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General NPI Number Information
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NPI Number | 1477510428
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Entity Type | Individual
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Provider Name | KRISTIN BEIZAI MD
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Gender | Female
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3350 VIA LA JOLLA
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City | SAN DIEGO
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State | CA
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Zip | 92161-0001
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Country | US
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Telephone | 858-642-3686
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Fax |
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Provider Business Mailing Address
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Address Line | 13335 WINSTANLEY WAY
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City | SAN DIEGO
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State | CA
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Zip | 92130-1403
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Country | US
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Telephone | 858-703-4029
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 29202
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A62658
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License Number State | CA
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