Provider Demographics
NPI:1598730335
Name:DOVE, KRISTI ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:ANN
Last Name:DOVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 90259
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92169-2259
Mailing Address - Country:US
Mailing Address - Phone:858-568-6313
Mailing Address - Fax:
Practice Address - Street 1:4094 4TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2143
Practice Address - Country:US
Practice Address - Phone:619-515-2300
Practice Address - Fax:619-906-4564
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0556672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGF85033Medicare UPIN
CADP1702Medicare PIN
CAA55667Medicare PIN