KM Dickson Medical Corporation

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

KM DICKSON MEDICAL CORPORATION

Practice address

555 Saturn Blvd Ste B292
San Diego, CA 92154-4766

Phone

(619) 591-9999

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Kimberly S Dickson, DO

Title

Provider

Phone

(619) 997-4502

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Douglas Dickson, D.O.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1457388720
  Medicare reassignment NPD
• Kimberly K Sheker-Dickson, D.O.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1194755363
  Medicare reassignment NPD

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1265642250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 OCEAN LN",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919322556",
            "telephone_number": "619-591-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SATURN BLVD STE B292",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544766",
            "telephone_number": "619-591-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KM DICKSON MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "619-997-4502",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Klus, PT, CMT
• Maureen Klus, RPT
• Carolyn Klusmeier, LMFT 119360
• Philip Matthew Kluss
• Sriwan Kluythong
• KMD Medical Group, Inc.
• KMN Psychology Inc
• KN Hospice
• Michael Knabel, PHARMD
• Danielle Knack

• General Practice Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.