Provider Demographics
NPI:1497250674
Name:WERTIN, KRISTIN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:WERTIN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:STORAASLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1272 CAMINO CARMELO
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-3552
Mailing Address - Country:US
Mailing Address - Phone:808-265-8884
Mailing Address - Fax:
Practice Address - Street 1:USS SOMERSET (LPD 25) UNIT 100232
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92155-0001
Practice Address - Country:US
Practice Address - Phone:808-265-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101268064207Q00000X, 171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider