Provider Demographics
NPI:1477501450
Name:HOSTETLER, KARL YODER (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:YODER
Last Name:HOSTETLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14024 RUE SAINT RAPHAEL
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3043
Mailing Address - Country:US
Mailing Address - Phone:858-755-7503
Mailing Address - Fax:858-755-6095
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:UCSD MEDICAL CENTER
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8201
Practice Address - Country:US
Practice Address - Phone:858-657-8440
Practice Address - Fax:619-543-3183
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC32005207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C320050Medicaid
CA00C320050Medicaid
CAA87547Medicare UPIN