Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A135480 | CA |
NPI | 1437536216 |
---|---|
Provider Name | Dr. Kiersten L. Riedler |
First Address | San Diego, CA 92121-1700 |
Second Address | San Diego, CA 92121-1700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 23/04/2021 |