| Ucsd Medical Group | |
|
200 W Arbor Dr San Diego CA 92103-9000 | |
| (800) 926-8273 | |
| (888) 539-8781 |
| Full Name | Ucsd Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 200 W Arbor Dr, San Diego, California |
| Authorized Official Name and Position | Michael Dennis Price (DIRECTOR, REVENUE CYCLE & OPERATION) |
| Authorized Official Contact | 8582496752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ucsd Medical Group File 57326 Los Angeles CA 90074-2410 Ph: (800) 926-8273 | Ucsd Medical Group 200 W Arbor Dr San Diego CA 92103-9000 Ph: (800) 926-8273 |
| NPI Number | 1649372673 |
|---|---|
| Provider Enumeration Date | 09/01/2006 |
| Last Update Date | 04/25/2024 |
| Certification Date | 04/25/2024 |
| Medicare PECOS PAC ID | 3577476761 |
|---|---|
| Medicare Enrollment ID | O20031204001250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649372673 | NPI | - | NPPES |
| 364823306 | Other | US DEPT OF LABOR | |
| 364823305 | Other | US DEPT OF LABOR | |
| 364823307 | Other | US DEPT OF LABOR | |
| ZZZP3712Z | Medicaid | CA | |
| CQ4024 | Other | RAILROAD MEDICARE | |
| 364823300 | Other | US DEPT OF LABOR | |
| CGP016905 | Other | CA | GHPP |
| 364823302 | Other | US DEPT OF LABOR | |
| 364823310 | Other | US DEPT OF LABOR | |
| 364823301 | Other | US DEPT OF LABOR | |
| 364823303 | Other | US DEPT OF LABOR | |
| 364823304 | Other | US DEPT OF LABOR | |
| 2327 | Other | CA | CMS |
| Provider Name | Erik S Viirre |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1093743601 PECOS PAC ID: 0244127421 Enrollment ID: I20040302000997 |
| Provider Name | Thomas M Hemmen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902821945 PECOS PAC ID: 6002880184 Enrollment ID: I20040824000829 |
| Provider Name | Sean J Evans |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366503427 PECOS PAC ID: 2961447339 Enrollment ID: I20050627000216 |
| Provider Name | Stephanie L Lessig |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134167141 PECOS PAC ID: 3072559921 Enrollment ID: I20050630001080 |
| Provider Name | Patrick A Delaney |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699741645 PECOS PAC ID: 7517987225 Enrollment ID: I20051123000679 |
| Provider Name | Rohini J Joshi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538190806 PECOS PAC ID: 7012938327 Enrollment ID: I20051214000830 |
| Provider Name | Jonathan D Bui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730247974 PECOS PAC ID: 6901908839 Enrollment ID: I20070223000609 |
| Provider Name | William C Mobley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902941743 PECOS PAC ID: 4486751625 Enrollment ID: I20070522000626 |
| Provider Name | Huitzilin Mauricio Olmecah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821181553 PECOS PAC ID: 9638277239 Enrollment ID: I20070605000554 |
| Provider Name | Mark H Tuszynski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669405007 PECOS PAC ID: 2860561370 Enrollment ID: I20080522000560 |
| Provider Name | Michael S Rafii |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598875775 PECOS PAC ID: 4385712074 Enrollment ID: I20081008000231 |
| Provider Name | Jeffrey H Gertsch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730352287 PECOS PAC ID: 3072681766 Enrollment ID: I20081008000265 |
| Provider Name | James B Brewer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033144985 PECOS PAC ID: 1355396359 Enrollment ID: I20081022000037 |
| Provider Name | Gail Reiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710167853 PECOS PAC ID: 4486701919 Enrollment ID: I20090420000502 |
| Provider Name | David E Piccioni |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851542575 PECOS PAC ID: 2860544046 Enrollment ID: I20090720000115 |
| Provider Name | Ignacio M Carrillo-nunez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205827201 PECOS PAC ID: 8921146937 Enrollment ID: I20091112000122 |
| Provider Name | Santosh Kesari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891785960 PECOS PAC ID: 1658382684 Enrollment ID: I20091230000226 |
| Provider Name | Richard H Haas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700801867 PECOS PAC ID: 8325173529 Enrollment ID: I20100312000601 |
| Provider Name | Jody P Corey-bloom |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053400093 PECOS PAC ID: 3870627664 Enrollment ID: I20100816000649 |
| Provider Name | Brett C Meyer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316011265 PECOS PAC ID: 1456485077 Enrollment ID: I20100818001033 |
| Provider Name | Leena R Kansal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871759084 PECOS PAC ID: 8820112030 Enrollment ID: I20100825000127 |
| Provider Name | Charles Jablecki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255315677 PECOS PAC ID: 6103941588 Enrollment ID: I20100909000592 |
| Provider Name | Ronald J Ellis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992763114 PECOS PAC ID: 3779608229 Enrollment ID: I20100921000658 |
| Provider Name | Vincente Iragui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053326710 PECOS PAC ID: 0547385031 Enrollment ID: I20100921001150 |
| Provider Name | Evelyn S Tecoma |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174556518 PECOS PAC ID: 2668598905 Enrollment ID: I20100924000012 |
| Provider Name | Dawn M Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467575126 PECOS PAC ID: 5294796736 Enrollment ID: I20100928001709 |
| Provider Name | Geoffrey L Sheean |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326124736 PECOS PAC ID: 8224224019 Enrollment ID: I20101118000991 |
| Provider Name | Hoai-huong K Huynh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194035501 PECOS PAC ID: 2062609209 Enrollment ID: I20101214000390 |
| Provider Name | Melissa M Mortin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972740090 PECOS PAC ID: 3274721501 Enrollment ID: I20101230000309 |
| Provider Name | Shauna Hsiaosan Yuan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679659098 PECOS PAC ID: 4981893674 Enrollment ID: I20110111000954 |
| Provider Name | William N Devor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093874604 PECOS PAC ID: 7719167246 Enrollment ID: I20110215000840 |
| Provider Name | Homira Feely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972839975 PECOS PAC ID: 9133258379 Enrollment ID: I20110321000771 |
| Provider Name | Jennifer S Graves |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992849863 PECOS PAC ID: 3274711585 Enrollment ID: I20110708000251 |
| Provider Name | John M Ravits |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396858965 PECOS PAC ID: 6204894108 Enrollment ID: I20110815000924 |
| Provider Name | Navaz P Karanjia |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073774873 PECOS PAC ID: 9830360585 Enrollment ID: I20110929000159 |
| Provider Name | Irene Litvan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568460715 PECOS PAC ID: 2961536453 Enrollment ID: I20111116000102 |
| Provider Name | Stuart A Lipton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578596292 PECOS PAC ID: 6709052897 Enrollment ID: I20111220000186 |
| Provider Name | Douglas R Galasko |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336197730 PECOS PAC ID: 4688840101 Enrollment ID: I20120105000358 |
| Provider Name | Nina Yakovlevna Riggins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568655264 PECOS PAC ID: 3678736220 Enrollment ID: I20120518000441 |
| Provider Name | Neal Matsumori Rao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144423849 PECOS PAC ID: 3274796255 Enrollment ID: I20120601000139 |
| Provider Name | Matthew Shtrahman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740440460 PECOS PAC ID: 0345404349 Enrollment ID: I20120601000413 |
| Provider Name | Anitha Rao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396989976 PECOS PAC ID: 5193965713 Enrollment ID: I20130702000637 |
| Provider Name | Shifteh Sattar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750407300 PECOS PAC ID: 9739320391 Enrollment ID: I20131023000741 |
| Provider Name | Fatta B Nahab |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942291729 PECOS PAC ID: 4981630464 Enrollment ID: I20131101000419 |
| Provider Name | Revere P Kinkel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043325939 PECOS PAC ID: 7719991553 Enrollment ID: I20140210001463 |
| Provider Name | Joshua Alexander |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437387677 PECOS PAC ID: 0840420972 Enrollment ID: I20140311000623 |
| Provider Name | Royya F Modir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295909554 PECOS PAC ID: 1153564471 Enrollment ID: I20140317001350 |
| Provider Name | Rita Ceponiene |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356584015 PECOS PAC ID: 6800012576 Enrollment ID: I20140801001719 |
| Provider Name | Josh L Duckworth |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194797647 PECOS PAC ID: 4183841331 Enrollment ID: I20140811002863 |
| Provider Name | Chamindra G Laverty |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538320395 PECOS PAC ID: 4183893084 Enrollment ID: I20141113002248 |
| Provider Name | Cynthia Gonzalez |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1871767210 PECOS PAC ID: 1951555176 Enrollment ID: I20141211000564 |
| Provider Name | Rebecca M Dodd-sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760823629 PECOS PAC ID: 2668795899 Enrollment ID: I20141219001085 |
| Provider Name | Branko N Huisa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063551000 PECOS PAC ID: 5698955250 Enrollment ID: I20150210001202 |
| Provider Name | Lori Ann Glicklich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912248618 PECOS PAC ID: 6800020546 Enrollment ID: I20150513000111 |
| Provider Name | Hossein Ansari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578774949 PECOS PAC ID: 6901076108 Enrollment ID: I20150529002442 |
| Provider Name | Ana T Kukulj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063800316 PECOS PAC ID: 3173831153 Enrollment ID: I20150925000521 |
| Provider Name | Simon Zimnowodzki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437182292 PECOS PAC ID: 4284525320 Enrollment ID: I20160502001966 |
| Provider Name | Suzan Khoromi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588803340 PECOS PAC ID: 3375694821 Enrollment ID: I20160701001813 |
| Provider Name | Jamie N Labuzetta |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1316268949 PECOS PAC ID: 4082875992 Enrollment ID: I20160706000739 |
| Provider Name | David J Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871884130 PECOS PAC ID: 0244522449 Enrollment ID: I20160708000863 |
| Provider Name | Kunal Agrawal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093074122 PECOS PAC ID: 6608160932 Enrollment ID: I20160810000666 |
| Provider Name | June Yoshii-contreras |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437441763 PECOS PAC ID: 0042505828 Enrollment ID: I20160817002741 |
| Provider Name | Jerry Shih |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790774156 PECOS PAC ID: 3577585751 Enrollment ID: I20160922000248 |
| Provider Name | Natalie Mari Guido-estrada |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528353521 PECOS PAC ID: 2264720754 Enrollment ID: I20161017001645 |
| Provider Name | Lovella S Hailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730489899 PECOS PAC ID: 6901185503 Enrollment ID: I20161123001313 |
| Provider Name | Zvinka Z Zlatar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497139059 PECOS PAC ID: 0345521126 Enrollment ID: I20170111001603 |
| Provider Name | Yadollah Harati |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205916566 PECOS PAC ID: 5496935082 Enrollment ID: I20170116000269 |
| Provider Name | Sara Siavoshi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548604101 PECOS PAC ID: 4880977669 Enrollment ID: I20170202001012 |
| Provider Name | Daniel Ahoubim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740415686 PECOS PAC ID: 0345480406 Enrollment ID: I20170207002813 |
| Provider Name | Leslie M Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225198781 PECOS PAC ID: 5294964847 Enrollment ID: I20170419002165 |
| Provider Name | Fernando Mediano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730558743 PECOS PAC ID: 4486952249 Enrollment ID: I20170531001003 |
| Provider Name | Janne Kristoffer Nissinen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710278569 PECOS PAC ID: 6800192394 Enrollment ID: I20170724003070 |
| Provider Name | Allyn E Leblanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376732685 PECOS PAC ID: 0042365280 Enrollment ID: I20170927002236 |
| Provider Name | Jeremy Naftali Rich |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093885824 PECOS PAC ID: 2567550973 Enrollment ID: I20171018001222 |
| Provider Name | Kelvin K Ma |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215115308 PECOS PAC ID: 8123918273 Enrollment ID: I20171109001164 |
| Provider Name | Brenton Alan Wright |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215188701 PECOS PAC ID: 0042473092 Enrollment ID: I20171121001688 |
| Provider Name | Dominic Alexander Ferrey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548603186 PECOS PAC ID: 3476845959 Enrollment ID: I20180316001156 |
| Provider Name | Maria Khristina A Vibal-poaster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376046680 PECOS PAC ID: 8224386800 Enrollment ID: I20180731000368 |
| Provider Name | Jose Angel Soria-lopez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225474034 PECOS PAC ID: 9830315803 Enrollment ID: I20180809006264 |
| Provider Name | Anjelica Therese Pascual Cosino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295238749 PECOS PAC ID: 4183973019 Enrollment ID: I20180824002622 |
| Provider Name | Gabriel C Leger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720367899 PECOS PAC ID: 8527230341 Enrollment ID: I20180911003546 |
| Provider Name | Sarah J Banks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164701132 PECOS PAC ID: 8527231612 Enrollment ID: I20181012002106 |
| Provider Name | Anastasie Marie Dunn-pirio |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700177136 PECOS PAC ID: 7315299674 Enrollment ID: I20181015002168 |
| Provider Name | Melek Betul Gundogdu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437253671 PECOS PAC ID: 3476659806 Enrollment ID: I20181016001545 |
| Provider Name | Regina M Troxell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013350586 PECOS PAC ID: 3375895592 Enrollment ID: I20181016001960 |
| Provider Name | Sarah Elizabeth Norton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730659756 PECOS PAC ID: 3971843152 Enrollment ID: I20190326001707 |
| Provider Name | Juliette N Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881198356 PECOS PAC ID: 0648504472 Enrollment ID: I20190627000875 |
| Provider Name | Jessica Dasmarinas Schulte |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467870576 PECOS PAC ID: 7113272600 Enrollment ID: I20190705001121 |
| Provider Name | David Coughlin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740543784 PECOS PAC ID: 4385942531 Enrollment ID: I20190819000688 |
| Provider Name | Elizabeth Ann Bevins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013395151 PECOS PAC ID: 3678802535 Enrollment ID: I20190903001447 |
| Provider Name | Kevin Michael Mcgehrin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972913101 PECOS PAC ID: 7113210774 Enrollment ID: I20190926000063 |
| Provider Name | Caitlin Jacobs Mulligan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245674274 PECOS PAC ID: 8224305057 Enrollment ID: I20191003001705 |
| Provider Name | Cody James Frieben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992179162 PECOS PAC ID: 9830492693 Enrollment ID: I20191105003074 |
| Provider Name | Jong M Rho |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235243999 PECOS PAC ID: 2466428784 Enrollment ID: I20191206001052 |
| Provider Name | Katherine Longardner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801215926 PECOS PAC ID: 2668766148 Enrollment ID: I20200731000828 |
| Provider Name | Clare E Skora |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902223373 PECOS PAC ID: 0143444018 Enrollment ID: I20200731002522 |
| Provider Name | Christa Elaine Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396371431 PECOS PAC ID: 5799196531 Enrollment ID: I20201130000670 |
| Provider Name | Felise S Zollman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235297078 PECOS PAC ID: 5294790317 Enrollment ID: I20210224002221 |
| Provider Name | Courtney Ann Hornfeld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982234027 PECOS PAC ID: 5890102081 Enrollment ID: I20210406002249 |
| Provider Name | Reza Bavarsad Shahripour |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699129668 PECOS PAC ID: 7113216367 Enrollment ID: I20210528002139 |
| Provider Name | Aliya L Frederick |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548657992 PECOS PAC ID: 1850794454 Enrollment ID: I20210720002178 |
| Provider Name | Andrew P Hannawi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194179135 PECOS PAC ID: 2961805585 Enrollment ID: I20210720002915 |
| Provider Name | Wali Z Qayoumi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093178220 PECOS PAC ID: 5294000980 Enrollment ID: I20210827002384 |
| Provider Name | Sarah E Wiegand |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164818035 PECOS PAC ID: 8224338827 Enrollment ID: I20210901000428 |
| Provider Name | Alison Johnson Headley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386007383 PECOS PAC ID: 2365848272 Enrollment ID: I20210901000500 |
| Provider Name | Eric Gutflais |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700231339 PECOS PAC ID: 2264778596 Enrollment ID: I20210907001601 |
| Provider Name | Natalie Bilotta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144809393 PECOS PAC ID: 3476950106 Enrollment ID: I20210923001097 |
| Provider Name | Allyssa Marie Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497358915 PECOS PAC ID: 4981092442 Enrollment ID: I20211102002896 |
| Provider Name | Stephanie D. Alsteen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013680982 PECOS PAC ID: 9335535988 Enrollment ID: I20220406002941 |
| Provider Name | Rafael Paolo Himang Aquino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376149609 PECOS PAC ID: 0042607806 Enrollment ID: I20220425002471 |
| Provider Name | Jenelle Raynowska |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386176063 PECOS PAC ID: 1951773746 Enrollment ID: I20230203000810 |
| Provider Name | Adriana Cruz Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669189494 PECOS PAC ID: 5991179913 Enrollment ID: I20230314002731 |
| Provider Name | Vishal Gupta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114376209 PECOS PAC ID: 0446597918 Enrollment ID: I20230425002116 |
| Provider Name | Jennifer Huasi Yang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528420619 PECOS PAC ID: 8325406473 Enrollment ID: I20230621002528 |
| Provider Name | Gaurav Chenji |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063917409 PECOS PAC ID: 9032579107 Enrollment ID: I20230720002691 |
| Provider Name | Robert Thomas Hess |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992200398 PECOS PAC ID: 3971850363 Enrollment ID: I20230724001822 |
| Provider Name | Taha Gholipour |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801159611 PECOS PAC ID: 7416102108 Enrollment ID: I20230815000658 |
| Provider Name | Emily Michelle Schorr |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255862041 PECOS PAC ID: 2365780384 Enrollment ID: I20231201002042 |
| Provider Name | Lanika Antoinette Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477325181 PECOS PAC ID: 7315395290 Enrollment ID: I20231204000750 |
| Provider Name | Chelsea Zale |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548615495 PECOS PAC ID: 2668765140 Enrollment ID: I20240530003830 |
| Provider Name | Kayla Marie Jacques |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538622014 PECOS PAC ID: 4183166184 Enrollment ID: I20240605003229 |
Aefct Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4669 Murphy Canyon Rd Ste 212, San Diego, CA 92123 Phone: 858-569-0056 Fax: 858-569-4233 | |
The Center For Behavior Change, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7676 Hazard Center Dr Ste 500, San Diego, CA 92108 Phone: 619-876-8261 | |
R D Dipp Do Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1350 Columbia St, Unit 800, San Diego, CA 92101 Phone: 619-255-1649 Fax: 619-255-1649 | |
Alba Community School Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4041 Oregon St, San Diego, CA 92104 Phone: 619-521-5720 | |
True Crew California Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8910 University Center Ln Ste 400, San Diego, CA 92122 Phone: 603-692-8173 | |
Adapt Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6070 Mission Gorge Rd, San Diego, CA 92120 Phone: 619-957-0888 | |
Wise Self Psychology, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2535 Kettner Blvd Ste 2b1, San Diego, CA 92101 Phone: 619-678-0020 |