DR. RYAN ANTHONY FREDERIKSEN (NPI# 1922260033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922260033 |
| Entity Type | Individual |
| Full Name | DR. RYAN ANTHONY FREDERIKSEN |
| Credential | MD |
| Practice Address |
13280 Evening Creek Dr S San Diego CA 92128-4101 |
| Practice Telephone | 8054039924 |
| Mailing Telephone | 8054039924 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2016-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | A108502 | CA | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A108502 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
13280 EVENING CREEK DR S |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128-4101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700863198 | Christopher William Park | Radiology | 13280 Evening Creek Dr S, Suite 110, San Diego, CA 92128-4101 | 2005-12-27 |
| 1629374061 | David Lee | Radiology | 13280 Evening Creek Dr S, #110, San Diego, CA 92128-4101 | 2011-02-02 |
| 1740518547 | Lien Nhu Doan | Radiology | 13280 Evening Creek Dr S, Suite 110, San Diego, CA 92128-4101 | 2009-12-07 |
| 1457587073 | Jill Kei Furubayashi | Radiology | 13280 Evening Creek Dr S, Ste 110, San Diego, CA 92128-4101 | 2009-06-10 |
| 1427210855 | Max Rosenberg Pollock | Internal Medicine | 13280 Evening Creek Dr S, Suite 110, San Diego, CA 92128-4101 | 2008-06-26 |
| 1841304029 | Kevin P Rudny | Radiology | 13280 Evening Creek Dr S, Suite 110, San Diego, CA 92128-4101 | 2006-08-18 |
| 1992719165 | Robert Brian Fortuna | Radiology | 13280 Evening Creek Dr S, Suite 110, San Diego, CA 92128-4101 | 2006-07-27 |
| 1881613586 | Vishal Verma | Radiology | 13280 Evening Creek Dr S, Suite 110, San Diego, CA 92128-4101 | 2006-07-19 |
| 1821060724 | Manal Mosaad Schoellerman | Radiology | 13280 Evening Creek Dr S, Suite 110, San Diego, CA 92128-4101 | 2006-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1376034348 | Eddie Reginald Burston II | In Home Supportive Care | 12727 Camino Emparrado, San Diego, CA 92128 | 2018-05-24 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
| Find all providers in zip 92128 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790208155 | St. Jude Radiology Medical Group, Inc. | Radiology | 8070 Entrada De Luz E, San Diego, CA 92127-2561 | 2017-07-18 |
| 1225586423 | Regional Diagnostic Imaging | Radiology | 3731 Torrey View Ct, San Diego, CA 92130-2623 | 2016-09-15 |
| 1093127680 | William James Tom | Radiology | 200 West Arbor Drive, Mc 0834, San Diego, CA 92103-0834 | 2014-05-30 |
| 1649697947 | Ashley Caitlin Altman | Radiology | Uc San Diego Health, 200 West Arbor Drive, Mc 8829, San Diego, CA 92103 | 2014-03-25 |
| 1477811693 | Michele Christina Mcgahan | Radiology | 8745 Aero Drive #200, San Diego, CA 92193-3540 | 2012-04-25 |
| 1447557996 | Luke R Scalcione | Radiology | 7540 Charmant Dr, Apt 1216, San Diego, CA 92122-5044 | 2011-02-18 |
| 1144537606 | Jasmine Jamin Koo | Radiology | 5330 Carroll Canyon Rd Ste 140, San Diego, CA 92121-3758 | 2010-09-04 |
| 1265743595 | David R Wallace Jr. | Radiology | 200 W Arbor Dr # Mc0834, Department of Radiology, San Diego, CA 92102-0834 | 2010-07-01 |
| 1881837748 | John Joseph Krol | Radiology | 11125 Red Cedar Dr, San Diego, CA 92131-1309 | 2009-04-08 |
| 1700022712 | Thomas N. Folan | Radiology | 425 W Beech St Unit 1707, San Diego, CA 92101-2965 | 2008-12-22 |
| 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.