Provider Demographics
NPI:1417482399
Name:KASTON, ESSA SUHEIL (DO)
Entity Type:Individual
Prefix:DR
First Name:ESSA
Middle Name:SUHEIL
Last Name:KASTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10451 E PIVITOL AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-8037
Mailing Address - Country:US
Mailing Address - Phone:602-695-5985
Mailing Address - Fax:
Practice Address - Street 1:4025 W CHANDLER BLVD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3771
Practice Address - Country:US
Practice Address - Phone:480-587-7452
Practice Address - Fax:480-222-7271
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ009263208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine