DR. FREDERIC JEROME KOLB (NPI# 1790341832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790341832 |
| Entity Type | Individual |
| Full Name | DR. FREDERIC JEROME KOLB |
| Credential | MD |
| Practice Address |
200 W Arbor Dr # Mc8890 San Diego CA 92103-1911 |
| Mailing Address |
Po Box 232410 San Diego CA 92193-2410 |
| Practice Telephone | 6195436084 |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | SFP39 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | ZZZP3716Z | 01 |
| CA | UCSD PLASTIC SURGERY | 95-6006144 | 01 |
| CA | UCSD MEDICAL GROUP | 23-7064656 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4510 Executive Dr Ste 103, San Diego, CA 921213022 | 8584531469 |
| Street Address |
200 W ARBOR DR # MC8890 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-1911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626938 | Garrison Alecsander Leach | Student in an Organized Health Care Education/Training Program | 200 W Arbor Dr # Mc8890, San Diego, CA 92103-1911 | 2020-04-01 |
| 1942866785 | Meera Reghunathan | Student in an Organized Health Care Education/Training Program | 200 W Arbor Dr # Mc8890, San Diego, CA 92103-1911 | 2019-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1891213245 | Rishi Jindal Md Inc | Plastic Surgery | 12264 El Camino Real Ste 101, San Diego, CA 92130-3060 | 2017-09-06 |
| 1548530454 | Dan Sullivan Smith | Plastic Surgery | 5988 Saint Denis Ter, San Diego, CA 92120-3015 | 2012-01-09 |
| 1134453640 | Gary Haves Manchester | Plastic Surgery | 3720 Fourth Ave, San Diego, DC 92110-4763 | 2009-09-30 |
| 1992937304 | Stuart B Kincaid Md, Facs, Apc | Plastic Surgery | 8929 University Center Ln Ste 201, San Diego, CA 92122-1008 | 2009-08-18 |
| 1851528137 | Aram Harijan | Plastic Surgery | 1830 Reed Ave Apt 2, San Diego, CA 92109 | 2009-06-15 |
| 1760636534 | Ahmad Nazih Saad | Plastic Surgery | 5370 Toscana Way, Unit H212, San Diego, CA 92122-5656 | 2008-11-06 |
| 1528239761 | Innovative Plastic & Cosmetic Surgery Inc | Plastic Surgery | 6610 Flanders Dr, Suite 101, San Diego, CA 92121-3940 | 2008-03-16 |
| 1316069503 | Salvatore John Pacella IIi | Plastic Surgery | 12395 El Camino Real Ste 112, San Diego, CA 92130-3084 | 2007-04-06 |
| 1639290075 | Farid Brad Mozaffari | Plastic Surgery | 3655 Nobel Dr Ste 100, San Diego, CA 92122-1004 | 2007-04-03 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on DR. FREDERIC JEROME KOLB.
| 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.