Active NPI
Kenneth W Albertson, M.D.
- Neuroradiology Physician
- San Diego, CA
National Provider Identifier
1497059976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- G15488
- Practice address
- 845 Armada Ter
San Diego, CA 92106-3055 - Phone
- (619) 223-6037
- Fax
- (619) 226-0400
- NPI assigned
- Dec 27, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | G15488 | CA | Primary |
Addresses
Primary practice location
845 Armada Ter
San Diego, CA 92106-3055
Mailing address
845 Armada Ter
San Diego, CA 92106-3055
Phone (619) 223-6037
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G15488 | CA | MD | Neuroradiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293408000000",
"number": "1497059976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "845 ARMADA TER",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921063055",
"telephone_number": "619-223-6037",
"fax_number": "619-226-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "845 ARMADA TER",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921063055",
"telephone_number": "619-223-6037",
"fax_number": "619-226-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALBERTSON",
"first_name": "KENNETH",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-27",
"last_updated": "2010-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "CA",
"license": "G15488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.