Individual
KRISTAN KAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11425 EL CAMINO REAL, SAN DIEGO, CA 92130-2045
(858) 794-6363
Mailing address
763 G AVE, CORONADO, CA 92118-2178
(619) 300-2210
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15533
CA
Other
Enumeration date
10/02/2014
Last updated
05/07/2020
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