DR. MICHAEL W KISTLER (NPI# 1508811175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508811175 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL W KISTLER |
| Credential | M.D. |
| Practice Address |
501 Washington St Ste 510 San Diego CA 92103-2231 |
| Mailing Address |
Po Box 910514 San Diego CA 92191-0514 |
| Practice Telephone | 6198196501 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2008-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
G17434 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G174340 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609438969 | Michael E Kistler | Massage Therapist | 9123 Se Saint Helens St Ste 100a, Clackamas, OR 97015-6800 | 2019-07-07 |
| 1437123239 | Michael L Kistler | Physical Therapist | 309 E Farwell Rd, Suite 104, Spokane, WA 99218 | 2006-02-16 |
| Street Address |
501 WASHINGTON ST STE 510 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194726117 | Daniel J. Bressler, M.d., Inc. | Internal Medicine | 501 Washington St, Suite 705, San Diego, CA 92103-2231 | 2005-08-02 |
| 1639686496 | Marie Melanie Deetjen | Nurse Practitioner | 501 Washington St, San Diego, CA 92103-2231 | 2018-01-03 |
| 1629518246 | Chin Jung Jien Chang | Nurse Practitioner | 501 Washington St, San Diego, CA 92103-2231 | 2017-03-01 |
| 1013459478 | Amy Rosenbaum | Physician Assistant | 501 Washington St, San Diego, CA 92103-2231 | 2016-11-15 |
| 1295100683 | Felicity Nga Ying Fung | Nurse Practitioner | 501 Washington St, Suite 512, San Diego, CA 92103-2231 | 2015-12-10 |
| 1932505831 | Hilary Beth Hill | Nurse Practitioner | 501 Washington St, Suite 600, San Diego, CA 92103-2231 | 2014-11-05 |
| 1063834331 | Karissa Bartholme | Physician Assistant | 501 Washington St, San Diego, CA 92103 | 2014-01-06 |
| 1447695465 | San Diego Heart Rhythm Center A Medical Corporation | Internal Medicine | 501 Washington St, Suite 512, San Diego, CA 92103-2231 | 2013-05-03 |
| 1578883971 | Leonard S Bernstein M D Inc | Internal Medicine | 501 Washington St, #508, San Diego, CA 92103-2231 | 2010-06-08 |
| 1871817312 | Patrick W Blake | Dermatology | 501 Washington St, Suite 502, San Diego, CA 92103-2231 | 2010-03-25 |
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| 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 | 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 |
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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.