Provider Demographics
NPI:1518377894
Name:SAVILLE, KUN
Entity type:Individual
Prefix:
First Name:KUN
Middle Name:
Last Name:SAVILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31581 CANYON ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-0424
Mailing Address - Country:US
Mailing Address - Phone:951-244-3500
Mailing Address - Fax:951-344-3535
Practice Address - Street 1:31581 CANYON ESTATES DR
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-0424
Practice Address - Country:US
Practice Address - Phone:951-244-3500
Practice Address - Fax:951-344-3535
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51508363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant