Healthcare Provider Details

I. General information

NPI: 1306069653
Provider Name (Legal Business Name): CAROLE A CASTEEN M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 CALLOWAY DR SUITE 200
BAKERSFIELD CA
93312
US

IV. Provider business mailing address

PO BOX 22650
BAKERSFIELD CA
93390-2650
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-9090
  • Fax: 661-829-6754
Mailing address:
  • Phone: 661-663-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0584260001
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG50991
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG50991
License Number StateCA

VIII. Authorized Official

Name: DR. CAROLE ANN CASTEEN
Title or Position: OWNER
Credential: MD
Phone: 661-663-9090