Provider Demographics
NPI:1437440526
Name:STONEGARZA, KRISTI KIM (MD)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:KIM
Last Name:STONEGARZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-532-7475
Mailing Address - Fax:
Practice Address - Street 1:NAVY MEDICAL CENTER SAN DIEGO GME
Practice Address - Street 2:34800 BOB WILSON DR.
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-0001
Practice Address - Country:US
Practice Address - Phone:619-532-5200
Practice Address - Fax:619-532-7508
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26885207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVAD0000OtherVAD0000