KEITH E KORTMAN (NPI# 1942276332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942276332 |
| Entity Type | Individual |
| Full Name | KEITH E KORTMAN |
| Credential | MD |
| Practice Address |
8745 Aero Drive Suite 200 San Diego CA 92123-1174 |
| Mailing Address |
Po Box 23540 San Diego CA 92193-3540 |
| Practice Telephone | 8585650950 |
| Practice Fax Number | 8582441100 |
| Mailing Telephone | 8585650950 |
| Mailing Fax Number | 8582441100 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2007-10-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
G48065 | CA | Allopathic & Osteopathic Physicians |
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
G48065 | CA | Allopathic & Osteopathic Physicians |
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
G48065 | CA | Allopathic & Osteopathic Physicians |
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
G48065 | CA | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
G48065 | CA | Allopathic & Osteopathic Physicians |
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
G48065 | CA | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
G48065 | CA | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
G48065 | CA | Allopathic & Osteopathic Physicians |
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
G48065 | CA | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
G48065 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0083815 | 05 | |
| CA | ZZZ75341Z | 05 | |
| CA | GR0083817 | 05 | |
| CA | GR0083811 | 05 | |
| CA | GR0083813 | 05 | |
| CA | GR0083812 | 05 | |
| CA | GR0083814 | 05 | |
| CA | GR0083816 | 05 | |
| CA | GR0083810 | 05 |
| Street Address |
8745 AERO DRIVE SUITE 200 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-1174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659341071 | Patrick H Carey | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-01-26 |
| 1063448785 | Christopher E Dory | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-06-24 |
| 1417994252 | Shanoe Cutts | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-06-01 |
| 1356317747 | Scott M Boles | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-02-24 |
| 1194799163 | Melvin O Senac Jr. | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-02-15 |
| 1225002355 | Robert C Yacullo | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-02-15 |
| 1497729446 | Russell N Low | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-02-15 |
| 1972577922 | William D Carter | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-02-15 |
| 1881668838 | John A Amberg | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-02-15 |
| 1750355657 | Clinton R Nichols | Radiology | 8745 Aero Drive, Suite 200, San Diego, CA 92123-1774 | 2006-02-15 |
| Find all providers in the same location | ||||
| 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 | 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 |
| 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.