Provider Demographics
NPI:1184723728
Name:KAESTNER, JOAN H (MD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:H
Last Name:KAESTNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4403 MANCHESTER AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-7903
Mailing Address - Country:US
Mailing Address - Phone:760-942-9225
Mailing Address - Fax:760-942-9343
Practice Address - Street 1:4403 MANCHESTER AVE STE 208
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-7903
Practice Address - Country:US
Practice Address - Phone:760-942-9225
Practice Address - Fax:760-942-9343
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42901207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G429010OtherBLUE SHIELD
CA00G429010OtherBLUE SHIELD
D36157Medicare UPIN