| Omni Family Health | |
|
277 E Front Street Buttonwillow CA 93206-0917 | |
| (866) 707-6664 | |
| (661) 746-9197 |
| Full Name | Omni Family Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 277 E Front Street, Buttonwillow, California |
| Authorized Official Name and Position | Francisco L Castillon (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6616307050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Family Health 4900 California Ave 400b Bakersfield CA 93309-7081 Ph: (661) 459-1900 | Omni Family Health 277 E Front Street Buttonwillow CA 93206-0917 Ph: (866) 707-6664 |
| NPI Number | 1700891660 |
|---|---|
| Provider Enumeration Date | 07/29/2006 |
| Last Update Date | 09/24/2024 |
| Medicare PECOS PAC ID | 9234176363 |
|---|---|
| Medicare Enrollment ID | O20050411000986 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700891660 | NPI | - | NPPES |
| CLP 320413 | Medicaid | CA | |
| ZZZ13785Z | Other | CA | MEDICARE PART B |
| HAP03893F | Other | CA | DHCS |
| FHC03893F | Medicaid | CA | |
| BCP03893F | Other | CA | CDHS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 120000153 (California) | Primary |
| Provider Name | Diego Mendez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437181922 PECOS PAC ID: 7911803804 Enrollment ID: I20031212000580 |
| Provider Name | Young Wu Park |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245312958 PECOS PAC ID: 2961393947 Enrollment ID: I20040320000638 |
| Provider Name | Helaine Boggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134123672 PECOS PAC ID: 6901797422 Enrollment ID: I20040323001835 |
| Provider Name | Garrick K Peterson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649216235 PECOS PAC ID: 8123910304 Enrollment ID: I20040325000445 |
| Provider Name | Luz A Garcia Aristizabal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801998133 PECOS PAC ID: 6002800133 Enrollment ID: I20040412001656 |
| Provider Name | Juan Manuel Lopez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508885856 PECOS PAC ID: 6002894250 Enrollment ID: I20040713000706 |
| Provider Name | Perry W Beal |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851391627 PECOS PAC ID: 9335197177 Enrollment ID: I20050107000490 |
| Provider Name | Nagy Awadalla |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1255335956 PECOS PAC ID: 1850328006 Enrollment ID: I20050720000312 |
| Provider Name | Jelita I Macanas |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1265457055 PECOS PAC ID: 9234167305 Enrollment ID: I20050729000782 |
| Provider Name | Amal Abiaoui |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1407853690 PECOS PAC ID: 1658300116 Enrollment ID: I20050805000256 |
| Provider Name | Roy Ponce Daug |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730198193 PECOS PAC ID: 2062439326 Enrollment ID: I20051026001156 |
| Provider Name | Herbert A Cruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023107513 PECOS PAC ID: 0042204448 Enrollment ID: I20051102000640 |
| Provider Name | Preeti Verma |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821000324 PECOS PAC ID: 0042230468 Enrollment ID: I20051130000716 |
| Provider Name | Norbert Gal |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1225197627 PECOS PAC ID: 1658373055 Enrollment ID: I20070214000295 |
| Provider Name | Bobby J Bramlett |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1013048008 PECOS PAC ID: 6204935661 Enrollment ID: I20070626000285 |
| Provider Name | Maria L Ferrer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427162304 PECOS PAC ID: 8729173026 Enrollment ID: I20071002000302 |
| Provider Name | Jose L Bautista |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134119308 PECOS PAC ID: 8022928233 Enrollment ID: I20080117000544 |
| Provider Name | Amy M Autry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851335624 PECOS PAC ID: 3274618772 Enrollment ID: I20080307000419 |
| Provider Name | Ravi Goklaney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437212636 PECOS PAC ID: 5294800512 Enrollment ID: I20080821000417 |
| Provider Name | Pamela Louise Emeney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033260559 PECOS PAC ID: 1759326051 Enrollment ID: I20081024000361 |
| Provider Name | Gregory R Heyart |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1699885608 PECOS PAC ID: 6204986300 Enrollment ID: I20090611000308 |
| Provider Name | Kulraj S Sidhu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992957088 PECOS PAC ID: 9133265382 Enrollment ID: I20091001000574 |
| Provider Name | Lilith B Idea |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275646606 PECOS PAC ID: 3971642554 Enrollment ID: I20091120000620 |
| Provider Name | Nassef Henein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851316749 PECOS PAC ID: 5193820215 Enrollment ID: I20091230000378 |
| Provider Name | Dorothy B Meneses-samson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548590623 PECOS PAC ID: 0042345456 Enrollment ID: I20100323000912 |
| Provider Name | Yasser S Ratl Mrad |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003042987 PECOS PAC ID: 1759411515 Enrollment ID: I20100605000006 |
| Provider Name | Luis Bautista |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295712206 PECOS PAC ID: 2668505785 Enrollment ID: I20100727000116 |
| Provider Name | Luis Lopez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992818322 PECOS PAC ID: 7618000480 Enrollment ID: I20100729000969 |
| Provider Name | Ruben P Comelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699777896 PECOS PAC ID: 1658456173 Enrollment ID: I20110104000629 |
| Provider Name | Anne B Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407089014 PECOS PAC ID: 5597926121 Enrollment ID: I20120409000328 |
| Provider Name | Anuradha Rao |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174534069 PECOS PAC ID: 3779746649 Enrollment ID: I20120514000363 |
| Provider Name | Doreen Y Tadokoro |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093975617 PECOS PAC ID: 0244487254 Enrollment ID: I20120827000758 |
| Provider Name | Juan Carlos Gutierrez |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1790031979 PECOS PAC ID: 1456505684 Enrollment ID: I20130215000400 |
| Provider Name | Robert Heartsill |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1326262999 PECOS PAC ID: 4385899822 Enrollment ID: I20130306000497 |
| Provider Name | Carol A Addo-yobo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093020935 PECOS PAC ID: 1759526031 Enrollment ID: I20130315000224 |
| Provider Name | Debra Metter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649371055 PECOS PAC ID: 4486891447 Enrollment ID: I20130510000245 |
| Provider Name | Niraj S Doctor |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285925883 PECOS PAC ID: 0244470631 Enrollment ID: I20130708000655 |
| Provider Name | Nicholas Daniel Urrutia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205171378 PECOS PAC ID: 3577797414 Enrollment ID: I20131104000635 |
| Provider Name | Ruby Tan Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518392448 PECOS PAC ID: 7012130842 Enrollment ID: I20140524000197 |
| Provider Name | Christopher D Downer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205003233 PECOS PAC ID: 7214151620 Enrollment ID: I20140604002076 |
| Provider Name | Pushpa Bisarya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245218924 PECOS PAC ID: 0042117012 Enrollment ID: I20140626001094 |
| Provider Name | Tyler May |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1720308638 PECOS PAC ID: 3274754379 Enrollment ID: I20141014001103 |
| Provider Name | Derek James Florek |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750678652 PECOS PAC ID: 1052534542 Enrollment ID: I20141104002527 |
| Provider Name | Grant D Hoffman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1154302875 PECOS PAC ID: 9032432430 Enrollment ID: I20141215002596 |
| Provider Name | Peter Galerio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295163400 PECOS PAC ID: 4183943897 Enrollment ID: I20150430002269 |
| Provider Name | Frederick Machado |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831217397 PECOS PAC ID: 4082934682 Enrollment ID: I20150521002479 |
| Provider Name | Clarissa Y De Castro |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1952507600 PECOS PAC ID: 1153641485 Enrollment ID: I20150527002350 |
| Provider Name | Nathan A Spencer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1194121533 PECOS PAC ID: 5395065528 Enrollment ID: I20150529000036 |
| Provider Name | Sally S William |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1982739736 PECOS PAC ID: 9830410737 Enrollment ID: I20150603002917 |
| Provider Name | Josephine C Silverio |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1609086446 PECOS PAC ID: 1759602535 Enrollment ID: I20150604002228 |
| Provider Name | Ramya M Sarva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447534599 PECOS PAC ID: 1456662691 Enrollment ID: I20150615002360 |
| Provider Name | Guia C Tadle |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1851588297 PECOS PAC ID: 8325359219 Enrollment ID: I20150618001964 |
| Provider Name | Neloufa Merrill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548335920 PECOS PAC ID: 2769793330 Enrollment ID: I20150623002376 |
| Provider Name | Dashrath P Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326254525 PECOS PAC ID: 1153633508 Enrollment ID: I20150629000698 |
| Provider Name | Douglas C Reber |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245211465 PECOS PAC ID: 5092024356 Enrollment ID: I20151027003196 |
| Provider Name | Agnes G Ong |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1700880622 PECOS PAC ID: 8628007267 Enrollment ID: I20151216001624 |
| Provider Name | Farhad Kiani |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1356664189 PECOS PAC ID: 1658672563 Enrollment ID: I20151218001073 |
| Provider Name | Bonnie J Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841454352 PECOS PAC ID: 6709189244 Enrollment ID: I20160119000603 |
| Provider Name | Jonathan Joseph Mayer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043389513 PECOS PAC ID: 5698840585 Enrollment ID: I20160120001137 |
| Provider Name | Lynnie B Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669847984 PECOS PAC ID: 9739482035 Enrollment ID: I20160120001658 |
| Provider Name | Chirag K Desai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275978330 PECOS PAC ID: 2264742733 Enrollment ID: I20160226000017 |
| Provider Name | Even H Moonga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194193938 PECOS PAC ID: 6507162146 Enrollment ID: I20160308002806 |
| Provider Name | Leilan A Samaniego |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366809576 PECOS PAC ID: 9739485715 Enrollment ID: I20160317001194 |
| Provider Name | Cristina S Dulcich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154781458 PECOS PAC ID: 5597062745 Enrollment ID: I20160401001755 |
| Provider Name | Asarulislam Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326379561 PECOS PAC ID: 5395044028 Enrollment ID: I20160502002556 |
| Provider Name | Glenn J Presores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811345747 PECOS PAC ID: 0345531810 Enrollment ID: I20160614002088 |
| Provider Name | Robert Shannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164879839 PECOS PAC ID: 8426342692 Enrollment ID: I20160810002426 |
| Provider Name | Ma Linda Aurea Ramos |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1518383041 PECOS PAC ID: 2466748314 Enrollment ID: I20160901001863 |
| Provider Name | Dilbagh Gehlawat |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639266216 PECOS PAC ID: 3779490537 Enrollment ID: I20161010000778 |
| Provider Name | Michael A Sladich |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1346467156 PECOS PAC ID: 4385932052 Enrollment ID: I20161012001328 |
| Provider Name | Lucille Ty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861829475 PECOS PAC ID: 8123307055 Enrollment ID: I20161117001305 |
| Provider Name | Parthiban Munnainathan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770924060 PECOS PAC ID: 9335439397 Enrollment ID: I20161117001560 |
| Provider Name | Moncy R John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043634686 PECOS PAC ID: 1658650221 Enrollment ID: I20161123000059 |
| Provider Name | Maria A Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801346069 PECOS PAC ID: 1951681634 Enrollment ID: I20161215001183 |
| Provider Name | Nisha Suman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891074167 PECOS PAC ID: 3678892650 Enrollment ID: I20170501001262 |
| Provider Name | Deanna A Padilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184160186 PECOS PAC ID: 2769768423 Enrollment ID: I20170612002375 |
| Provider Name | Angela Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265971915 PECOS PAC ID: 1052680402 Enrollment ID: I20170628002954 |
| Provider Name | Terry B Nelson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1083015580 PECOS PAC ID: 3375816002 Enrollment ID: I20170831001980 |
| Provider Name | Lisa C Welch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811323793 PECOS PAC ID: 8729352588 Enrollment ID: I20170919000639 |
| Provider Name | James J Ardis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548540867 PECOS PAC ID: 7214202381 Enrollment ID: I20170929001629 |
| Provider Name | Jose E Lagunda |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417016155 PECOS PAC ID: 8628334901 Enrollment ID: I20171102003412 |
| Provider Name | Geetha Shankar Narayan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1982054276 PECOS PAC ID: 7214229319 Enrollment ID: I20171110000885 |
| Provider Name | Brandy Drake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285085084 PECOS PAC ID: 4789940339 Enrollment ID: I20171114003190 |
| Provider Name | Rupinder K Sohi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811409360 PECOS PAC ID: 5890053201 Enrollment ID: I20171226001368 |
| Provider Name | Mary E Momen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821443813 PECOS PAC ID: 3577822246 Enrollment ID: I20180125003225 |
| Provider Name | Sherwin Yu Yee Loo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1164897369 PECOS PAC ID: 7810257169 Enrollment ID: I20180205002308 |
| Provider Name | Angela R Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497183560 PECOS PAC ID: 8921396052 Enrollment ID: I20180313001811 |
| Provider Name | Silvia Y Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831573930 PECOS PAC ID: 3971867979 Enrollment ID: I20180427000362 |
| Provider Name | Jorge Luis Lopez-aguado |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104935329 PECOS PAC ID: 4688938624 Enrollment ID: I20180427002228 |
| Provider Name | Graciela N Esquivel-aguilar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295837177 PECOS PAC ID: 5496648289 Enrollment ID: I20180514002598 |
| Provider Name | Yohanna A Mehretab Roman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871673004 PECOS PAC ID: 4981959145 Enrollment ID: I20180612003366 |
| Provider Name | Christy Elaine Nance-chastain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487968608 PECOS PAC ID: 9931455854 Enrollment ID: I20180709000849 |
| Provider Name | Alex Y Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720310592 PECOS PAC ID: 4486934460 Enrollment ID: I20180719003550 |
| Provider Name | Joseph Hayes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083681498 PECOS PAC ID: 3577511666 Enrollment ID: I20180820003380 |
| Provider Name | Cynthia Cuellar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104351121 PECOS PAC ID: 9436494788 Enrollment ID: I20181214002097 |
| Provider Name | Riosaline A Ishak |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1972096709 PECOS PAC ID: 8628316908 Enrollment ID: I20190212001100 |
| Provider Name | Ronakkumar D Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841615036 PECOS PAC ID: 2365781218 Enrollment ID: I20190311002927 |
| Provider Name | Kelly A Hughes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164606828 PECOS PAC ID: 3072856897 Enrollment ID: I20190520000960 |
| Provider Name | Angie Shaffner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790260875 PECOS PAC ID: 9133462831 Enrollment ID: I20190521001820 |
| Provider Name | Kim M Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043529167 PECOS PAC ID: 1951582139 Enrollment ID: I20190530002662 |
| Provider Name | Stephanie Hall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841406154 PECOS PAC ID: 4981613734 Enrollment ID: I20190912001445 |
| Provider Name | Paul S Bryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942647904 PECOS PAC ID: 5890025589 Enrollment ID: I20190923002805 |
| Provider Name | Alejandra Aguirre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417326174 PECOS PAC ID: 5991035081 Enrollment ID: I20191003000870 |
| Provider Name | Navdeep Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922578426 PECOS PAC ID: 8325370729 Enrollment ID: I20191105001296 |
| Provider Name | Trisha L Feliz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326261967 PECOS PAC ID: 0648602011 Enrollment ID: I20191125000249 |
| Provider Name | Htet Htet Win |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1538579073 PECOS PAC ID: 3678907656 Enrollment ID: I20191227002170 |
| Provider Name | Naga Venkata Satish Babu Bodapati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164839528 PECOS PAC ID: 7911205141 Enrollment ID: I20200115000928 |
| Provider Name | Oliver G Ranin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053969212 PECOS PAC ID: 7012342546 Enrollment ID: I20200330003537 |
| Provider Name | Shelley A Mccormack |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275920431 PECOS PAC ID: 0840616405 Enrollment ID: I20200813002683 |
| Provider Name | Henry Chien |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922530864 PECOS PAC ID: 7416373923 Enrollment ID: I20200814000736 |
| Provider Name | Lea Macias |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750814216 PECOS PAC ID: 8921425026 Enrollment ID: I20200903002850 |
| Provider Name | Archana Reddy Bongurala |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942719125 PECOS PAC ID: 2769800572 Enrollment ID: I20200910002461 |
| Provider Name | Kathryn C Cameron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316584030 PECOS PAC ID: 0749692622 Enrollment ID: I20201217001559 |
| Provider Name | Fausto J J Castillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780115972 PECOS PAC ID: 2264856616 Enrollment ID: I20201217001850 |
| Provider Name | Christina M Buckner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396333456 PECOS PAC ID: 8224443346 Enrollment ID: I20210222002874 |
| Provider Name | Edith M Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578619839 PECOS PAC ID: 3476960568 Enrollment ID: I20210408001312 |
| Provider Name | Akshita S Khode |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1922685221 PECOS PAC ID: 5799185435 Enrollment ID: I20210616003240 |
| Provider Name | Luis E Zarazua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326628736 PECOS PAC ID: 5698176345 Enrollment ID: I20210701001558 |
| Provider Name | Katherine D Tong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164897104 PECOS PAC ID: 8325449929 Enrollment ID: I20210701003292 |
| Provider Name | Christine M Mclemore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114129061 PECOS PAC ID: 9436287026 Enrollment ID: I20210712000696 |
| Provider Name | Karla G Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386226272 PECOS PAC ID: 2062818552 Enrollment ID: I20210908004049 |
| Provider Name | Jennifr M Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245764273 PECOS PAC ID: 0244636553 Enrollment ID: I20210913001886 |
| Provider Name | Hen Caspi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568844207 PECOS PAC ID: 3476951633 Enrollment ID: I20211003000012 |
| Provider Name | Data O Don-pedro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235624255 PECOS PAC ID: 9638421290 Enrollment ID: I20211006002350 |
| Provider Name | Gurdeep Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629503990 PECOS PAC ID: 9638577513 Enrollment ID: I20211006002954 |
| Provider Name | Daniel Adams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083111595 PECOS PAC ID: 0749670263 Enrollment ID: I20211123003086 |
| Provider Name | Justina Adangai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760070932 PECOS PAC ID: 3072906965 Enrollment ID: I20220217001909 |
| Provider Name | Pavla Senkyrikova |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508148792 PECOS PAC ID: 5496993776 Enrollment ID: I20220321001163 |
| Provider Name | Monica Elizabeth Raible |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558850537 PECOS PAC ID: 7719360130 Enrollment ID: I20220818000639 |
| Provider Name | Blanca Mejia |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255983409 PECOS PAC ID: 5991033144 Enrollment ID: I20220829002817 |
| Provider Name | Abhinay Walia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821650730 PECOS PAC ID: 5991030058 Enrollment ID: I20220907003060 |
| Provider Name | Ulisses Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669033908 PECOS PAC ID: 8224412424 Enrollment ID: I20220907003917 |
| Provider Name | Rogelio Ramos Sanchez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194386060 PECOS PAC ID: 3577948587 Enrollment ID: I20220912002330 |
| Provider Name | Vincent Rager |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972810422 PECOS PAC ID: 5193101350 Enrollment ID: I20220926003431 |
| Provider Name | Levon Dang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760153845 PECOS PAC ID: 9234529413 Enrollment ID: I20220929001096 |
| Provider Name | Alice Chalongwongse |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841967858 PECOS PAC ID: 2163898040 Enrollment ID: I20221018000930 |
| Provider Name | Peggy Kaw Ting |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1912045113 PECOS PAC ID: 0143528307 Enrollment ID: I20221024000118 |
| Provider Name | Sarah E Frost-morgan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841571429 PECOS PAC ID: 8224405857 Enrollment ID: I20221110000979 |
| Provider Name | Saqib Abdul Razzak |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982366738 PECOS PAC ID: 3375911860 Enrollment ID: I20221114002527 |
| Provider Name | Evalin Zhao |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518537950 PECOS PAC ID: 4183020134 Enrollment ID: I20221201001975 |
| Provider Name | Casey Lauren Sautter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144671066 PECOS PAC ID: 1456646421 Enrollment ID: I20221202000108 |
| Provider Name | Tiffany Mattox-rubin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700373115 PECOS PAC ID: 5890165302 Enrollment ID: I20221227002283 |
| Provider Name | Barbara E Gonzalez Ambrosino |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1821705138 PECOS PAC ID: 1557734837 Enrollment ID: I20230307003021 |
| Provider Name | Yang Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992413645 PECOS PAC ID: 8527432426 Enrollment ID: I20230315003020 |
| Provider Name | Terence J Chen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1164073847 PECOS PAC ID: 6901138510 Enrollment ID: I20230420002641 |
| Provider Name | Binita Manhar Shah |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1356793814 PECOS PAC ID: 1456648732 Enrollment ID: I20230502001470 |
| Provider Name | Marileth Tan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588360127 PECOS PAC ID: 3577928035 Enrollment ID: I20230505000720 |
| Provider Name | Zachary S Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538869748 PECOS PAC ID: 6800251240 Enrollment ID: I20230508001818 |
| Provider Name | Chetan Lamba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144936576 PECOS PAC ID: 9537526132 Enrollment ID: I20230612003118 |
| Provider Name | Belinda Sibanda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902426711 PECOS PAC ID: 6103282546 Enrollment ID: I20230615003714 |
| Provider Name | Stephanie Melchor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215499033 PECOS PAC ID: 1759742174 Enrollment ID: I20230802000886 |
| Provider Name | Ella Stephanie S Cruz |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1831889468 PECOS PAC ID: 1557723566 Enrollment ID: I20230808001801 |
| Provider Name | Talal Barlas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679195143 PECOS PAC ID: 8123424918 Enrollment ID: I20230828003332 |
| Provider Name | Fatemeh Moormehei |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1336538016 PECOS PAC ID: 0547561045 Enrollment ID: I20230915001115 |
| Provider Name | Isis S Macias Moreno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720604853 PECOS PAC ID: 7810341757 Enrollment ID: I20230927001120 |
| Provider Name | Steffi Lorraine D'souza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043830144 PECOS PAC ID: 3577989383 Enrollment ID: I20231017003463 |
| Provider Name | Charles M Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356039473 PECOS PAC ID: 4688020985 Enrollment ID: I20231023002618 |
| Provider Name | Charmaine F Shearer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033604046 PECOS PAC ID: 2062869647 Enrollment ID: I20231103003382 |
| Provider Name | Nazeli N Shishoyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033812284 PECOS PAC ID: 9739536137 Enrollment ID: I20231107000836 |
| Provider Name | Thalia C Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235911132 PECOS PAC ID: 3072963073 Enrollment ID: I20240102003807 |
| Provider Name | Denise L Lyons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629404710 PECOS PAC ID: 1254784267 Enrollment ID: I20240125004033 |
| Provider Name | Anastasia Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821544420 PECOS PAC ID: 7214370956 Enrollment ID: I20240208004497 |
| Provider Name | Balwinder K Dhillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114792850 PECOS PAC ID: 9638512338 Enrollment ID: I20240209001840 |
| Provider Name | Ann Jonalyn O Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730956871 PECOS PAC ID: 7517301187 Enrollment ID: I20240222001462 |
| Provider Name | Roshonda L Cureton |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104958248 PECOS PAC ID: 9537503131 Enrollment ID: I20240222002503 |
| Provider Name | Mehran Ali |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1598535171 PECOS PAC ID: 4981041423 Enrollment ID: I20240320001974 |
| Provider Name | Fnu Rani Devi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578260204 PECOS PAC ID: 9537508254 Enrollment ID: I20240415001724 |
| Provider Name | Shantell D Utley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689443459 PECOS PAC ID: 0143669697 Enrollment ID: I20240416003286 |
| Provider Name | Nancy Yareth Gonzalez-mckenzie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366942302 PECOS PAC ID: 9830538362 Enrollment ID: I20240417001851 |
| Provider Name | Ravneet Kaur Tiwana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659137909 PECOS PAC ID: 7416399936 Enrollment ID: I20240529001322 |
| Provider Name | Mohamed Gara |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1356033088 PECOS PAC ID: 0143762062 Enrollment ID: I20240606003832 |