APC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8929 UNIVERSITY CENTER LN STE 201 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921221008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8584504199 | ||||||||
| FaxNumber: | 8584504197 | ||||||||
| Practice Location | |||||||||
| Address1: | 8929 UNIVERSITY CENTER LN STE 201 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921221008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8584504199 | ||||||||
| FaxNumber: | 8584504197 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2009 | ||||||||
| LastUpdateDate: | 08/18/2009 | ||||||||
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| AuthorizedOfficialLastName: | KINCAID | ||||||||
| AuthorizedOfficialFirstName: | STUART | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8584504199 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | G34875 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.