Healthcare Provider Details

I. General information

NPI: 1003891482
Provider Name (Legal Business Name): KATHERINE COVINGTON AUSTIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL CAMP PENDLETON UILDING H-100
CAMP PENDLETON CA
92055-5191
US

IV. Provider business mailing address

17385 FRONDOSO DR
SAN DIEGO CA
92128-2153
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-6383
  • Fax:
Mailing address:
  • Phone: 760-450-7227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01055881A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC176875
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: