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General NPI Number Information
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NPI Number | 1437536216
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Entity Type | Individual
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Provider Name | KIERSTEN L. RIEDLER M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 9850 GENESEE AVE STE 130
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City | LA JOLLA
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State | CA
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Zip | 92037-1206
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Country | US
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Telephone | 858-452-1981
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Fax |
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Provider Business Mailing Address
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Address Line | 9850 GENESEE AVE STE 130
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City | LA JOLLA
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State | CA
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Zip | 92037-1206
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Country | US
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Telephone | 858-452-1981
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | A135480
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License Number State | CA
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