CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF NS (NPI# 1396802872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396802872 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF NS |
| Other Organization Name | CHILDREN'S ASSOCIATED MEDICAL GROUP |
| Practice Address |
8010 Frost St Suite 502 San Diego CA 92123-2778 |
| Mailing Address |
3860 Calle Fortunada Suite 210 San Diego CA 92123-4800 |
| Practice Telephone | 8589668574 |
| Mailing Telephone | 8583096303 |
| Mailing Fax Number | 8583096301 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2008-04-22 |
| Authorized Official Name | HERBERT C. KIMMONS JR. (PRESIDENT) |
| Authorized Official Telephone | 8589668567 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | CHILDREN'S SPECIALISTS OF SAN DIEGO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR006886N | 05 |
| Other Name | Type Code |
|---|---|
| Children's Associated Medical Group | Former Legal Business Name - Organization |
| Street Address |
8010 FROST ST SUITE 502 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-2778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902888522 | Joseph H Chammas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 8010 Frost St, Suite 408, San Diego, CA 92123-2778 | 2005-11-18 |
| 1780071399 | Eliza Barrett Kasian | Physician Assistant | 8010 Frost St, Suite 602, San Diego, CA 92123-2778 | 2015-04-21 |
| 1477977932 | Sharp Healthcare | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 8010 Frost St, Suite 408, San Diego, CA 92123-2778 | 2014-02-04 |
| 1609209238 | Stephanie N Mcclafferty | Physician Assistant | 8010 Frost St, Ste 602, San Diego, CA 92123-2778 | 2013-08-19 |
| 1356665657 | Pamela Cristine Lee | Surgery | 8010 Frost St, 2nd Flr, San Diego, CA 92123-2778 | 2010-03-16 |
| 1548497373 | Olivia Hsin | Psychologist | 8010 Frost St, 2nd Floor Dec, San Diego, CA 92123-2778 | 2009-06-19 |
| 1821232778 | Janelle Penny Dela Vina | Nurse Practitioner | 8010 Frost St, Suite 414, San Diego, CA 92123-2778 | 2009-04-22 |
| 1306091186 | Joshua Cohen Md Inc | Obstetrics & Gynecology | 8010 Frost St, Suite 408, San Diego, CA 92123-2778 | 2008-11-20 |
| 1487819546 | Michael Richard Zimbric | Psychiatry & Neurology | 8010 Frost St, Ste 510, San Diego, CA 92123-2778 | 2008-07-28 |
| 1407010556 | Timothy Joseph Fairbanks | Surgery | 8010 Frost St, Ste 414, San Diego, CA 92123-2778 | 2008-07-17 |
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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 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093205312 | Vikram Udani Md Inc | Neurological Surgery | 3590 Camino Del Rio N Ste 200, San Diego, CA 92108-1707 | 2018-05-11 |
| 1639428238 | Victor Lo | Neurological Surgery | 5251 Viewridge Ct, San Diego, CA 92123 | 2012-08-29 |
| 1902176399 | Robert Francis Andrews | Neurological Surgery | 2156 Guy St, San Diego, CA 92103-1537 | 2012-01-03 |
| 1336399567 | Lance L. Altenau | Neurological Surgery | 3525 Del Mar Heights Rd # 355, San Diego, CA 92130-2122 | 2008-09-24 |
| 1316141898 | Ganna L Breland | Neurological Surgery | 10350 Barnes Canyon Rd Ste 200, San Diego, CA 92121-2709 | 2007-06-11 |
| 1508912031 | Jonathon Cooke | Neurological Surgery | 6540 Reflection Dr, San Diego, CA 92124-5119 | 2007-01-26 |
| 1396899837 | San Diego Neurosurgery and Spine Institute | Neurological Surgery | 7930 Frost St Ste 304, San Diego, CA 92123-2740 | 2007-01-22 |
| 1083792220 | Rex L Rhoten | Neurological Surgery | 4510 Executive Dr Ste 125, San Diego, CA 92121-3054 | 2006-11-02 |
| 1881709673 | Neurosurgical Medical Clinic, Inc | Neurological Surgery | 3750 Convoy St Ste 301, San Diego, CA 92111-3741 | 2006-08-20 |
| 1144333436 | Lance L Altenau | Neurological Surgery | 2100 5th Ave, Ste 200, San Diego, CA 92101-2102 | 2006-08-17 |
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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.