Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 10256938-1205 | UT |
NPI | 1518191915 |
---|---|
Provider Name | Dr. Zachary Jon Kastenberg |
First Address | Stanford, CA 94305-5641 |
Second Address | Stanford, CA 94305-5641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2009 |
Last Update Date | 29/10/2021 |