Kenneth William Anderson, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

57040 Issued in GA

Practice address

50 N la Cienega Blvd
Suite 200
Beverly Hills, CA 90211-2227

Phone

(310) 985-3104

NPI assigned

Jan 5, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1790921294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N LA CIENEGA BLVD",
            "address_2": "SUITE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112227",
            "telephone_number": "310-985-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N LA CIENEGA BLVD",
            "address_2": "SUITE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112227",
            "telephone_number": "310-985-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KENNETH",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-05",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "GA",
            "license": "57040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John M Anastasatos, MD
• Alexia Meshie Anavim
• Andalisia Healthcare Inc.
• Julie Lynn Anderson, PH.D.
• Kari L Anderson, MA
• Alexa Christine Andraos, PHARMD
• John Edward Andraos, PHARM.D.
• Andre Aboolian M D a Professional Medical Corporation
• Andre P. Marshall, MD Inc
• Joel Andres, M.F.T.

• Facial Plastic Surgery Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.