Look up the most recent NPI and PECOS records

Patrick Thomas Kiernan

General Practice

Allopathic & Osteopathic Physicians

34800 Bob Wilson Dr, San Diego, CA 92134-1098

PECOS Enrollment

Based on the most recent information from CMS, provider Patrick Thomas Kiernan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1821688953
Provider Type
Individual
Full Name
Kiernan, Patrick Thomas
Title
Dr.
Credential
DO

Gender
Male
Sole Proprietor
No
Enumeration Date
1/22/2021
Last Updated
8/7/2025

Contact Information

Practice Location

34800 Bob Wilson Dr, San Diego, CA 92134-1098

(619) 532-6400

Unlisted Fax

Mailing Location

162 1st St Bldg 1402, Port Hueneme, CA 93043-4316

(805) 216-1663

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208D00000X Primary	Description General Practice Allopathic & Osteopathic Physicians	License 0102207423 Virginia
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer
Code 171000000X	Description Military Health Care Provider Other Service Providers	License 0102207423 Virginia

Patrick Thomas Kiernan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Havko, Benjamin

Bowen, Daniel

Choi, Ryan Kyu

Gedestad, Michael

Nguyen, Truong Dan

Durrua, Kelle

Devera, Justin James D

Bresslour-Rashap, Elan Harder

Bascome, Makala Marie

Hawkins, Jack