Provider Demographics
NPI:1407891393
Name:CASTEEN, CAROLE ANN (MD)
Entity Type:Individual
Prefix:MISS
First Name:CAROLE
Middle Name:ANN
Last Name:CASTEEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22650
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-2650
Mailing Address - Country:US
Mailing Address - Phone:661-869-2600
Mailing Address - Fax:661-869-2003
Practice Address - Street 1:1026 CALLOWAY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-6337
Practice Address - Country:US
Practice Address - Phone:661-663-9090
Practice Address - Fax:661-869-2003
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1100X, 156FX1800X, 332B00000X
CAG50991174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No174400000XOther Service ProvidersSpecialist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ40586ZOtherBLUE SHIELD
CA00G509910Medicaid
CA180007011OtherMEDICARE RAILROAD
CA00G509911Medicare PIN
CA180007011OtherMEDICARE RAILROAD
CA00G509910Medicaid