KENNETH PETTERSEN (NPI# 1710371927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710371927 |
| Entity Type | Individual |
| Full Name | KENNETH PETTERSEN |
| Credential | MD, MPH |
| Practice Address |
14445 Olive View Dr # 2d-154 Sylmar CA 91342-1437 |
| Mailing Address |
14445 Olive View Dr # 2b182 Sylmar CA 91342-1438 |
| Practice Telephone | 7472104990 |
| Practice Fax Number | 7472104573 |
| Mailing Telephone | 7472103205 |
| Mailing Fax Number | 7472104573 |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2019-12-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | A147825 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
14445 OLIVE VIEW DR # 2D-154 |
| City | SYLMAR |
| State | CA |
| Zip Code | 91342-1437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629687223 | Evelyn Pinto Morales | Technician, Other | 14445 Olive View Dr, Sylmar, CA 91342 | 2020-07-29 |
| 1528520988 | Yeun Lim | Student in an Organized Health Care Education/Training Program | 14445 Olive View Dr., Cottage H1, Attn D. Ray, Sylmar, CA 91342 | 2019-04-04 |
| 1467914317 | Sevak Hovagimyan | Pharmacist | 13677 Foothill Blvd #b, Sylmar, CA 91342 | 2019-04-01 |
| 1619455086 | Cameda Trichele Dickerson | Counselor | Phoenix House 116600 Eldridge, Lake View Terrace, CA 91342 | 2018-07-30 |
| 1407349624 | Joseph Sungkon Choi | Acupuncturist | 10274 Foothill Blvd, Sylmar, CA 91342 | 2018-06-12 |
| 1780194522 | Joe Anthony Cardenas | Specialist/Technologist | 15450 Roxford Street, Sylmar, CA 91342 | 2017-10-06 |
| 1336668466 | Juan Hernandez | Chiropractor | 13950 Foothill Blvd Apt 108, Sylmar, CA 91342 | 2017-09-09 |
| 1891213492 | Richard Ignacio Martinez | Nurse Practitioner | 14987 Oro Grande St., Sylmar, CA 91342 | 2017-09-03 |
| 1104349497 | Vanessa Gamboa | Social Worker | 13145 Bromont Ave., 14, Sylmar, CA 91342 | 2017-07-19 |
| 1982138368 | Christina Guest | Psychiatry & Neurology | Olive View Medical Center, 14445 Olive View Drive, Sylmar, CA 91342 | 2017-04-12 |
| Find all providers in zip 91342 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1831478122 | Arash Nafisi | Internal Medicine | 14445 Olive View Dr Ste 2b182, Sylmar, CA 91342-1437 | 2011-08-04 |
| 1265667968 | Brian Walter Van Den Burg | Internal Medicine | 14445 Olive View Drive, 2b-182, Olive View - Ucla Medical Center, Sylmar, CA 91342 | 2009-05-26 |
| 1558563700 | Charissa Hoi Yan So | Internal Medicine | 14445 Olive View Dr # 2b-182, Sylmar, CA 91342-1437 | 2007-06-01 |
| 1770500316 | Phuong Chi T Pham | Internal Medicine | 14445 Olive View Dr # 2b182, Dept of Midicine, Sylmar, CA 91342-1437 | 2006-07-17 |
| 1144727355 | Oliver Neil Refugio | Internal Medicine | 14445 Olive View Dr, Sylmar, CA 91342-1437 | 2018-04-12 |
| 1598278202 | Salvador Hernandez | Internal Medicine | 14445 Olive View Dr, Sylmar, CA 91342-1437 | 2017-11-16 |
| 1457887606 | Yurhee Lee | Internal Medicine | 14445 Olive View Dr, Ucla-olive View Program (2b-182), Sylmar, CA 91342-1437 | 2017-05-10 |
| 1881128957 | Thomas Michael Kalinoski | Internal Medicine | 14445 Olive View Dr, Sylmar, CA 91342-1437 | 2017-04-17 |
| 1982137279 | Serene Ahmed Tareen | Internal Medicine | 14445 Olive View Dr, Olive View-ucla Medical Center, Sylmar, CA 91342-1437 | 2017-04-04 |
| 1437681046 | Ashley Suraweera | Internal Medicine | 14445 Olive View Dr, Sylmar, CA 91342-1437 | 2017-04-02 |
| Find all providers in SYLMAR | ||||
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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.