| Pacific Heritage Medical Group Inc | |
|
3625 E Thousand Oaks Blvd Ste 232 Westlake Village CA 91362-6932 | |
| (805) 601-5199 | |
| Not Available |
| Full Name | Pacific Heritage Medical Group Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3625 E Thousand Oaks Blvd Ste 232, Westlake Village, California |
| Authorized Official Name and Position | Nitin Nanda (PRESIDENT) |
| Authorized Official Contact | 8056015199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Heritage Medical Group Inc 3625 E Thousand Oaks Blvd Ste 232 Westlake Village CA 91362-6932 Ph: (805) 601-5199 | Pacific Heritage Medical Group Inc 3625 E Thousand Oaks Blvd Ste 232 Westlake Village CA 91362-6932 Ph: (805) 601-5199 |
| NPI Number | 1467899450 |
|---|---|
| Provider Enumeration Date | 05/30/2013 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/20/2022 |
| Medicare PECOS PAC ID | 7517284029 |
|---|---|
| Medicare Enrollment ID | O20150323000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467899450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | A56386 (California) | Primary |
| Provider Name | Nitin Nanda |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1225076748 PECOS PAC ID: 5496669129 Enrollment ID: I20031117000943 |
| Provider Name | Rekha Raja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427227917 PECOS PAC ID: 4981599578 Enrollment ID: I20040220001177 |
| Provider Name | Robert C Krueger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174606255 PECOS PAC ID: 7911953484 Enrollment ID: I20050328000813 |
| Provider Name | Tejas I Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437125770 PECOS PAC ID: 7911930300 Enrollment ID: I20050915000929 |
| Provider Name | Amir H Bahadori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518992585 PECOS PAC ID: 9739195074 Enrollment ID: I20060223000857 |
| Provider Name | Erik V Sitker |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1205931722 PECOS PAC ID: 7618912346 Enrollment ID: I20070803000308 |
| Provider Name | Dharmapalan V Pillai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518034545 PECOS PAC ID: 6507955465 Enrollment ID: I20071130000295 |
| Provider Name | Tapeesh Kansal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841291408 PECOS PAC ID: 7113816455 Enrollment ID: I20090130000534 |
| Provider Name | Jyotila Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215096920 PECOS PAC ID: 7810917846 Enrollment ID: I20090211000750 |
| Provider Name | Vijay Kumar N Chennamchetty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811194145 PECOS PAC ID: 6800946278 Enrollment ID: I20090604000507 |
| Provider Name | Ani Balabegian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285868828 PECOS PAC ID: 3971659293 Enrollment ID: I20090928000586 |
| Provider Name | Ricardo J Whyte |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124215710 PECOS PAC ID: 2567509862 Enrollment ID: I20091019000494 |
| Provider Name | Kalpesh B Bhavsar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457546913 PECOS PAC ID: 3678698321 Enrollment ID: I20100917000630 |
| Provider Name | Pei-huey Nie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235317256 PECOS PAC ID: 5890980742 Enrollment ID: I20101117000738 |
| Provider Name | Harbans S Multani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831175033 PECOS PAC ID: 3577590488 Enrollment ID: I20110706000181 |
| Provider Name | Roger L Girion |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386912806 PECOS PAC ID: 3971761701 Enrollment ID: I20120223000913 |
| Provider Name | Cordelia Rose E Onyekwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194026542 PECOS PAC ID: 2163686577 Enrollment ID: I20120615000265 |
| Provider Name | Victoria Omuson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184920050 PECOS PAC ID: 6608030028 Enrollment ID: I20120615000290 |
| Provider Name | May Awkal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316181027 PECOS PAC ID: 4981850559 Enrollment ID: I20120814000549 |
| Provider Name | Trilok Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295991701 PECOS PAC ID: 2668629437 Enrollment ID: I20120829000817 |
| Provider Name | Samer M Kamal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649458977 PECOS PAC ID: 0547403438 Enrollment ID: I20130824000030 |
| Provider Name | Harkirat S Saggu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306053392 PECOS PAC ID: 3274716584 Enrollment ID: I20150210000983 |
| Provider Name | Katia Sirel Stoletniy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366701401 PECOS PAC ID: 1557656543 Enrollment ID: I20160830002157 |
| Provider Name | Michael M Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164833018 PECOS PAC ID: 3274812276 Enrollment ID: I20170508002561 |
| Provider Name | Diana Havill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003053307 PECOS PAC ID: 9436309002 Enrollment ID: I20200228002180 |
| Provider Name | Salisu A Aikoye |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497173694 PECOS PAC ID: 2163744699 Enrollment ID: I20200623003097 |
| Provider Name | Ashley Danielle Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649922568 PECOS PAC ID: 5597158576 Enrollment ID: I20220216000184 |
| Provider Name | Ramandeep Kaur Behniwal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508527458 PECOS PAC ID: 5496149189 Enrollment ID: I20220223000198 |
| Provider Name | Antuela Dino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184372278 PECOS PAC ID: 4082000476 Enrollment ID: I20220412002061 |
| Provider Name | Ehtesham Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326020330 PECOS PAC ID: 3072608975 Enrollment ID: I20220615001470 |
| Provider Name | Aneeta Afzal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396727335 PECOS PAC ID: 2961539317 Enrollment ID: I20220929001632 |
| Provider Name | Olajumoke Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114694635 PECOS PAC ID: 6709242035 Enrollment ID: I20230511002534 |
| Provider Name | Grace Angeles Acdan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275146110 PECOS PAC ID: 1254798390 Enrollment ID: I20230606001410 |
| Provider Name | Omorogiuwa Maureen Adeneye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770271280 PECOS PAC ID: 9436519279 Enrollment ID: I20230712002229 |
| Provider Name | Jagannath Nayak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548764863 PECOS PAC ID: 9234590696 Enrollment ID: I20230801003086 |
| Provider Name | Roselia Contreras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962071639 PECOS PAC ID: 6507228244 Enrollment ID: I20230814000564 |
| Provider Name | Suchet Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275840878 PECOS PAC ID: 4688051063 Enrollment ID: I20230919000606 |
| Provider Name | Amanda Renee Layman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275308744 PECOS PAC ID: 6103274956 Enrollment ID: I20231205000229 |
| Provider Name | Perpetua Ebalulu Okoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992983787 PECOS PAC ID: 0840639415 Enrollment ID: I20240416000049 |
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