KEN ROTH MD & ROLF EHLERS MD SAN DIEGO INTERNAL MEDICINE ASSOC (NPI# 1578657383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578657383 |
| Entity Type | Organization |
| Organization Name | KEN ROTH MD & ROLF EHLERS MD SAN DIEGO INTERNAL MEDICINE ASSOC |
| Other Organization Name | SAN DIEGO INTERNAL MEDICINE ASSOCIATES |
| Practice Address |
8765 Aero Drive Suite 130 San Diego CA 92123-1767 |
| Practice Telephone | 8585410181 |
| Practice Fax Number | 8586379035 |
| Mailing Telephone | (858) 541-0181 |
| Mailing Fax Number | 8586379035 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | KENNETH J ROTH (GENERAL PARTNER) |
| Authorized Official Telephone | 8585410181 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0000X |
Internal Medicine Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE | W12070 | 01 |
| Other Name | Type Code |
|---|---|
| San Diego Internal Medicine Associates | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2790 Truxtun Rd Ste 100, San Diego, CA 921066135 | 8585410181 |
| Street Address |
8765 AERO DRIVE SUITE 130 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-1767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043253958 | Khoa Huu Nguyen | Internal Medicine | 8765 Aero Drive, Suite 130, San Diego, CA 92123 | 2006-06-14 |
| 1629391123 | Katie Lynn Tone Byrne | Counselor | 8765 Aero Drive, Suite 221, San Diego, CA 92123 | 2010-03-11 |
| 1750475562 | Kenneth J. Roth | Internal Medicine | 8765 Aero Drive, Suite 130, San Diego, CA 92123-1767 | 2006-10-03 |
| 1396839726 | Stephen Y.p. Shen | Internal Medicine | 8765 Aero Drive, Suite 130, San Diego, CA 92123 | 2006-10-02 |
| 1992726095 | Arthur Lovgren-moritz | Internal Medicine | 8765 Aero Drive, Suite 130, San Diego, CA 92123-1767 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 207RA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Adolescent Medicine |
| An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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 |
|---|---|---|---|---|
| 1841473154 | Hoang Sy Dong | Internal Medicine | 200 W Arbor Dr, Suite 380 Mpf# 8425, San Diego, CA 92103-9001 | 2007-12-10 |
| 1396839726 | Stephen Y.p. Shen | Internal Medicine | 8765 Aero Drive, Suite 130, San Diego, CA 92123 | 2006-10-02 |
| 1104841303 | Lawrence S Friedman | Internal Medicine | 402 Dickinson St, Mail Code 8985, San Diego, CA 92103-6902 | 2006-07-12 |
| 1629000880 | Samuel Elliot Halpern | Internal Medicine | 200 W Arbor Dr, San Diego, CA 92103-9001 | 2006-07-07 |
| 1386670438 | Hossain Ali Ronaghy | Internal Medicine | 3023 Bunker Hill St, #106, San Diego, CA 92109-5706 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396115853 | Cedars Primary Care Apmc | Internal Medicine | 18370 Burbank Blvd Ste 201, Tarzana, CA 91356-2853 | 2015-09-28 |
| 1669886933 | Marius Viseroi | Internal Medicine | 3231 Waring Ct Ste D, Oceanside, CA 92056-4510 | 2014-06-16 |
| 1730314378 | Lofty L Basta | Internal Medicine | 765 Market St Apt 35a, San Francisco, CA 94103-2041 | 2009-05-27 |
| 1659534766 | Goodfaith Family Medical Clinic | Internal Medicine | 7540 Garvey Ave Ste C, Rosemead, CA 91770-2960 | 2008-07-08 |
| 1710109509 | Joshua A Jacobi | Internal Medicine | 301 S Fair Oaks Ave Ste 404, Pasadena, CA 91105-2562 | 2007-05-03 |
| 1972624955 | Innovative Medical Solutions Inc A Medical Group | Internal Medicine | 14860 Roscoe Blvd Ste 200, Panorama City, CA 91402-4683 | 2007-04-03 |
| 1326101445 | Karen K.w. Kakishiba, M.d. Inc. | Internal Medicine | 810 Richland Rd, Yuba City, CA 95991-6200 | 2006-12-19 |
| 1518030543 | Lisa Law | Internal Medicine | 728 Pacific Ave Ste 302, San Francisco, CA 94133-4489 | 2006-11-16 |
| 1497844864 | Shigeki Fujitani | Internal Medicine | 6170 Canterbury Dr, Apt 222, Culver City, CA 90230-7929 | 2006-10-12 |
| 1982791562 | Rafayel Gevorkian | Internal Medicine | 5129 W Sunset Blvd, Los Angeles, CA 90027-5715 | 2006-10-06 |
| Find all providers with the same taxonomy | ||||
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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.