Provider Demographics
NPI:1083758403
Name:LESTER, ERIN ILLENE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ILLENE
Last Name:LESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:STONEKING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:858-554-9800
Mailing Address - Fax:
Practice Address - Street 1:380 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2063
Practice Address - Country:US
Practice Address - Phone:858-554-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-18
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC164671207Q00000X
IL036.121918207Q00000X
IA37496207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036121918Medicaid
ILCB6569OtherRR GROUP #
ILP00729197OtherRR INDIVIDUAL #
IL036121918Medicaid
ILP00729197OtherRR INDIVIDUAL #