Kenneth B Fryer (NPI# 1962576959, PAC ID# 8325097421) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1962576959 |
| PAC ID by PECOS | 8325097421 |
| Professional Enrollment ID | I20100429000823 |
| Full Name | Kenneth B Fryer |
| Organization Legal Name | CENTRAL COAST ORTHOPEDIC MEDICAL GROUP |
| Address |
862 Meinecke Ave Suite 100 San Luis Obispo CA 93405-3701 |
| Phone Number | 8055414600 |
| Gender | M |
| Medical School | NEW YORK MEDICAL COLLEGE |
| Graduation Year | 1970 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 8426945916 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050107 | MARIAN REGIONAL MEDICAL CENTER |
| 050232 | FRENCH HOSPITAL MEDICAL CENTER |
| 050506 | SIERRA VISTA REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 | 8055414600 | CENTRAL COAST ORTHOPEDIC MEDICAL GROUP |
| Organization Legal Name | CENTRAL COAST ORTHOPEDIC MEDICAL GROUP |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicholas Manes Caggiano | Hand Surgery | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Jeffrey E Spoo | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 2342 Professional Pkwy, Suite 200, Santa Maria, CA 93455-1690 |
| Sean D Devine | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Michael T Laird | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 921 Oak Park Blvd, Suite 204, Pismo Beach, CA 93449-3400 |
| Stacy Dawn Mierau | Physician Assistant | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Paul H Castello | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 2342 Professional Pkwy, Suite 200, Santa Maria, CA 93455-1690 |
| Adam A Schraub | Physician Assistant | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Otto J Schueckler | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Daniel W Woods | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Dennis C Blackburn | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 2342 Professional Pkwy, Suite 200, Santa Maria, CA 93455-1690 |
| Street Address |
862 MEINECKE AVE SUITE 100 |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip | 93405-3701 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicholas Manes Caggiano | Hand Surgery | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Sean D Devine | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Stacy Dawn Mierau | Physician Assistant | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Adam A Schraub | Physician Assistant | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Otto J Schueckler | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Daniel W Woods | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Dimitri Emmanuel Delagrammaticas | Orthopedic Surgery | Central Coast Orthopedic Medical Group | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-3701 |
| Charles E St Vincent | Physical Therapy | Sport, Spine and Orthopedic | 862 Meinecke Ave, Suite 101, San Luis Obispo, CA 93405-3702 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William F D Ambruoso | Internal Medicine | 179 Twin Ridge Rd, San Luis Obispo, CA 93405 | |
| Amanda Michelle Parreira | Optometry | 894 Meinecke Ave A, San Luis Obispo, CA 93405-1790 | |
| Tyrone G Mcsorley | Physical Therapy | 894 Meinecke Ave, Suite B, San Luis Obispo, CA 93405-1791 | |
| Julie L Mcsorley | Physical Therapy | 894 Meinecke Ave, Suite B, San Luis Obispo, CA 93405-1791 | |
| Harold D Segal | Neurosurgery | 140 Casa St, San Luis Obispo, CA 93405-1804 | |
| Gayle S Cekada | Internal Medicine | 184 Casa St, San Luis Obispo, CA 93405-1804 | |
| Stephen A Hilty | Internal Medicine | 148 Casa St, San Luis Obispo, CA 93405-1804 | |
| Eric W Dunlop | General Practice | 148 Casa St, San Luis Obispo, CA 93405-1804 | |
| Ginger Christianne Cochran | Registered Dietitian Or Nutrition Professional | 148 Casa St, San Luis Obispo, CA 93405-1804 | |
| Kristina N Dilworth | Nurse Practitioner | First Choice Physician Partners | 1064 Murray Ave, San Luis Obispo, CA 93405-1806 |
| Find all physicians in zip 93405 | |||
| City | SAN LUIS OBISPO |
| Zip Code | 93405 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | SAN LUIS OBISPO + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Kenneth B Fryer.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.