1437215241 NPI number — CHRISTINA M CASTEEL M D INC

Table of content: (NPI 1437215241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437215241 NPI number — CHRISTINA M CASTEEL M D INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTINA M CASTEEL M D INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437215241
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10755 SCRIPPS POWAY PKWY # 565
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92131-3924
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-279-5599
Provider Business Mailing Address Fax Number:
858-279-5599

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9888 GENESEE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA JOLLA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92037-1205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-626-4123
Provider Business Practice Location Address Fax Number:
858-279-5599
Provider Enumeration Date:
12/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CASTEEL
Authorized Official First Name:
CHRISTINA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT, CORPORATION
Authorized Official Telephone Number:
858-279-5599

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  G82208 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00G822081 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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