DR. KENNETH GRUDKO (NPI# 1164522199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164522199 |
| Entity Type | Individual |
| Full Name | DR. KENNETH GRUDKO |
| Credential | M.D. |
| Practice Address |
10666 N Torrey Pines Rd La Jolla CA 92037-1027 |
| Mailing Address |
54433 File Los Angeles CA 90074-0001 |
| Practice Telephone | 8585548860 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2009-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
G80633 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G806330 | 05 |
| Street Address |
10666 N TORREY PINES RD |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073513610 | James Francis Brown | Podiatrist | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2005-07-26 |
| 1356958250 | Tyrone Bryant | Pharmacist | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2020-09-25 |
| 1356965552 | Priya Reddy | Student in an Organized Health Care Education/Training Program | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2020-06-03 |
| 1114541497 | Vivian Sardone | Student in an Organized Health Care Education/Training Program | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2020-06-03 |
| 1174145387 | Samantha Tu Duong | Pharmacist | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2020-05-11 |
| 1144840646 | Lee Kyung Hong | Student in an Organized Health Care Education/Training Program | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2020-04-24 |
| 1548880503 | Aren Ebrahimi | Student in an Organized Health Care Education/Training Program | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2020-04-20 |
| 1295355303 | Max Akihiro Macmillan | Student in an Organized Health Care Education/Training Program | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2020-04-17 |
| 1336768886 | Jean Min | Student in an Organized Health Care Education/Training Program | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2020-04-15 |
| 1780203232 | Sunit Rajit Shah | Student in an Organized Health Care Education/Training Program | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2020-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063753168 | Byong M Kim | Internal Medicine | 8607 Nottingham Pl, La Jolla, CA 92037-2127 | 2013-03-14 |
| 1598039604 | Kevin Peltier Glynn | Internal Medicine | 2247 Via Pravia, La Jolla, CA 92037-5841 | 2012-03-07 |
| 1831330109 | Herman Field Froeb | Internal Medicine | 8336 Paseo Del Ocaso, La Jolla, CA 92037-3021 | 2009-03-17 |
| 1245426519 | Wynnshang C. Sun Apc | Internal Medicine | 9850 Genesee Ave Ste 870, La Jolla, CA 92037-1233 | 2007-09-20 |
| 1669680757 | Timothy Martin Fernandes | Internal Medicine | 9300 Campus Point Drive, Mail Code 7381, La Jolla, CA 92037-7381 | 2007-05-20 |
| 1316171283 | Anuja Vyas | Internal Medicine | 9300 Campus Point Dr, Mail Code 7381, La Jolla, CA 92037-1300 | 2009-05-07 |
| 1912076365 | La Jolla Pulmonary and Critical Care Inc. | Internal Medicine | 9850 Genesee Ave, Suite 780, La Jolla, CA 92037-1224 | 2006-11-07 |
| 1164507059 | Fredrick Hanson | Internal Medicine | 9850 Genesee Ave, Suite 780, La Jolla, CA 92037-1224 | 2006-10-26 |
| 1609975689 | Arthur D. Dawson | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2006-09-22 |
| 1902917784 | D Scott Mccaul | Internal Medicine | 9850 Genesee Ave, Suite 780, La Jolla, CA 92037-1224 | 2006-08-31 |
| Find all providers in LA JOLLA | ||||
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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.