KENNETH L. ANDERSON III (NPI# 1437172533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437172533 |
| Entity Type | Individual |
| Full Name | KENNETH L. ANDERSON III |
| Credential | D.O. |
| Practice Address |
1945 Garnet Ave San Diego CA 92109-3595 |
| Mailing Address |
1945 Garnet Avenue San Diego CA 92109-4292 |
| Practice Telephone | 8582247977 |
| Practice Fax Number | 8582247978 |
| Mailing Telephone | 8582247977 |
| Mailing Fax Number | 8582247978 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2011-11-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
20A5441 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | UPIN | F01223 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023279080 | Kenneth M Anderson | Physical Therapist | 823 Kennedy St Ne, Washington, DC 20011 | 2008-06-23 |
| 1063683233 | Kenneth Lee Anderson | Dental Hygienist | 111 Muldoon Rd Apt 5, Anchorage, AK 99504-1435 | 2008-03-17 |
| 1154469690 | Kenneth William Anderson | Optometrist | 8048 San Miguel Canyon Rd, Salinas, CA 93907-1208 | 2007-02-04 |
| 1659434108 | Kenneth W Anderson IIi | Family Medicine | 14451 Morningside Rd, Orland Park, IL 60462-7413 | 2006-12-18 |
| 1528075793 | Kenneth Albert Anderson | Anesthesiology | 6605 Abercorn St Ste 108, Savannah, GA 31405-5896 | 2006-08-01 |
| 1215951611 | Kenneth David Anderson | Dentist | 204 Mcfarland Cir N, Tuscaloosa, AL 35406-1800 | 2006-07-27 |
| 1467483867 | Kenneth Robert Anderson | Family Medicine | 15701 State Road 50suite 101, Suite 101, Clermont, FL 34711 | 2006-07-05 |
| 1073569224 | Kenneth Allen Anderson | Physician Assistant | 1321 N Center St, Hickory, NC 28601-2535 | 2006-05-26 |
| 1508825860 | Kenneth Robert Anderson | Dentist | 132 N West St, Wichita, KS 67203 | 2006-03-23 |
| 1194792671 | Kenneth Carl Anderson | Internal Medicine | 440 Binney St, Dana Farber Cancer Institute, Boston, MA 02115 | 2006-03-03 |
| Street Address |
1945 GARNET AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92109-3595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790283737 | Shawn Renner | Physical Medicine & Rehabilitation | 1945 Garnet Ave, San Diego, CA 92109-3595 | 2018-01-24 |
| 1124307970 | Get Well Stay Well Medical | Family Medicine | 1945 Garnet Ave, San Diego, CA 92109-3595 | 2011-08-11 |
| 1700019262 | Denise O'hagan | Physical Therapist | 1945 Garnet Ave, San Diego, CA 92109-3595 | 2009-09-01 |
| 1245474196 | Diane Fons | Physical Therapist | 1945 Garnet Ave, San Diego, CA 92109-3595 | 2009-04-22 |
| 1649450016 | Theresa Denise Maloney | Nurse Practitioner | 1945 Garnet Ave, San Diego, CA 92109-3595 | 2007-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538620786 | San Diego Forensic Psychology Corporation | Psychologist | 4640 Cass Street, # 90422, San Diego, CA 92109 | 2019-03-29 |
| 1982113874 | Holly Mansur | Registered Nurse | 3663 Jewell Street, San Diego, CA 92109 | 2017-09-24 |
| 1669906178 | Kelley Ann Riley | Prevention Professional | 4328 Gresham St, San Diego, CA 92109 | 2017-04-12 |
| 1689113524 | Tyler Marquis | Pharmacist | 2636 Grand Avenue Apartment 326, San Diego, CA 92109 | 2017-02-13 |
| 1912372574 | Lonnie Butler | Doula | 841 Turquoise Street, F-405, San Diego, CA 92109 | 2015-12-08 |
| 1275924995 | Pratima S. Gowdar, Dds, Inc | Dentist | 4655 Cass St. Ste 104, San Diego, CA 92109 | 2015-02-17 |
| 1417388562 | Pacific Rim Pathology Medical Corporation | Clinical Medical Laboratory | 3030 Bunker Hill Street, Suite 201, San Diego, CA 92109 | 2013-11-27 |
| 1023379997 | Eric Berquist | Student in an Organized Health Care Education/Training Program | 2009 Reed Ave, San Diego, CA 92109 | 2012-06-06 |
| 1982996724 | Miramar Health Physicians Group | Acupuncturist | 1321 Garnet Avenue, San Diego, CA 92109 | 2011-05-12 |
| 1902109325 | Anna N Amagou | Behavioral Analyst | 2221 Felspar Street Apt #c, San Diego, CA 92109 | 2010-12-07 |
| Find all providers in zip 92109 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699015529 | Andrew Saleh | Family Medicine | 1370 Rosecrans St Ste A, San Diego, CA 92106-2676 | 2013-03-01 |
| 1487913588 | James Toldi | Family Medicine | 4010 Sorrento Valley Blvd Ste 300, San Diego, CA 92121-1433 | 2012-05-09 |
| 1881798221 | Frederick Allen Richburg II | Family Medicine | 4010 Sorrento Valley Blvd, Suite 300, San Diego, CA 92121-1432 | 2006-09-07 |
| 1346351665 | Stephen M Daquino | Family Medicine | 16445 Bernardo Center Dr, San Diego, CA 92128-2523 | 2006-08-31 |
| 1093821639 | Robert Arnold Baker | Family Medicine | 1820 Washington Pl, San Diego, CA 92103-2723 | 2006-08-23 |
| 1417936295 | Joseph Lee Moore | Family Medicine | 975 Garnet Ave, San Diego, CA 92109-2729 | 2006-01-11 |
| 1154313971 | Kelly Dean Skanchy | Family Medicine | 2450 Craven St Bldg 3300, Naval Health Clinic Naval Station San Diego, San Diego, CA 92136-5599 | 2005-08-18 |
| 1376106849 | Joseph E Allen Md Inc | Family Medicine | 4116 W Point Loma Blvd, San Diego, CA 92110-5605 | 2019-04-19 |
| 1215382841 | Alex Bernadett | Family Medicine | 4010 Sorrento Valley Blvd Ste 300, San Diego, CA 92121-1433 | 2016-05-02 |
| 1770966988 | Samuel Galloway | Family Medicine | 9909 Mira Mesa Blvd Ste 200, San Diego, CA 92131-1061 | 2015-07-07 |
| Find all providers in SAN DIEGO | ||||
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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.