MEDICARE: KASTNER ACUPUNCTURE GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC2899	CA

General Provider Information

NPI Number	:	1144253766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KASTNER ACUPUNCTURE GROUP, INC.

Provider Business Mailing Address
First Line	:	4638 PARK BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-8600
Country	:	US
Telephone Number	:	619-220-0878
Fax Number	:	619-220-8147

Provider Business Practice Location Address
First Line	:	4638 PARK BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-8600
Country	:	US
Telephone Number	:	619-220-0878
Fax Number	:	619-220-8147

Authorized Official
Title or Position	:	OWNER
Name	:	JANE MARIE KASTNER
Credential	:	L.AC
Telephone Number	:	619-220-0878

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/22/2020

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