Doctor Name: | DR. CHRISTOPHER KEVIN KOLSTAD |
NPI Number: | 1649477654 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A100294 |
Business Practice Address: | 4150 Regents Park Row Suite 325 La Jolla, CA - 92037 |
Business Phone Number: | 8588592563 |
Business Fax Number: | 8589993541 |
Mailing Address: | 4150 Regents Park Row, Suite 325 LA JOLLA |
State: | CA |
Postal Code: | 92037 |
Phone Number: | 8588592563 |
Fax Number: | 8589993541 |
NPI Enumeration Date: | 07/02/2007 |
NPI Last Update Date: | 06/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | A100294 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |