{"npi":"1790341832","type":"NPI-1","status":"active","name":{"display":"Dr. Frederic Kolb MD","other":[],"first":"FREDERIC","last":"KOLB","middle":"JEROME","credential":"MD"},"specialty":{"primary_taxonomy":"208200000X","primary_taxonomy_description":"Plastic Surgery Physician","slug":"plastic-surgery-physician","schema_org_specialty":null,"all":[{"code":"208200000X","description":"Plastic Surgery Physician","primary":true,"state":"CA","license":"SFP39"}]},"addresses":[{"purpose":"LOCATION","street_1":"200 W ARBOR DR # MC8890","city":"SAN DIEGO","state":"CA","postal_code":"921031911","country_code":"US","phone":"6195436084"},{"purpose":"MAILING","street_1":"PO BOX 232410","city":"SAN DIEGO","state":"CA","postal_code":"921932410","country_code":"US"}],"license":{"state":"CA","number":"SFP39"},"identifiers":[{"type_code":"01","label":"Other","value":"ZZZP3716Z","state":"CA","issuer":"MEDI-CAL"},{"type_code":"01","label":"Other","value":"23-7064656","state":"CA","issuer":"UCSD MEDICAL GROUP"},{"type_code":"01","label":"Other","value":"95-6006144","state":"CA","issuer":"UCSD PLASTIC SURGERY"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20191106002357","type_code":"14-24","type_desc":"PRACTITIONER - PLASTIC AND RECONSTRUCTIVE SURGERY","state":"CA","pac_id":"5395077689"}]},"enumeration_date":"2019-05-14","last_updated":"2019-10-03","_meta":{"source":"NPPES","snapshot_date":"2019-10-03","doc_url":"https://findmynpi.com/api"}}