Healthcare Provider Details

I. General information

NPI: 1740365618
Provider Name (Legal Business Name): SHARMEL KASTEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 SHAW AVE STE E6
CLOVIS CA
93611-8910
US

IV. Provider business mailing address

2139 SHAW AVE STE E6
CLOVIS CA
93611-8910
US

V. Phone/Fax

Practice location:
  • Phone: 559-483-9911
  • Fax: 559-387-5499
Mailing address:
  • Phone: 559-483-9911
  • Fax: 559-387-5499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A8648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: