KENNETH JUTZY (NPI# 1073531802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073531802 |
| Entity Type | Individual |
| Full Name | KENNETH JUTZY |
| Credential | M.D. |
| Practice Address |
11234 Anderson St #1617 Loma Linda CA 92354-2804 |
| Mailing Address |
File # 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095588591 |
| Mailing Telephone | 9095583111 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-04-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G37876 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
G37876 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G378760 | 05 |
| Street Address |
11234 ANDERSON ST #1617 |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891794657 | Leigh Ann Ballou | Physician Assistant | 11234 Anderson St, Rm 2562b, Loma Linda, CA 92354-2804 | 2005-07-14 |
| 1285233759 | Daemian Alexander Martin Sr. | Registered Nurse | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-10-25 |
| 1922610450 | Samantha Zepeda Merchant | Registered Nurse | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-08-17 |
| 1609493451 | Romina Mcgalliard | Registered Nurse | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-27 |
| 1811514854 | Christopher Jihoon Kim | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-25 |
| 1912523135 | Shelly Marie Bogue | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-23 |
| 1962028613 | Sikai Song | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-18 |
| 1720604515 | Nelson Horsley | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-17 |
| 1134744055 | Teddy Matthew Mumu | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-16 |
| 1124643135 | Kristofer John Vance | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1548899230 | Holistic Physical Therapy Inc. | Physical Therapist | 25003 Starr Str, Loma Linda, CA 92354 | 2020-04-03 |
| 1508494071 | Eric Allen | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-03-31 |
| 1730640244 | Rose Valley Rcfe | Assisted Living Facility | 11574 Poplar St, Loma Linda, CA 92354 | 2019-03-27 |
| 1336633676 | David A Lawrence | Student in an Organized Health Care Education/Training Program | Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 | 2018-06-20 |
| 1205329547 | Rachael Nicole Spady | Student in an Organized Health Care Education/Training Program | Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 | 2018-06-12 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| Find all providers in zip 92354 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316206832 | Howard Wenhung Lan | Internal Medicine | 11234 Anderson St, Sp1637, Loma Linda, CA 92354-2804 | 2012-05-04 |
| 1083980486 | Vinisha Garg | Internal Medicine | 11234 Anderson St Spc 1637, Loma Linda, CA 92354-2871 | 2012-03-29 |
| 1659394328 | Micheal Kuhn | Internal Medicine | 11370 Anderson St, Ste B-100, Loma Linda, CA 92354-3450 | 2006-07-25 |
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|---|---|---|---|---|
| 1104430412 | Anitha Rajamanickam Md Apmc | Internal Medicine | 3907 Waring Rd Ste 3, Oceanside, CA 92056-4454 | 2020-09-03 |
| 1316574890 | Woodland Hills Cardiology Group, PC | Internal Medicine | Woodland Hills Cardiology Group, PC, 22900 Ventura Blvd, Ste 165, Woodland Hills, CA 91364 | 2020-03-25 |
| 1841820677 | Sarsam Cardiology A Professional Corporation | Internal Medicine | 31285 Temecula Pkwy Ste 220, Temecula, CA 92592-6833 | 2020-01-21 |
| 1982246575 | Golden State Heart & Vascular Associates | Internal Medicine | 1850 El Camino Real Ste 200, Burlingame, CA 94010 | 2019-10-15 |
| 1861048613 | Sam Dawkins | Internal Medicine | Suite 415e, 8631 West Third Street, Los Angeles, CA 90048 | 2019-08-16 |
| 1336708494 | Peripheral Vascular Institute, Inc. A Podiatry Corp | Internal Medicine | 2100 Solar Dr Ste 103, Oxnard, CA 93036-0649 | 2019-06-11 |
| 1568020709 | Bakersfield Vascular Care Inc | Internal Medicine | 3550 Q St Ste 205, Bakersfield, CA 93301-1645 | 2019-06-03 |
| 1669974689 | Hossein Eftekhari Md Inc | Internal Medicine | 4147 Pascal Pl, Palos Verdes Peninsula, CA 90274-3941 | 2018-03-06 |
| 1104324102 | Adventist Health Physicians Network | Internal Medicine | 414 G St Ste 108, Marysville, CA 95901-5669 | 2018-01-25 |
| 1194223198 | Adventist Health Physicians Network | Internal Medicine | 414 G St Ste 210, Marysville, CA 95901-5669 | 2018-01-25 |
| Find all providers with the same taxonomy | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.