Provider Demographics
NPI:1518191915
Name:KASTENBERG, ZACHARY JON (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JON
Last Name:KASTENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR.
Mailing Address - Street 2:ROOM H3591
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5641
Mailing Address - Country:US
Mailing Address - Phone:650-736-1355
Mailing Address - Fax:650-724-9806
Practice Address - Street 1:300 PASTEUR DR.
Practice Address - Street 2:ROOM H3591
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5641
Practice Address - Country:US
Practice Address - Phone:650-736-1355
Practice Address - Fax:650-724-9806
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X, 390200000X
UT10256938-12052086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery