| Doctor Name: | KEVIN MARK DEITEL |
| NPI Number: | 1033111380 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | G85673 |
| Business Practice Address: | 3525 Loma Vista Rd Ventura, CA - 930033101 |
| Business Phone Number: | 8056416415 |
| Business Fax Number: | 8056416424 |
| Mailing Address: | 3525 Loma Vista Rd A, VENTURA |
| State: | CA |
| Postal Code: | 930033101 |
| Phone Number: | 8058044165 |
| Fax Number: | 8056416495 |
| NPI Enumeration Date: | 06/01/2005 |
| NPI Last Update Date: | 10/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207XS0117X |
| License Number: | G85673 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Orthopaedic Surgery |
| Taxonomy Specialization: | Orthopaedic Surgery of the Spine |
| Taxonomy Definition: | Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |