Provider Demographics
NPI:1679770903
Name:PAULANTONIO, KRISTINA ALLISON (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:ALLISON
Last Name:PAULANTONIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTINA
Other - Middle Name:ALLISON
Other - Last Name:JOHANSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:960 GRIFFITH DR
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:CA
Mailing Address - Zip Code:95620-4817
Mailing Address - Country:US
Mailing Address - Phone:559-908-3684
Mailing Address - Fax:
Practice Address - Street 1:101 BODIN CIR
Practice Address - Street 2:DAVID GRANT MEDICAL CENTER
Practice Address - City:TRAVIS AFB
Practice Address - State:CA
Practice Address - Zip Code:94535-1809
Practice Address - Country:US
Practice Address - Phone:707-423-5311
Practice Address - Fax:707-423-7356
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24945207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology