DR. KOOROSH KOOROS (NPI# 1356372924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356372924 |
| Entity Type | Individual |
| Full Name | DR. KOOROSH KOOROS |
| Credential | M.D. |
| Practice Address |
8110 Birmingham Way San Diego CA 92123-2758 |
| Mailing Address |
3020 Childrens Way Mc 5003 San Diego CA 92123-4223 |
| Practice Telephone | 8589664032 |
| Mailing Telephone | 8583096300 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2016-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
C138035 | CA | Allopathic & Osteopathic Physicians |
| N | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
N7631 | TX | Allopathic & Osteopathic Physicians |
| N | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
002125 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02562449 | 05 |
| Street Address |
8110 BIRMINGHAM WAY |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-2758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821083338 | Hayat Mousa | Pediatrics | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2005-09-12 |
| 1396276259 | Shuran Liang | Student in an Organized Health Care Education/Training Program | 8110 Birmingham Way, Building #28, San Diego, CA 92123-2758 | 2017-03-22 |
| 1528507191 | Kristine N Fu | Dentist | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2017-02-15 |
| 1720463649 | Brian Whitaker | Physician Assistant | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2015-07-21 |
| 1770962144 | Hoa Pham | Student in an Organized Health Care Education/Training Program | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2015-05-19 |
| 1740668177 | Nicole Oparaeke | Dentist | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2015-05-18 |
| 1598029332 | Nidhi Pandhoh Goyal | Pediatrics | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2012-06-26 |
| 1659646792 | Kristen S Ginger | Nurse Practitioner | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2012-03-21 |
| 1205128089 | Cathleen Ann Collins | Allergy & Immunology | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2011-05-11 |
| 1538485586 | Elizabeth Louise Yu | Pediatrics | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2010-04-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
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| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821083338 | Hayat Mousa | Pediatrics | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2005-09-12 |
| 1598029332 | Nidhi Pandhoh Goyal | Pediatrics | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2012-06-26 |
| 1285994921 | Maria Lourdes Herrera | Pediatrics | 3020 Childrens Way # Mc5124, San Diego, CA 92123-4223 | 2012-05-28 |
| 1538485586 | Elizabeth Louise Yu | Pediatrics | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2010-04-15 |
| 1932328747 | Mamata Sivagnanam | Pediatrics | 8110 Birmingham Way, Bldg 28, San Diego, CA 92123-2758 | 2007-04-24 |
| 1477620300 | Warren L. Shapiro | Pediatrics | 8110 Birmingham Way, Bldg 28, San Diego, CA 92123-2758 | 2006-11-29 |
| 1114098969 | Sherry Chu-sing Huang | Pediatrics | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2006-11-13 |
| 1013088871 | Jeannie Shih Huang | Pediatrics | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2006-11-13 |
| 1932270782 | Jeffrey Barnett Schwimmer | Pediatrics | 8110 Birmingham Way, San Diego, CA 92123-2758 | 2006-11-13 |
| 1427140839 | David Brent Polk | Pediatrics | 3030 Childrens Way, San Diego, CA 92123-4232 | 2006-09-30 |
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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.