Healthcare Provider Details

I. General information

NPI: 1033678800
Provider Name (Legal Business Name): ANTOINETTE KITCH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 CITRACADO PKWY STE 320
ESCONDIDO CA
92029-4151
US

IV. Provider business mailing address

2130 CITRACADO PKWY STE 320
ESCONDIDO CA
92029-4151
US

V. Phone/Fax

Practice location:
  • Phone: 858-485-0130
  • Fax: 858-485-9424
Mailing address:
  • Phone: 858-485-0130
  • Fax: 858-485-9424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number14249440-1204
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A25691
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036.161097
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: