Individual
DR. AMELIA STAR EASTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
9350 CAMPUS POINT DR, STE. 1B, LA JOLLA, CA 92037-1300
(858) 657-8200
(858) 657-8235
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(858) 249-6749
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
20A 11643
CA
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
20A11643
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FU580A
MEDICARE PTAN
CA
Enumeration date
11/10/2008
Last updated
03/07/2017
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