Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jerry William San Diego, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1285694604

Dr. Jerry William San Diego, MD is an Anatomic Pathology & Clinical Pathology Physician in Leavenworth, Kansas. Licensed in Louisiana. Registered with an NPI since 2006.

Licensed in
LA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4101 S 4th St P And Lms
Leavenworth, KS 66048-5014
Phone: (913) 682-2000
Fax: (913) 758-4193
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 024399 (LA)

Record details

NPI number1285694604
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 28, 2006
Last updated in NPPESAugust 4, 2014

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