Rachelle Marie Keltner Edstrom, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 11900TPG Issued in CA

Practice address

13173 Black Mountain Rd
Suite 7
San Diego, CA 92129-2687

Phone

(858) 538-6695

Fax

(858) 538-3182

NPI assigned

Nov 17, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Rachelle Marie Keltner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Focal Point Optometry

  • Optometrist
  • San Diego, CA
  • NPI 1366983264
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1922080720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13173 BLACK MOUNTAIN RD",
            "address_2": "SUITE 7",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292687",
            "telephone_number": "858-538-6695",
            "fax_number": "858-538-3182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13173 BLACK MOUNTAIN RD",
            "address_2": "SUITE 7",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292687",
            "telephone_number": "858-538-6695",
            "fax_number": "858-538-3182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDSTROM",
        "first_name": "RACHELLE",
        "middle_name": "MARIE KELTNER",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 11900TPG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHELLE",
            "last_name": "KELTNER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alayna Edquid
• Rosario Cecilia Perez Edquid
• Emilio Chan Edquilang Jr.
• Marcy Anna Edson, M.S. SLP
• Theodore Durner Edson, M.D.
• Eduardo Diaz DDS PC
• Pia Alissa Edusada
• Edward Ayub M S a P C
• Edward C Federman M D Inc
• Edward Sall Dental Corporation

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.