Provider Demographics
NPI:1740308360
Name:LESTINO, JOSEPH A
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:LESTINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5648 LAKE MURRAY BLVD
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-1929
Mailing Address - Country:US
Mailing Address - Phone:619-464-1352
Mailing Address - Fax:619-464-7255
Practice Address - Street 1:5648 LAKE MURRAY BLVD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1929
Practice Address - Country:US
Practice Address - Phone:619-464-1352
Practice Address - Fax:619-464-7255
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 33613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist