Kenneth V. Miselis, M.D. Inc.
Organization Active NPI Specialist · Stockton, CA
NPI 1962413740 · NPPES record last updated Jun 17, 2020
Key facts
- NPI
- 1962413740
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- G502810 (CA)
- Legal business name
- KENNETH V. MISELIS, M.D. INC.
- Practice address
- 445 W Poplar St
Stockton, CA 95203-2426 - Phone
- (209) 465-5933
- Fax
- (209) 465-2562
- NPI assigned
- Aug 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Kenneth Victor Miselis, M.D.
- Title
- President
- Phone
- (209) 465-5933
Practitioners 48
-
Michio Abe, MD
-
Katherine Anglin, MD, MS
-
Manuel Arroyo, M.D.
-
Khatereh A Assadi, M.D.
-
Gerard H Boghossian, D.P.M.
-
Jonathan D Botts, M.D.
-
John W Bulrice, PAC
-
Sourav Das, MD
-
Anthony Jay Dulgeroff, M.D.
-
Kanwaljit S Gill, MD
-
Steven P. Grahek, MD
-
Vincent A.K. Ho, M.D.
-
Zulianna Ibrahim, M.D.
-
Young J Ko, MD
-
Oscar Gabriel Larrazolo, M.D.
-
Dennis Honasan Latuno, M.D.
-
Charles Myaing Lim, M.D.
-
Kathleen Magill, RN
-
Navid Mahabadi, DO
-
Berna Lee Mayer, RN, MSN, CFNP
National Provider Directory
Locations
5000 Physicians Blvd
Bakersfield, CA 93301
Phone (661) 215-1500
500 S 7th Ave
Ste C
Barstow, CA 92311
Phone (760) 256-0062
801 E Mountain View St
#1
Barstow, CA 92311
1700 E Cesar E Chavez Ave
Ste 3500
Los Angeles, CA 90033
Phone (323) 264-0430
3936 Phelan Rd
Ste F1
Phelan, CA 92371
Phone (760) 868-6622
12370 Hesperia Rd
Ste 13
Victorville, CA 92395
Phone (760) 245-4747
12408 Hesperia Rd
Ste 21
Victorville, CA 92395
Phone (760) 245-4747
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | G502810 | CA | Yes |
Addresses
Primary practice location
445 W Poplar St
Stockton, CA 95203-2426
Mailing address
445 W Poplar St
Stockton, CA 95203-2426
Phone (209) 465-5933
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180033368 | Other | CA | RAILROAD MEDICARE |
| GR0050600 | Medicaid | CA |
Other names
- HERITAGE EYE ASSOCIATES
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.