=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740396167
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINA M CASTEEL MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2006
-----------------------------------------------------
Last Update Date | 06/25/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7910 FROST ST SUITE 430
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92123-2795
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-279-5599
-----------------------------------------------------
Fax | 858-279-5848
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10755 SCRIPPS POWAY PKWY # 565
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92131-3924
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-279-5599
-----------------------------------------------------
Fax | 858-279-5599
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | G82208
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------