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DR. KENNETH GRUDKO M.D. NPI 1164522199


NPI Information

NPI: 1164522199
Provider Name: DR. KENNETH GRUDKO, M.D.
Classification: Internal Medicine - 207RP1001X
Entity Type: Individual

Specialization: Pulmonary Disease

Organization: SCRIPPS HEALTH

PECOS Registration: Yes

Address:
10666 N TORREY PINES RD
LA JOLLA, CA
ZIP 92037
Phone: (858) 554-8860
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DR. Kenneth Grudko, M.D. is a pulmonary disease internal medicine in La Jolla, CA with 33 years of experience. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. DR. Kenneth Grudko, M.D. NPI is 1164522199. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10666 N TORREY PINES RD
LA JOLLA, CA
ZIP 92037-027
Phone: (858) 554-8860

The NPI 1164522199 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 6/25/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RP1001XInternal MedicinePulmonary DiseaseG80633CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1WG80633CMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
200G806330MEDICAIDCALIFORNIA
3G16252MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.