Provider Demographics
NPI:1740365618
Name:KASTEN, SHARMEL (DO)
Entity type:Individual
Prefix:MRS
First Name:SHARMEL
Middle Name:
Last Name:KASTEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2139 SHAW AVE STE E6
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-8910
Mailing Address - Country:US
Mailing Address - Phone:559-483-9911
Mailing Address - Fax:559-387-5499
Practice Address - Street 1:2139 SHAW AVE STE E6
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-8910
Practice Address - Country:US
Practice Address - Phone:559-483-9911
Practice Address - Fax:559-387-5499
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8648207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A8648OtherSTATE LICENSE
CA20A8648OtherSTATE LICENSE
CABK8572394OtherDEA