| Kab Medical Group Inc | |
|
765 Third Ave Ste 100 Chula Vista CA 91910-5842 | |
| (619) 765-2684 | |
| Not Available |
| Full Name | Kab Medical Group Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 765 Third Ave Ste 100, Chula Vista, California |
| Authorized Official Name and Position | Ankur Bindal (CEO) |
| Authorized Official Contact | 6825518229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kab Medical Group Inc 15144 Barolo Ct San Diego CA 92127-5006 Ph: () - | Kab Medical Group Inc 765 Third Ave Ste 100 Chula Vista CA 91910-5842 Ph: (619) 765-2684 |
| NPI Number | 1639634421 |
|---|---|
| Provider Enumeration Date | 02/05/2019 |
| Last Update Date | 08/11/2023 |
| Certification Date | 08/11/2023 |
| Medicare PECOS PAC ID | 7719211358 |
|---|---|
| Medicare Enrollment ID | O20190702000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639634421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | (* (Not Available)) | Secondary |
| Provider Name | Randi C Maples |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023037561 PECOS PAC ID: 0749330728 Enrollment ID: I20090612000338 |
| Provider Name | Jerry C Bobo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194836429 PECOS PAC ID: 9537297635 Enrollment ID: I20100511000772 |
| Provider Name | Timothy M Veal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326333485 PECOS PAC ID: 5193026938 Enrollment ID: I20151221000416 |
| Provider Name | Ankur Bindal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588820880 PECOS PAC ID: 6406085042 Enrollment ID: I20160711002012 |
| Provider Name | Alicia Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891233649 PECOS PAC ID: 7911334966 Enrollment ID: I20200303002745 |
| Provider Name | Donna M Grandi-nikander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689890303 PECOS PAC ID: 0345130589 Enrollment ID: I20210625000718 |
| Provider Name | Madalyn Jasmine Cosensci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285369124 PECOS PAC ID: 3678945920 Enrollment ID: I20230214002159 |
| Provider Name | Catherine Dang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528715943 PECOS PAC ID: 8022483338 Enrollment ID: I20230418001833 |
| Provider Name | Manuel Romero Garcia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649388828 PECOS PAC ID: 4981069796 Enrollment ID: I20230501002290 |
| Provider Name | Julie A Cabading |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346944287 PECOS PAC ID: 6204293657 Enrollment ID: I20230531001144 |
| Provider Name | Molly Michelle Mclaren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922757145 PECOS PAC ID: 3779940705 Enrollment ID: I20230607001689 |
| Provider Name | Thomas Dixon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144883190 PECOS PAC ID: 6103283924 Enrollment ID: I20230608002695 |
| Provider Name | Xander Jack Cooper |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114403573 PECOS PAC ID: 4688013386 Enrollment ID: I20240415001240 |
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