| Chemehuevi Health Clinic | |
|
1970 Palo Verde Havasu Lake CA 92363 | |
| (760) 858-4790 | |
| (928) 669-3232 |
| Full Name | Chemehuevi Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1970 Palo Verde, Havasu Lake, California |
| Authorized Official Name and Position | Sky Rainbow Black Elk-volkmann (SUPERVISOR, PATIENT BUSINESS OFFC.) |
| Authorized Official Contact | 6053844844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chemehuevi Health Clinic 1970 Palo Verde Drive Havasu Lake CA 92363-1858 Ph: () - | Chemehuevi Health Clinic 1970 Palo Verde Havasu Lake CA 92363 Ph: (760) 858-4790 |
| NPI Number | 1396022026 |
|---|---|
| Provider Enumeration Date | 11/09/2011 |
| Last Update Date | 12/13/2022 |
| Medicare PECOS PAC ID | 0244405629 |
|---|---|
| Medicare Enrollment ID | O20120105000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396022026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Primary |
| Provider Name | Suzanne L Belzer |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1497840383 PECOS PAC ID: 8527964998 Enrollment ID: I20031208001073 |
| Provider Name | Betsy Berkovich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992898563 PECOS PAC ID: 8820990146 Enrollment ID: I20040126000547 |
| Provider Name | Michael W Rada |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447240148 PECOS PAC ID: 6103725189 Enrollment ID: I20040316001411 |
| Provider Name | Roland A Palmquist |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750301545 PECOS PAC ID: 9931165347 Enrollment ID: I20041207001246 |
| Provider Name | Steven C White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174529507 PECOS PAC ID: 3375595846 Enrollment ID: I20050211000808 |
| Provider Name | Lisa M Sumner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962512012 PECOS PAC ID: 4284675182 Enrollment ID: I20050520000756 |
| Provider Name | Reginald Franklin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790703841 PECOS PAC ID: 1052381506 Enrollment ID: I20050524000524 |
| Provider Name | Anuma K. Ulu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982731741 PECOS PAC ID: 4486679057 Enrollment ID: I20051012000829 |
| Provider Name | Kristen R Burkholder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083795108 PECOS PAC ID: 4981626553 Enrollment ID: I20051222000638 |
| Provider Name | Paul Raymond Bloomquist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730167065 PECOS PAC ID: 8426095316 Enrollment ID: I20060504000566 |
| Provider Name | Donald L Heine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285682542 PECOS PAC ID: 9638118375 Enrollment ID: I20061120000036 |
| Provider Name | Lilly M Shimahara |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1184735920 PECOS PAC ID: 4284657693 Enrollment ID: I20070803000155 |
| Provider Name | Anthony Vincent Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811074834 PECOS PAC ID: 9032214911 Enrollment ID: I20071019000478 |
| Provider Name | Criselle Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366517385 PECOS PAC ID: 4981656899 Enrollment ID: I20080225000741 |
| Provider Name | Charles G Silas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245431121 PECOS PAC ID: 7416930086 Enrollment ID: I20080317000582 |
| Provider Name | Robert L Kesead |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003879123 PECOS PAC ID: 7911085303 Enrollment ID: I20080425000254 |
| Provider Name | Roseline N Ihim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790979391 PECOS PAC ID: 4183703663 Enrollment ID: I20080508000672 |
| Provider Name | Michael L Buenafe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871555961 PECOS PAC ID: 0446327993 Enrollment ID: I20080924000648 |
| Provider Name | Geniel Harrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528243805 PECOS PAC ID: 5092876532 Enrollment ID: I20081203000161 |
| Provider Name | Christian J Ingui |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407893894 PECOS PAC ID: 0042213431 Enrollment ID: I20081203000324 |
| Provider Name | Ari D Plosker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639141682 PECOS PAC ID: 4587693320 Enrollment ID: I20081203000368 |
| Provider Name | Ana P Sandee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649506668 PECOS PAC ID: 1951449065 Enrollment ID: I20091110000696 |
| Provider Name | Richard M Palmer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821280892 PECOS PAC ID: 7618880246 Enrollment ID: I20100201000454 |
| Provider Name | Kevin A Rodgers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720014434 PECOS PAC ID: 5698784817 Enrollment ID: I20100226000213 |
| Provider Name | Camlesh G Nirmul |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487742870 PECOS PAC ID: 0840329512 Enrollment ID: I20100519000374 |
| Provider Name | Mary B Mccoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437289782 PECOS PAC ID: 1052443611 Enrollment ID: I20100716000390 |
| Provider Name | James Davy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528031168 PECOS PAC ID: 3971523929 Enrollment ID: I20100716000712 |
| Provider Name | Brian F Hanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467657841 PECOS PAC ID: 1355511924 Enrollment ID: I20110909002578 |
| Provider Name | Melvin J Clark |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1093704751 PECOS PAC ID: 2860388303 Enrollment ID: I20111024000719 |
| Provider Name | Dianna L Mahoney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649372004 PECOS PAC ID: 4486828050 Enrollment ID: I20111116000418 |
| Provider Name | Judith H Weimer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063670263 PECOS PAC ID: 8729149398 Enrollment ID: I20130814000111 |
| Provider Name | Joan M Kohr |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376518688 PECOS PAC ID: 0941226724 Enrollment ID: I20131029001616 |
| Provider Name | Huma S Qureshi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568447357 PECOS PAC ID: 9335167733 Enrollment ID: I20140212000771 |
| Provider Name | Atul Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528045374 PECOS PAC ID: 6103844774 Enrollment ID: I20140228000080 |
| Provider Name | Nicolaus J Kuehn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518946649 PECOS PAC ID: 6507858651 Enrollment ID: I20140228000613 |
| Provider Name | Vickie P Clennon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578771952 PECOS PAC ID: 6103908470 Enrollment ID: I20140304001764 |
| Provider Name | Kamiar Massrour |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376791343 PECOS PAC ID: 4587704119 Enrollment ID: I20140310001736 |
| Provider Name | David Wells |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659447118 PECOS PAC ID: 0143128082 Enrollment ID: I20140313000790 |
| Provider Name | Jeffrey Caverly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912968686 PECOS PAC ID: 2961509500 Enrollment ID: I20140522002123 |
| Provider Name | Peilin Reed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265484794 PECOS PAC ID: 5991783227 Enrollment ID: I20140602001890 |
| Provider Name | Aaron Jun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033194253 PECOS PAC ID: 5496773061 Enrollment ID: I20140626000838 |
| Provider Name | Jose A Ospina |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033373287 PECOS PAC ID: 7618147653 Enrollment ID: I20140626002168 |
| Provider Name | Ashley J Randall |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1689080582 PECOS PAC ID: 2668698598 Enrollment ID: I20140729001773 |
| Provider Name | Jennifer L Himmelstein |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1669888525 PECOS PAC ID: 7810113776 Enrollment ID: I20140729002670 |
| Provider Name | Kristi A Petersen |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1548515406 PECOS PAC ID: 2365671583 Enrollment ID: I20150102000288 |
| Provider Name | Roger V Cox |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104038488 PECOS PAC ID: 2668646068 Enrollment ID: I20150105001861 |
| Provider Name | Jonathan Franco |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699736371 PECOS PAC ID: 6507820537 Enrollment ID: I20150115002134 |
| Provider Name | Perry D Guthrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477939882 PECOS PAC ID: 1254634850 Enrollment ID: I20160114000824 |
| Provider Name | Tanja Gunsberger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124220397 PECOS PAC ID: 4688758360 Enrollment ID: I20160223002576 |
| Provider Name | Michael Wasowicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922407063 PECOS PAC ID: 9931320264 Enrollment ID: I20160405000420 |
| Provider Name | Vicki L Jeffery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629370077 PECOS PAC ID: 7416126859 Enrollment ID: I20160427001754 |
| Provider Name | Dwala M Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346628088 PECOS PAC ID: 3274822630 Enrollment ID: I20160525001521 |
| Provider Name | Surender Kurapati |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073558383 PECOS PAC ID: 8628982428 Enrollment ID: I20160714001549 |
| Provider Name | Aljinder S Mangat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821100884 PECOS PAC ID: 6002703006 Enrollment ID: I20160811002517 |
| Provider Name | Juli M Haws |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1316264856 PECOS PAC ID: 9335437763 Enrollment ID: I20161018000416 |
| Provider Name | Kelly A Cricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346501012 PECOS PAC ID: 9133439144 Enrollment ID: I20161029000047 |
| Provider Name | Rishi Patel |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1154797165 PECOS PAC ID: 9739468604 Enrollment ID: I20161116002196 |
| Provider Name | Virgilio A Cantu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437184686 PECOS PAC ID: 0042279671 Enrollment ID: I20161118001141 |
| Provider Name | Charlene R Wood |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1356620504 PECOS PAC ID: 0648407882 Enrollment ID: I20161121002153 |
| Provider Name | Moses B Benavides |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326332768 PECOS PAC ID: 1254623549 Enrollment ID: I20161130001914 |
| Provider Name | Tahir Alkhairy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023026234 PECOS PAC ID: 8527960434 Enrollment ID: I20170508002146 |
| Provider Name | Sumin T Li |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205086337 PECOS PAC ID: 8022259472 Enrollment ID: I20170823000762 |
| Provider Name | Charles M Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447240171 PECOS PAC ID: 9335230291 Enrollment ID: I20170825001969 |
| Provider Name | Adrian A Cordovi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407084353 PECOS PAC ID: 6901921121 Enrollment ID: I20170919000534 |
| Provider Name | Rebekah C Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205121647 PECOS PAC ID: 2163644493 Enrollment ID: I20171009002955 |
| Provider Name | Vicki Mazzorana |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609821180 PECOS PAC ID: 5991798092 Enrollment ID: I20171014000414 |
| Provider Name | Alexander Figueroa Madera |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760890123 PECOS PAC ID: 1557682200 Enrollment ID: I20171130000333 |
| Provider Name | Linda-jo Saunders |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124062229 PECOS PAC ID: 2769419498 Enrollment ID: I20171130002662 |
| Provider Name | Raymond B Wallace |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437181153 PECOS PAC ID: 8921161001 Enrollment ID: I20180102000337 |
| Provider Name | Tamara J Hoover |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104836519 PECOS PAC ID: 0840274049 Enrollment ID: I20180124000932 |
| Provider Name | Keith G Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437225786 PECOS PAC ID: 8123051877 Enrollment ID: I20180209000227 |
| Provider Name | Pierre Lanthiez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801864970 PECOS PAC ID: 2769570860 Enrollment ID: I20180319000669 |
| Provider Name | Nancy R Sagona |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679574461 PECOS PAC ID: 9537148762 Enrollment ID: I20180502001119 |
| Provider Name | Dana C Ugwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639461395 PECOS PAC ID: 5092959643 Enrollment ID: I20190411000517 |
| Provider Name | Francoise Bansenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275877409 PECOS PAC ID: 8022303213 Enrollment ID: I20190417000399 |
| Provider Name | Daniel N Lucas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417905522 PECOS PAC ID: 8527040195 Enrollment ID: I20190502000487 |
| Provider Name | Steven Grondalski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164509071 PECOS PAC ID: 2769712009 Enrollment ID: I20190930000527 |
| Provider Name | Vijay Kannan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699188524 PECOS PAC ID: 1557638251 Enrollment ID: I20191007001520 |
| Provider Name | Supriya Gupta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548521883 PECOS PAC ID: 5092004523 Enrollment ID: I20191203000373 |
| Provider Name | Jonathan B Light |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902009269 PECOS PAC ID: 5890828529 Enrollment ID: I20191227000464 |
| Provider Name | Yeu Shin Cindy Chang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003158817 PECOS PAC ID: 0648540880 Enrollment ID: I20200115001221 |
| Provider Name | Jermaine D Bridges |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851612139 PECOS PAC ID: 7113167032 Enrollment ID: I20200127000077 |
| Provider Name | Tina Evenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114151214 PECOS PAC ID: 3173669645 Enrollment ID: I20200310002228 |
| Provider Name | Vicken Y Totten |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831179001 PECOS PAC ID: 3375552995 Enrollment ID: I20200408001169 |
| Provider Name | Amy E Allegretti |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033193883 PECOS PAC ID: 2365478872 Enrollment ID: I20200707000779 |
| Provider Name | David N Ishimitsu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497919641 PECOS PAC ID: 3173783057 Enrollment ID: I20200924002219 |
| Provider Name | Jonathan I. Meyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265481725 PECOS PAC ID: 6709847833 Enrollment ID: I20200930000787 |
| Provider Name | Mahdieh Haji Amou Assar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518953926 PECOS PAC ID: 5799675781 Enrollment ID: I20201013001345 |
| Provider Name | Troy M Tompkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245219674 PECOS PAC ID: 9032121934 Enrollment ID: I20201020003671 |
| Provider Name | Patrick L Mccarthy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821098906 PECOS PAC ID: 3577469337 Enrollment ID: I20201102001090 |
| Provider Name | Daniel Clyde Cummings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538114889 PECOS PAC ID: 8123917382 Enrollment ID: I20210104001714 |
| Provider Name | John A Gnassi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629066105 PECOS PAC ID: 2365488715 Enrollment ID: I20210119001789 |
| Provider Name | Maya I Koehler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144751256 PECOS PAC ID: 3476812215 Enrollment ID: I20210125000537 |
| Provider Name | Manraj Chahal Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356964076 PECOS PAC ID: 2264849728 Enrollment ID: I20210329002060 |
| Provider Name | Sean M Tierney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578593232 PECOS PAC ID: 3870483787 Enrollment ID: I20210408002138 |
| Provider Name | Kupusamy Umapathy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306842786 PECOS PAC ID: 1557386356 Enrollment ID: I20210525001455 |
| Provider Name | Selina Clow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821371923 PECOS PAC ID: 8022278399 Enrollment ID: I20210526002718 |
| Provider Name | Michael Santarlas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548379613 PECOS PAC ID: 8921062449 Enrollment ID: I20210709000171 |
| Provider Name | Brett Jacob Schneiderman |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1831603125 PECOS PAC ID: 8325440670 Enrollment ID: I20210709001051 |
| Provider Name | Brandon Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649695248 PECOS PAC ID: 6406198316 Enrollment ID: I20210804002073 |
| Provider Name | Michael Dickerson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073512059 PECOS PAC ID: 0143133371 Enrollment ID: I20210823000250 |
| Provider Name | Julia D Whiting |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144290024 PECOS PAC ID: 4688628050 Enrollment ID: I20210909001362 |
| Provider Name | Helen Lo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225230618 PECOS PAC ID: 3274702048 Enrollment ID: I20210916000183 |
| Provider Name | Surendar G Rao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134450869 PECOS PAC ID: 2264754944 Enrollment ID: I20211013000514 |
| Provider Name | Cynthia D Raya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770037251 PECOS PAC ID: 9335437144 Enrollment ID: I20220106002350 |
| Provider Name | Douglas Mckendry |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1285028092 PECOS PAC ID: 2264829209 Enrollment ID: I20220421002654 |
| Provider Name | Keith Arnold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780117549 PECOS PAC ID: 1951679612 Enrollment ID: I20220708000847 |
| Provider Name | Brenda Kay Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275824120 PECOS PAC ID: 3678895232 Enrollment ID: I20220803001977 |
| Provider Name | Jesse Coenen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376832345 PECOS PAC ID: 4082839063 Enrollment ID: I20220805000476 |
| Provider Name | Todd Salmans |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1902858277 PECOS PAC ID: 3476879883 Enrollment ID: I20220915000285 |
| Provider Name | Michael Henry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609338102 PECOS PAC ID: 5799168977 Enrollment ID: I20221003000241 |
| Provider Name | David P. Reiner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174572572 PECOS PAC ID: 4981616661 Enrollment ID: I20230418001589 |
| Provider Name | Stephen Herring |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942718176 PECOS PAC ID: 7012264443 Enrollment ID: I20230420001631 |
| Provider Name | David Lau |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144303611 PECOS PAC ID: 3678938214 Enrollment ID: I20230503002207 |
| Provider Name | Lynester Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396344586 PECOS PAC ID: 3173929254 Enrollment ID: I20230505001452 |
| Provider Name | Joseph Lawton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205368735 PECOS PAC ID: 4688908361 Enrollment ID: I20230614000083 |
| Provider Name | Betty Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336863778 PECOS PAC ID: 3779942396 Enrollment ID: I20230629002918 |
| Provider Name | Daniel B Bordt |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760852602 PECOS PAC ID: 8527361716 Enrollment ID: I20230727002598 |
| Provider Name | Emily F Veltus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427687391 PECOS PAC ID: 4587026083 Enrollment ID: I20230815004275 |
| Provider Name | Quinn D Bott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336572619 PECOS PAC ID: 0345664157 Enrollment ID: I20230821000087 |
| Provider Name | Charles Rocamboli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366639049 PECOS PAC ID: 1658398284 Enrollment ID: I20231003003463 |
| Provider Name | Cynthia Mc Donald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184063422 PECOS PAC ID: 5193953230 Enrollment ID: I20240223000316 |
Chemehuevi Indian Tribe Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1970 Palo Verde Drive, Havasu Lake, CA 92363 Phone: 760-858-5426 |