Individual provider Active NPI

Kristopher J Kersch, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Los Angeles, CA
National Provider Identifier
1558700922
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A109211 Issued in CA
Practice address
1225 Wilshire Blvd
Los Angeles, CA 90017-1901
Phone
(213) 977-2412
Fax
(310) 698-7054
NPI assigned
Jun 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X A109211 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A109211 CA Primary

Addresses

Primary practice location

1225 Wilshire Blvd
Los Angeles, CA 90017-1901

Mailing address

2374 E Pacifica PL
Rancho Dominguez, CA 90220-6214
Phone (310) 225-3244

Other identifiers 1

IdentifierTypeStateIssuer
A109211OtherCAMEDICAL LICENSE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A109211CAMDCytopathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1558700922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2374 E PACIFICA PL",
            "city": "RANCHO DOMINGUEZ",
            "state": "CA",
            "postal_code": "902206214",
            "telephone_number": "310-225-3244",
            "fax_number": "310-698-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171901",
            "telephone_number": "213-977-2412",
            "fax_number": "310-698-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSCH",
        "first_name": "KRISTOPHER",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "A109211",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A109211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL  LICENSE",
            "identifier": "A109211",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.