Organization
KMD MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL KOSOY MD FACS FRCSC (PRESIDENT)
(858) 637-4800
Entity
Organization
Contact information
Practice address
7910 FROST ST, SUITE 250, SAN DIEGO, CA 92123-2771
(858) 637-4800
(858) 637-4801
Mailing address
501 KRISTEN CT, ENCINITAS, CA 92024-2700
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
A60375
CA
208600000X
Surgery Physician
Primary
A60375
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE226Y
MEDICARE PTAN (BALBOA NEPHROLOGY MEDICAL GROUP)
CA
Enumeration date
02/16/2007
Last updated
06/02/2014
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