Theo Neal Kirkland III, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

G39331 Issued in CA

Practice address

5709 Waverly Ave
La Jolla, CA 92037-7336

Phone

(858) 752-7989

Fax

(858) 459-7471

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1528079795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5709 WAVERLY AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377336",
            "telephone_number": "858-752-7989",
            "fax_number": "858-459-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5709 WAVERLY AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377336",
            "telephone_number": "858-752-7989",
            "fax_number": "858-459-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "THEO",
        "middle_name": "NEAL",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G39331",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G39331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G393310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Kinori
• Yasuko Ogata Kinoshita, OTR/L, CHT
• Thomas J Kipps, M.D.
• Matthew R. Kirk, M.D.
• Patrick Kirkland, MD
• Georgia Anne Kirn
• Sara Kisiel
• David Lee Kitchen, DDS
• Alessandara Kitishian, R. D.
• Kristina M. Kjeldsberg, M.D.

• Infectious Disease Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.