| Careconnectmd Ca Pc | |
|
3090 Bristol St Ste 200 Costa Mesa CA 92626-3061 | |
| (888) 789-9585 | |
| (562) 803-4500 |
| Full Name | Careconnectmd Ca Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3090 Bristol St Ste 200, Costa Mesa, California |
| Authorized Official Name and Position | Christine Mlot (PRESIDENT) |
| Authorized Official Contact | 8887899585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Careconnectmd Ca Pc 16162 Beach Blvd Ste 100 Huntington Beach CA 92647-3828 Ph: (888) 789-9585 | Careconnectmd Ca Pc 3090 Bristol St Ste 200 Costa Mesa CA 92626-3061 Ph: (888) 789-9585 |
| NPI Number | 1366063125 |
|---|---|
| Provider Enumeration Date | 05/04/2020 |
| Last Update Date | 08/24/2021 |
| Medicare PECOS PAC ID | 5496178055 |
|---|---|
| Medicare Enrollment ID | O20200715000596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366063125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kathryn Amacher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366545568 PECOS PAC ID: 4880508795 Enrollment ID: I20031114000641 |
| Provider Name | Angela J Lamotte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538166764 PECOS PAC ID: 7416853619 Enrollment ID: I20031209000668 |
| Provider Name | Melvin Coats |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376599159 PECOS PAC ID: 0547166233 Enrollment ID: I20031211001138 |
| Provider Name | Richard Hill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629013669 PECOS PAC ID: 9234122805 Enrollment ID: I20040407001539 |
| Provider Name | Dat W Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386626448 PECOS PAC ID: 8224018700 Enrollment ID: I20040723001097 |
| Provider Name | Steven H Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700893294 PECOS PAC ID: 1254303076 Enrollment ID: I20040811000597 |
| Provider Name | Jesse J Licuanan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396795514 PECOS PAC ID: 3678547601 Enrollment ID: I20040824001319 |
| Provider Name | Christine M Mlot |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1538240239 PECOS PAC ID: 5193788685 Enrollment ID: I20041105000408 |
| Provider Name | Vakas A Sial |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659302305 PECOS PAC ID: 3870556087 Enrollment ID: I20041109000525 |
| Provider Name | Sujata N Lalla-reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891711909 PECOS PAC ID: 5496710998 Enrollment ID: I20041124000288 |
| Provider Name | Blaine K Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518079565 PECOS PAC ID: 6406813369 Enrollment ID: I20041213000891 |
| Provider Name | Stephanie S Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427062462 PECOS PAC ID: 5395795199 Enrollment ID: I20050128000952 |
| Provider Name | Ujjwala S Dheeriya |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1770508582 PECOS PAC ID: 7911950936 Enrollment ID: I20050301000992 |
| Provider Name | Simon Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760594097 PECOS PAC ID: 9739133588 Enrollment ID: I20050307000457 |
| Provider Name | Terry M Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184796104 PECOS PAC ID: 1254388572 Enrollment ID: I20050408001110 |
| Provider Name | Archna Chaudhary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548372634 PECOS PAC ID: 8729025606 Enrollment ID: I20050412001010 |
| Provider Name | Nikhil R Gandhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609934538 PECOS PAC ID: 6800823774 Enrollment ID: I20050721000939 |
| Provider Name | George E Fields |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457387482 PECOS PAC ID: 3173413994 Enrollment ID: I20050722000881 |
| Provider Name | Nghi D Vo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255410320 PECOS PAC ID: 1456380328 Enrollment ID: I20050810001145 |
| Provider Name | Asim Guha Roy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083659528 PECOS PAC ID: 9638196470 Enrollment ID: I20051031000692 |
| Provider Name | Shreeti Hasmukh Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154322691 PECOS PAC ID: 0244253003 Enrollment ID: I20060106000460 |
| Provider Name | Charles A Garretson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144284373 PECOS PAC ID: 5991603516 Enrollment ID: I20060114000092 |
| Provider Name | Dedra A Beckles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821011339 PECOS PAC ID: 3577577808 Enrollment ID: I20060125001022 |
| Provider Name | Hyong Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396792677 PECOS PAC ID: 7719998251 Enrollment ID: I20060511000203 |
| Provider Name | Peter P Ferrera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366481384 PECOS PAC ID: 6204830623 Enrollment ID: I20060826000095 |
| Provider Name | Roger M Samawi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275570822 PECOS PAC ID: 6204831142 Enrollment ID: I20060927000171 |
| Provider Name | Kien Tran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396831889 PECOS PAC ID: 5597669986 Enrollment ID: I20061204000120 |
| Provider Name | Melinda A Bataan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912933888 PECOS PAC ID: 8729088778 Enrollment ID: I20061222000161 |
| Provider Name | Xanthe Victoria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447270418 PECOS PAC ID: 0547362964 Enrollment ID: I20070302000262 |
| Provider Name | Daniel C Meador |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619925989 PECOS PAC ID: 0648374850 Enrollment ID: I20070328000282 |
| Provider Name | Ashish Malhotra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679583744 PECOS PAC ID: 4880655083 Enrollment ID: I20070726000253 |
| Provider Name | Vannarith So |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659416584 PECOS PAC ID: 5395833560 Enrollment ID: I20071121000594 |
| Provider Name | David T Shen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235100330 PECOS PAC ID: 0345330346 Enrollment ID: I20071213000886 |
| Provider Name | Shahriar Jarchi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417008772 PECOS PAC ID: 2062594310 Enrollment ID: I20080125000506 |
| Provider Name | Neha H Bhansali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700923893 PECOS PAC ID: 5890878417 Enrollment ID: I20080205000669 |
| Provider Name | David W Lehman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811078355 PECOS PAC ID: 9830143122 Enrollment ID: I20080505000320 |
| Provider Name | Daniel Matemotja |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821002759 PECOS PAC ID: 4183784408 Enrollment ID: I20081117000551 |
| Provider Name | Dan Tran |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1487709747 PECOS PAC ID: 4981767241 Enrollment ID: I20090113000207 |
| Provider Name | Flora Danque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013927425 PECOS PAC ID: 5890852776 Enrollment ID: I20090319000564 |
| Provider Name | Reginald Casilang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780784488 PECOS PAC ID: 6608923156 Enrollment ID: I20090420000659 |
| Provider Name | Tai H Wu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417963661 PECOS PAC ID: 9739110727 Enrollment ID: I20090506000156 |
| Provider Name | Michael A Pietila |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851315097 PECOS PAC ID: 7113076423 Enrollment ID: I20090515000348 |
| Provider Name | Jamison D Feramisco |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1043410871 PECOS PAC ID: 4688724602 Enrollment ID: I20090615000077 |
| Provider Name | Joanna Yao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861680555 PECOS PAC ID: 5890849400 Enrollment ID: I20090817000611 |
| Provider Name | Orlando Collado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205964947 PECOS PAC ID: 8820143134 Enrollment ID: I20090909000538 |
| Provider Name | Marco J Viruez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770732760 PECOS PAC ID: 7719023738 Enrollment ID: I20091006000185 |
| Provider Name | Yvonne Tyson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881617868 PECOS PAC ID: 6103963525 Enrollment ID: I20091016000261 |
| Provider Name | May P Goodly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164663753 PECOS PAC ID: 7416096458 Enrollment ID: I20091203000538 |
| Provider Name | James S Pratty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528049608 PECOS PAC ID: 4587695416 Enrollment ID: I20091222000364 |
| Provider Name | Karen T Dix |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811920424 PECOS PAC ID: 4082757257 Enrollment ID: I20100210000454 |
| Provider Name | Rodolfo Ibarra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376566323 PECOS PAC ID: 5698818870 Enrollment ID: I20100210000500 |
| Provider Name | Petra Ann Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578585915 PECOS PAC ID: 1355422056 Enrollment ID: I20100215000613 |
| Provider Name | Olga R Ginzburg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891723482 PECOS PAC ID: 8921142795 Enrollment ID: I20100217000208 |
| Provider Name | Cherie R Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497786396 PECOS PAC ID: 1456495233 Enrollment ID: I20100217000233 |
| Provider Name | Ali Alamar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972606374 PECOS PAC ID: 6103960604 Enrollment ID: I20100222000763 |
| Provider Name | Winston Chung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851322085 PECOS PAC ID: 9931244027 Enrollment ID: I20100301000289 |
| Provider Name | Steven J Lake |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669494001 PECOS PAC ID: 4486799145 Enrollment ID: I20100305000088 |
| Provider Name | Robert J Comer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134233158 PECOS PAC ID: 5193860864 Enrollment ID: I20100305000117 |
| Provider Name | Mansoor S Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962433706 PECOS PAC ID: 0446331144 Enrollment ID: I20100305000165 |
| Provider Name | Vinita Chaudhary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386679504 PECOS PAC ID: 5395880074 Enrollment ID: I20100305000218 |
| Provider Name | Diana R Bryant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255425146 PECOS PAC ID: 3971648650 Enrollment ID: I20100305000289 |
| Provider Name | Khalid Saeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114958956 PECOS PAC ID: 3779628458 Enrollment ID: I20100305000306 |
| Provider Name | Dennis L Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699700849 PECOS PAC ID: 0446395131 Enrollment ID: I20100305000383 |
| Provider Name | Scott A Gordon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033140801 PECOS PAC ID: 5991840605 Enrollment ID: I20100305000599 |
| Provider Name | James W Norcross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851305809 PECOS PAC ID: 4789729310 Enrollment ID: I20100305000852 |
| Provider Name | Gerald A Cohen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306877253 PECOS PAC ID: 8224163456 Enrollment ID: I20100312000925 |
| Provider Name | Asha Pritpal S Sidhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255430286 PECOS PAC ID: 9234224593 Enrollment ID: I20100324000734 |
| Provider Name | Andres Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548270200 PECOS PAC ID: 5294862371 Enrollment ID: I20100421000499 |
| Provider Name | Prode P Pascual |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558454595 PECOS PAC ID: 5890822720 Enrollment ID: I20100423000367 |
| Provider Name | Pedro De La Rosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114940145 PECOS PAC ID: 0648307348 Enrollment ID: I20100429000470 |
| Provider Name | Barry S Allswang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720016397 PECOS PAC ID: 2264513969 Enrollment ID: I20100429000767 |
| Provider Name | Clayton Dejong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467466409 PECOS PAC ID: 3072694777 Enrollment ID: I20100504000466 |
| Provider Name | Thomas Kellar Mccloy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568476513 PECOS PAC ID: 7517095037 Enrollment ID: I20100504000552 |
| Provider Name | Jennifer A Kim Loomis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215136940 PECOS PAC ID: 2062543986 Enrollment ID: I20100621000849 |
| Provider Name | Rafaelito S Victoria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548363989 PECOS PAC ID: 1759405319 Enrollment ID: I20100902000983 |
| Provider Name | Thuy Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891015871 PECOS PAC ID: 4082809835 Enrollment ID: I20101108000047 |
| Provider Name | Farschad K Birdjandi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205823929 PECOS PAC ID: 5395700918 Enrollment ID: I20110329000540 |
| Provider Name | Bernard Aron Michlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861492738 PECOS PAC ID: 7113103649 Enrollment ID: I20110518000652 |
| Provider Name | Sowmya A/ Muralidhara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851533285 PECOS PAC ID: 5698947992 Enrollment ID: I20111011000043 |
| Provider Name | Marjorie Chan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174811624 PECOS PAC ID: 0648431932 Enrollment ID: I20120412000749 |
| Provider Name | Lindsay A Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851618151 PECOS PAC ID: 6002062734 Enrollment ID: I20120810000609 |
| Provider Name | Tho Ngoc Pham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972765535 PECOS PAC ID: 1456508886 Enrollment ID: I20120820001083 |
| Provider Name | James E Sheppard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255686044 PECOS PAC ID: 1951558642 Enrollment ID: I20120831000411 |
| Provider Name | Mohamad Altriki |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1619061736 PECOS PAC ID: 8022003185 Enrollment ID: I20121004000425 |
| Provider Name | Mohamad Albouidani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770670713 PECOS PAC ID: 5698775526 Enrollment ID: I20130304000600 |
| Provider Name | Sherif Y Labatia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619165115 PECOS PAC ID: 6103906029 Enrollment ID: I20131008000076 |
| Provider Name | Tameem Alhayya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649283557 PECOS PAC ID: 8325141773 Enrollment ID: I20131206001645 |
| Provider Name | Edvin Dilanchiyan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245483700 PECOS PAC ID: 9830369123 Enrollment ID: I20140116000025 |
| Provider Name | Yu-hsiang S Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245262013 PECOS PAC ID: 1759430580 Enrollment ID: I20140131000939 |
| Provider Name | Marianne Mikhail |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164743464 PECOS PAC ID: 4880819093 Enrollment ID: I20140702000442 |
| Provider Name | Minas M Melidonian |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518254457 PECOS PAC ID: 2264659481 Enrollment ID: I20140812002601 |
| Provider Name | Rebecca H Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740576230 PECOS PAC ID: 1052533460 Enrollment ID: I20141118002690 |
| Provider Name | Marcelle Sagerian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285780437 PECOS PAC ID: 6507189230 Enrollment ID: I20150102001180 |
| Provider Name | Subrato Ghosh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083607055 PECOS PAC ID: 5193997617 Enrollment ID: I20150526001962 |
| Provider Name | Christina Lynn Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134509177 PECOS PAC ID: 0749596500 Enrollment ID: I20150825004365 |
| Provider Name | Siranuysh Salmastyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245527308 PECOS PAC ID: 9335111624 Enrollment ID: I20151006002567 |
| Provider Name | Ronald Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417954306 PECOS PAC ID: 6103806278 Enrollment ID: I20151006002798 |
| Provider Name | Jessica Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003299033 PECOS PAC ID: 8527377431 Enrollment ID: I20151015001624 |
| Provider Name | James Agatep |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578939153 PECOS PAC ID: 5799085627 Enrollment ID: I20151130000074 |
| Provider Name | Cristina Tobon-chung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053735019 PECOS PAC ID: 1951602549 Enrollment ID: I20151228000892 |
| Provider Name | Harkirat S Bal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114399953 PECOS PAC ID: 4587969738 Enrollment ID: I20160225001158 |
| Provider Name | Julie Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174977292 PECOS PAC ID: 8022317171 Enrollment ID: I20160425001468 |
| Provider Name | Tyler S Dejong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033537493 PECOS PAC ID: 9234436353 Enrollment ID: I20160513001682 |
| Provider Name | Jeffrey Felgner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790122497 PECOS PAC ID: 0648587337 Enrollment ID: I20160630001853 |
| Provider Name | Wesam Houshan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356467112 PECOS PAC ID: 0345472080 Enrollment ID: I20160926001447 |
| Provider Name | Andy H Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053748459 PECOS PAC ID: 5395974646 Enrollment ID: I20161018002357 |
| Provider Name | John Danjuma Adeiza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174918585 PECOS PAC ID: 9234417890 Enrollment ID: I20161102000715 |
| Provider Name | Andrew Imparato |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720400971 PECOS PAC ID: 1951680420 Enrollment ID: I20161128001933 |
| Provider Name | Iman Guirgis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1154774933 PECOS PAC ID: 5092099812 Enrollment ID: I20170222002711 |
| Provider Name | James Conrad J Contreras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033586870 PECOS PAC ID: 9436437829 Enrollment ID: I20170303002043 |
| Provider Name | Kimberly Huynh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215475710 PECOS PAC ID: 3173809811 Enrollment ID: I20170413000466 |
| Provider Name | Marianne Plakas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942503701 PECOS PAC ID: 3375782733 Enrollment ID: I20170419003034 |
| Provider Name | Dung Quoc Truong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205209285 PECOS PAC ID: 4688941958 Enrollment ID: I20170517002280 |
| Provider Name | Justine Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104265677 PECOS PAC ID: 4587935283 Enrollment ID: I20170728002400 |
| Provider Name | Kavneet Sandhu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992234827 PECOS PAC ID: 8224309331 Enrollment ID: I20170808003452 |
| Provider Name | John C Feng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346660081 PECOS PAC ID: 6709159775 Enrollment ID: I20170913003366 |
| Provider Name | Halie Holden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902320443 PECOS PAC ID: 9234404021 Enrollment ID: I20171004001613 |
| Provider Name | Lena M Rangel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679022628 PECOS PAC ID: 0244598209 Enrollment ID: I20171220001521 |
| Provider Name | Manuel Robert Brasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083127088 PECOS PAC ID: 3678833340 Enrollment ID: I20180129002245 |
| Provider Name | Christian De Guia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720478829 PECOS PAC ID: 6406173491 Enrollment ID: I20180322001654 |
| Provider Name | Mary Ann M Tanglao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134632490 PECOS PAC ID: 7911258108 Enrollment ID: I20180927001382 |
| Provider Name | Amir Mohamed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285096685 PECOS PAC ID: 2466705454 Enrollment ID: I20181021000014 |
| Provider Name | Bryan Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922580562 PECOS PAC ID: 6608113873 Enrollment ID: I20190125000750 |
| Provider Name | Kathleen Camia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306168752 PECOS PAC ID: 9830440106 Enrollment ID: I20190201002027 |
| Provider Name | Patrick Hachero Deligero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427412451 PECOS PAC ID: 2567725435 Enrollment ID: I20190208002025 |
| Provider Name | Retzel Naron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437627742 PECOS PAC ID: 2264770643 Enrollment ID: I20190208003107 |
| Provider Name | Ripal Chinubhai Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457720872 PECOS PAC ID: 1557678778 Enrollment ID: I20190312000424 |
| Provider Name | Matthew Lee Bloom |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1801273305 PECOS PAC ID: 0345546768 Enrollment ID: I20190312001127 |
| Provider Name | George Alburo Damasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104398890 PECOS PAC ID: 3375884653 Enrollment ID: I20190415001891 |
| Provider Name | Oluwaseun Boladale Ogunjimi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194243790 PECOS PAC ID: 4183965312 Enrollment ID: I20190416001189 |
| Provider Name | Natalie Pung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679055586 PECOS PAC ID: 5890038608 Enrollment ID: I20190520000483 |
| Provider Name | Anthony Fam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114245800 PECOS PAC ID: 8729214127 Enrollment ID: I20190605000164 |
| Provider Name | Stacy Lynn Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891252318 PECOS PAC ID: 3476883927 Enrollment ID: I20190925002818 |
| Provider Name | Steven Howard Farber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245248574 PECOS PAC ID: 6800880873 Enrollment ID: I20191004002903 |
| Provider Name | Priya Jagasia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679641971 PECOS PAC ID: 4385749654 Enrollment ID: I20191015003333 |
| Provider Name | Jonathan Youssefzadeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811415631 PECOS PAC ID: 6800128364 Enrollment ID: I20191101001711 |
| Provider Name | Anthony Karapetians |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144757030 PECOS PAC ID: 7517399496 Enrollment ID: I20191114001168 |
| Provider Name | Jacquiline R Jamora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215276456 PECOS PAC ID: 5799018222 Enrollment ID: I20191119003046 |
| Provider Name | Hussien Saab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245752500 PECOS PAC ID: 4082046446 Enrollment ID: I20200130000821 |
| Provider Name | Sinan Khayyat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578092318 PECOS PAC ID: 3870864101 Enrollment ID: I20200325001644 |
| Provider Name | Jennifer Ang Lim-quevedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588210504 PECOS PAC ID: 6002246618 Enrollment ID: I20200422003343 |
| Provider Name | Shoshana Panitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780210039 PECOS PAC ID: 8628408101 Enrollment ID: I20200423003385 |
| Provider Name | Joon Suh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518498674 PECOS PAC ID: 6901176205 Enrollment ID: I20200716004204 |
| Provider Name | Magdiel R. De La Rosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669845186 PECOS PAC ID: 1254633399 Enrollment ID: I20200811002408 |
| Provider Name | Sonali Wilborn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164523247 PECOS PAC ID: 0446317358 Enrollment ID: I20200825000822 |
| Provider Name | Rosemary Castoreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225135957 PECOS PAC ID: 8921009697 Enrollment ID: I20210216002776 |
| Provider Name | Jose Mari Atangan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427611656 PECOS PAC ID: 4587098827 Enrollment ID: I20210225001523 |
| Provider Name | Liliane Idylle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114298957 PECOS PAC ID: 1355567223 Enrollment ID: I20210519001474 |
| Provider Name | Atul Verma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093027989 PECOS PAC ID: 1355562943 Enrollment ID: I20210622000398 |
| Provider Name | Adenike Awolola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184263733 PECOS PAC ID: 7315343050 Enrollment ID: I20210907000205 |
| Provider Name | Eric Cui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003342395 PECOS PAC ID: 7012254352 Enrollment ID: I20211013003553 |
| Provider Name | Aliza H Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427410547 PECOS PAC ID: 1850799339 Enrollment ID: I20211013003677 |
| Provider Name | Gloria Pamela Otieno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427720234 PECOS PAC ID: 8628468444 Enrollment ID: I20211209000083 |
| Provider Name | Michael T Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902392665 PECOS PAC ID: 8022411420 Enrollment ID: I20220307001995 |
| Provider Name | Rishi Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528557865 PECOS PAC ID: 6406105543 Enrollment ID: I20220407001881 |
| Provider Name | Elena Cristiana Marin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134897598 PECOS PAC ID: 4688052251 Enrollment ID: I20220609003077 |
| Provider Name | Doreen Dora Chibweth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528715653 PECOS PAC ID: 5496133969 Enrollment ID: I20220613001060 |
| Provider Name | Roslyn Mazi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992449326 PECOS PAC ID: 8628459393 Enrollment ID: I20220713001901 |
| Provider Name | Allen Kris Navarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679237598 PECOS PAC ID: 9830570894 Enrollment ID: I20220721002706 |
| Provider Name | Rajdeep Sandhu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013473073 PECOS PAC ID: 0143604694 Enrollment ID: I20220831003612 |
| Provider Name | Sukhjit Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023780244 PECOS PAC ID: 8921482183 Enrollment ID: I20220907002255 |
| Provider Name | Vanessa Clara Seal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811352883 PECOS PAC ID: 3173909884 Enrollment ID: I20221004002102 |
| Provider Name | Mary Grace Matin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427779297 PECOS PAC ID: 5698151314 Enrollment ID: I20221004002325 |
| Provider Name | Navneet Boparai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972210284 PECOS PAC ID: 2668840620 Enrollment ID: I20221122002567 |
| Provider Name | Mary Terese Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386367381 PECOS PAC ID: 4486025962 Enrollment ID: I20230119002511 |
| Provider Name | Jasbir Kaur Dheri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811617046 PECOS PAC ID: 0547633828 Enrollment ID: I20230307003052 |
| Provider Name | Elena Marie Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548966096 PECOS PAC ID: 1951774132 Enrollment ID: I20230309000761 |
| Provider Name | Yohan Han Hwang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609515642 PECOS PAC ID: 7012373244 Enrollment ID: I20230515000596 |
| Provider Name | Alex Andria Judkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326748310 PECOS PAC ID: 2466818083 Enrollment ID: I20230523003017 |
| Provider Name | Ling Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396988416 PECOS PAC ID: 7214185826 Enrollment ID: I20231010000812 |
Nazli Ahmed, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 275 Victoria St, # 2m, Costa Mesa, CA 92627 Phone: 949-642-5390 Fax: 949-642-1224 | |
Roberto N Valenton Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Victoria St, Costa Mesa, CA 92627 Phone: 949-642-2734 | |
Bristol Park Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 722 Baker St, Costa Mesa, CA 92626 Phone: 714-557-6300 Fax: 714-966-9567 | |
Shahrestani Chiropractic Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2328 Newport Blvd, Costa Mesa, CA 92627 Phone: 949-631-3139 Fax: 949-631-0747 | |
Md24 San Diego, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Anton Blvd Ste 1100, Costa Mesa, CA 92626 Phone: 623-374-7774 | |
Coastal Mesa Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 777 W 19th St Ste J, Costa Mesa, CA 92627 Phone: 657-203-2133 | |
Newport Mesa Medical Group, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 275 Victoria St, Ste 1e, Costa Mesa, CA 92627 Phone: 949-574-3615 |