DR. SOMBATH SENETHONG (NPI# 1932104981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932104981 |
| Entity Type | Individual |
| Full Name | DR. SOMBATH SENETHONG |
| Credential | M.D. |
| Practice Address |
4060 Fairmount Ave San Diego CA 92105-1608 |
| Practice Telephone | 6192804213 |
| Practice Fax Number | 6192858134 |
| Mailing Telephone | 6192804213 |
| Mailing Fax Number | 6192858134 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2019-02-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A36779 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A3677900 | 05 |
| Street Address |
4060 FAIRMOUNT AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92105-1608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594286 | Nathanael Jonathan Luna | Pharmacist | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2020-10-07 |
| 1184243420 | Soona Ko | Student in an Organized Health Care Education/Training Program | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2020-04-15 |
| 1780233098 | Cristina L Kim | Nurse Practitioner | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2019-09-09 |
| 1275189110 | Jessica Wilson | Nurse Practitioner | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2019-08-15 |
| 1073177739 | La Maestra Family Clinic, Inc. | Clinic/Center | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2019-04-29 |
| 1982181772 | Vahid Niki | Dentist | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2018-07-24 |
| 1417446477 | Kellie Ramsey | Dentist | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2018-05-05 |
| 1528586716 | Emilia Kodiath | Dentist | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2017-09-07 |
| 1659814648 | Iran Felix | Nurse Practitioner | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2016-11-23 |
| 1265892814 | Marina Markova | Dentist | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2016-02-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851934798 | Point Loma Nazarene University | Nurse Practitioner | Point Loma Nazarene University Health Promotion Center, 4101 University Avenue, San Diego, CA 92105 | 2019-10-23 |
| 1104478809 | Kristin Lynn Nichols | Counselor | 4823 El Cajon Blvd Suite #115, San Diego, CA 92105 | 2019-07-12 |
| 1205343076 | Momentum Learning | Counselor | 3720 El Cajon Blvd., Sd, CA 92105 | 2018-01-03 |
| 1306352695 | Nathan Hien Le, Dds. Inc | Dentist | 4170 Fairmount Ave., San Diego, CA 92105 | 2017-12-21 |
| 1073038071 | Aika Mary Erlandson | Student in an Organized Health Care Education/Training Program | 5296 University Ave. Suite F-2, San Diego, CA 92105 | 2017-08-10 |
| 1457872178 | Ride-in Transport LLC | Non-emergency Medical Transport (VAN) | 4061 Fairmount Ave, San Diego, CA 92105 | 2017-07-03 |
| 1598205346 | Ahmed Mooge | Ambulance | 4061 Fairmout Ave, San Diego, CA 92105 | 2017-02-27 |
| 1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
| 1730634098 | Med Specialty Sai Inc. | Pharmacy | 4153 University Avenue, Suite B, San Diego, CA 92105 | 2016-08-16 |
| 1568857464 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 4074 Fairmount Avenue, Suite B, San Diego, CA 92105 | 2015-03-30 |
| Find all providers in zip 92105 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275145138 | Vishal Verma Md Inc | Family Medicine | 13280 Evening Creek Dr S Ste 225, San Diego, CA 92128-4664 | 2020-08-20 |
| 1225651508 | Charles N Le Medical Alliance, Professional Corp. | Family Medicine | 4440 Euclid Ave Ste A, San Diego, CA 92115-4522 | 2020-05-21 |
| 1457992927 | Huong T L Nguyen Md Inc | Family Medicine | 4444 El Cajon Blvd Ste 6, San Diego, CA 92115-4392 | 2019-10-04 |
| 1265082838 | Jessica Lynn Ross | Family Medicine | 1670 Kettner Blvd Apt 109, San Diego, CA 92101-2556 | 2019-09-16 |
| 1306406251 | Patrick Sweet Md PC | Family Medicine | 4460 Teralta Pl, San Diego, CA 92103-1247 | 2019-06-13 |
| 1225503048 | San Diego Health LLC | Family Medicine | 6610 Flanders Dr Ste 100, San Diego, CA 92121-3940 | 2018-10-08 |
| 1427553502 | Behrang Dehkordi Md Inc | Family Medicine | 444 W C St Ste 185, San Diego, CA 92101-3597 | 2018-03-29 |
| 1245767037 | Tam K Tran | Family Medicine | 7830 Clairemont Mesa Blvd Ste 100, San Diego, CA 92111-1632 | 2017-05-11 |
| 1912350455 | Ruben G Flores | Family Medicine | 2470 Pine Street, San Diego, CA 92103 | 2016-07-20 |
| 1396124145 | Chevon Alderson | Family Medicine | 4305 La Jolla Village Dr # 2518, San Diego, CA 92122-1270 | 2015-05-27 |
| Find all providers in SAN DIEGO | ||||
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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.