Kenneth L. Nudleman, M.D., Inc.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

G37407 Issued in CA

Legal business name

KENNETH L. NUDLEMAN, M.D., INC.

Practice address

801 N. Tustin Ave.
Suite 304
Santa Ana, CA 92705-3608

Phone

(714) 542-7996

Fax

(714) 542-3011

NPI assigned

Jan 10, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kenneth Leonard Nudleman, M.D.NPI 1558324145

Title

Owner/President

Phone

(714) 542-7996

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Leonard Nudleman, MD

  • Neurology Physician
  • Santa Ana, CA
  • NPI 1558324145
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1083951016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 IRVINE BLVD.",
            "address_2": "SUITE 105-241",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201998",
            "telephone_number": "714-542-7996",
            "fax_number": "714-542-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N. TUSTIN AVE.",
            "address_2": "SUITE 304",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053608",
            "telephone_number": "714-542-7996",
            "fax_number": "714-542-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH L. NUDLEMAN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "NUDLEMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LEONARD",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "714-542-7996",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G37407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G374070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lea Mouchet Kennedy, LPCC21647
• Ryan Patrick Kennedy, M.S.
• Sarah Justine Kennedy, LCSW
• Kenneth H Kim,DDS, a Professional Corp.
• Kenneth Johnson, MD, Apc
• Scott Wesley Kennifer
• Noemi D Kenny
• Geoffrey Ku Kenyota, MD
• Kistiyaporn Keratisomphon, ACSW
• Rynette Kerl

• Neurology Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.