Healthcare Provider Details

I. General information

NPI: 1306023593
Provider Name (Legal Business Name): KRISTIN E LINDSTROM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN E D'ACO MD

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 03/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 E CAMBRIDGE AVE STE 304
PHOENIX AZ
85006-1464
US

IV. Provider business mailing address

3200 E CAMELBACK RD STE 250
PHOENIX AZ
85018-2327
US

V. Phone/Fax

Practice location:
  • Phone: 602-933-4363
  • Fax: 602-933-2415
Mailing address:
  • Phone: 602-933-1814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number264846
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number264846
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number046719
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number49590
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: