| |
760 Otay Lakes Rd Chula Vista CA 91910-6915 | |
(619) 821-2300 | |
(619) 821-2301 |
Full Name | |
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Speciality | Clinic/Center |
Location | 760 Otay Lakes Rd, Chula Vista, California |
Authorized Official Name and Position | Daniel Lareaux (MEDICAL DIRECTOR) |
Authorized Official Contact | 8553629773 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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750 Otay Lakes Rd # 272 Chula Vista CA 91910-6915 Ph: (619) 821-2300 | 760 Otay Lakes Rd Chula Vista CA 91910-6915 Ph: (619) 821-2300 |
NPI Number | 1316225147 |
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Provider Enumeration Date | 07/27/2011 |
Last Update Date | 11/26/2024 |
Medicare PECOS PAC ID | 4981877735 |
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Medicare Enrollment ID | O20111024000461 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316225147 | NPI | - | NPPES |
Provider Name | Lisa M Sacco |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144358938 PECOS PAC ID: 0749203958 Enrollment ID: I20060112001062 |
Provider Name | Julie A Keeler |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912963109 PECOS PAC ID: 7315963113 Enrollment ID: I20080306000514 |
Provider Name | Luzviminda D Saidro |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750364386 PECOS PAC ID: 0244291599 Enrollment ID: I20081112000017 |
Provider Name | Jennifer Doumas |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1124038328 PECOS PAC ID: 9739363920 Enrollment ID: I20110817000425 |
Provider Name | Julie Elana Kaltgrad |
---|---|
Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1235444068 PECOS PAC ID: 9739354242 Enrollment ID: I20111212000938 |
Provider Name | Vicki Lynn Love |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699759134 PECOS PAC ID: 7517123110 Enrollment ID: I20120726000323 |
Provider Name | Charles M Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053762005 PECOS PAC ID: 8628356466 Enrollment ID: I20161028000596 |
Provider Name | Brandy Gallagher |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114476769 PECOS PAC ID: 5698055937 Enrollment ID: I20161202001969 |
Provider Name | Cristiana Golu |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1083684997 PECOS PAC ID: 6608013990 Enrollment ID: I20171011001094 |
Provider Name | Xavier Jeremiah Ernst |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780010595 PECOS PAC ID: 2961631239 Enrollment ID: I20171117003130 |
Provider Name | Aaron J Stirling |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588142533 PECOS PAC ID: 1052663317 Enrollment ID: I20181015002143 |
Provider Name | Rowena San Juan Dacanay-herman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144689175 PECOS PAC ID: 6709110059 Enrollment ID: I20190620002357 |
Provider Name | Mackenzie L Williams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629581764 PECOS PAC ID: 0345663134 Enrollment ID: I20200713002227 |
Provider Name | Mariusz Niedzwiecki |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083281679 PECOS PAC ID: 7719378504 Enrollment ID: I20220105002600 |
Provider Name | Alba Casco |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689066490 PECOS PAC ID: 3870988413 Enrollment ID: I20220318000304 |
Provider Name | Christina Braunworth |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831794023 PECOS PAC ID: 5294114203 Enrollment ID: I20220622002122 |
Provider Name | Malinda Anderson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326542424 PECOS PAC ID: 0143584383 Enrollment ID: I20221012003010 |
Provider Name | Erika Trujillo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396462917 PECOS PAC ID: 5698145092 Enrollment ID: I20221229001387 |
Provider Name | Renea Barrientos |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689333940 PECOS PAC ID: 7517339039 Enrollment ID: I20230209003174 |
Provider Name | Regina J Garcia |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639673858 PECOS PAC ID: 7416208137 Enrollment ID: I20230410000766 |
Provider Name | Michelle Brower |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588367668 PECOS PAC ID: 9537525118 Enrollment ID: I20230524002224 |
Provider Name | Daniel Owen Lareaux |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1629606173 PECOS PAC ID: 7517380546 Enrollment ID: I20230622002992 |
Provider Name | Philip Krause |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1942735295 PECOS PAC ID: 6507215266 Enrollment ID: I20231207001005 |
Provider Name | Rahel A Demessie |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619749041 PECOS PAC ID: 6901255587 Enrollment ID: I20231207002058 |
Provider Name | Michelle Wilcox |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194418012 PECOS PAC ID: 1557704806 Enrollment ID: I20240204000131 |
Provider Name | Sherlita Aguilar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205522083 PECOS PAC ID: 4981041969 Enrollment ID: I20240326003142 |
Provider Name | Donna Lagda Mather |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790243699 PECOS PAC ID: 0941742936 Enrollment ID: I20240605002948 |
Provider Name | Clarisa Pelayo Du |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528784345 PECOS PAC ID: 2062954894 Enrollment ID: I20240609000012 |
Provider Name | Naomi Twigg |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689203838 PECOS PAC ID: 4789002676 Enrollment ID: I20240618001572 |
Provider Name | Emily Torres Beltran |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811751712 PECOS PAC ID: 2668917451 Enrollment ID: I20240717000671 |
Provider Name | Autumn Sunshine Houston |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881454726 PECOS PAC ID: 5991241085 Enrollment ID: I20240725000862 |
Robert H Moon Md, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1030 White Alder Ave, Chula Vista, CA 91914 Phone: 619-800-6713 Fax: 619-503-9000 | |
Leticia Uwedjojevwe Md Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 340 4th Ave Ste 10, Chula Vista, CA 91910 Phone: 619-934-2215 Fax: 619-934-2340 | |
Centro De Salud De La Comunidad De San Ysidro Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1061 Tierra Del Rey, Ste 303, 304, 305, Chula Vista, CA 91910 Phone: 619-662-4100 | |
Sharna B Shachar M D A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 525 H St, Chula Vista, CA 91910 Phone: 619-409-9999 Fax: 619-409-9905 | |
Operation Samahan Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 480 4th Ave Ste 401, Chula Vista, CA 91910 Phone: 844-200-2426 Fax: 619-356-2726 |