IndividualActive
Kenneth Vereschagin, MD
NPI 1497837785 · Pediatric Sports Medicine Physician · Santa Clara, CA
Provider details
- NPI number
- 1497837785
- Entity type
- Individual
- Primary specialty
- Pediatric Sports Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- G61515 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2652 El Camino Real
Santa Clara, CA 95051-3041
Phone: (408) 524-5952
Approximate (ZIP-level) locationGet directions
Mailing address
2350 W El Camino Real
Mountain View, CA 94040-6201
Registry dates
- Enumerated
- 2006-10-19
- Last updated
- 2011-12-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.