Provider Demographics
NPI:1245387471
Name:KAESTNER MEDICAL CORPORATION
Entity Type:Organization
Organization Name:KAESTNER MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:KAESTNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-942-9225
Mailing Address - Street 1:477 N EL CAMINO REAL
Mailing Address - Street 2:C-308
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1328
Mailing Address - Country:US
Mailing Address - Phone:760-942-9225
Mailing Address - Fax:760-942-9343
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:C-308
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-942-9225
Practice Address - Fax:760-942-9343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42901207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty