| Grmc Specialty Care Center | |
|
133 Route 3 Dededo GU 96929-6911 | |
| (671) 645-5500 | |
| (671) 645-5549 |
| Full Name | Grmc Specialty Care Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 133 Route 3, Dededo, Guam |
| Authorized Official Name and Position | Alexander D. Wielaard (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7063064668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grmc Specialty Care Center 133 Route 3 Dededo GU 96929-6911 Ph: (671) 645-5500 | Grmc Specialty Care Center 133 Route 3 Dededo GU 96929-6911 Ph: (671) 645-5500 |
| NPI Number | 1326447939 |
|---|---|
| Provider Enumeration Date | 08/19/2014 |
| Last Update Date | 10/27/2024 |
| Medicare PECOS PAC ID | 9234351776 |
|---|---|
| Medicare Enrollment ID | O20150326000266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326447939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ronald T Kobayashi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104975689 PECOS PAC ID: 7911896618 Enrollment ID: I20040622000123 |
| Provider Name | Teresa D Borja |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558338509 PECOS PAC ID: 2466437629 Enrollment ID: I20040622000368 |
| Provider Name | Michael W Cruz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164552022 PECOS PAC ID: 8921083197 Enrollment ID: I20040622000441 |
| Provider Name | Ricardo B Eusebio |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679795603 PECOS PAC ID: 7911896774 Enrollment ID: I20040622000639 |
| Provider Name | Michelle Labrunda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902081318 PECOS PAC ID: 3072695741 Enrollment ID: I20080204000180 |
| Provider Name | Jerry R Castro |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326231655 PECOS PAC ID: 5496902769 Enrollment ID: I20120822000405 |
| Provider Name | Ashish Khandelwal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801055223 PECOS PAC ID: 8729230396 Enrollment ID: I20121205000131 |
| Provider Name | Alexander G Yap |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1346254463 PECOS PAC ID: 8820151970 Enrollment ID: I20121221000337 |
| Provider Name | Russel J Aubin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255690517 PECOS PAC ID: 7810918778 Enrollment ID: I20130325000114 |
| Provider Name | Mohamad H Alsabban |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1942226790 PECOS PAC ID: 0547255960 Enrollment ID: I20130411000525 |
| Provider Name | Pichet Iampornpipopchai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679738330 PECOS PAC ID: 8123267556 Enrollment ID: I20130617000042 |
| Provider Name | Felix T Cabrera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164697546 PECOS PAC ID: 7810167673 Enrollment ID: I20130802000121 |
| Provider Name | Virgilio I Lopez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255438347 PECOS PAC ID: 9931362456 Enrollment ID: I20130805000448 |
| Provider Name | Edna Ganacias-acuna |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1487601183 PECOS PAC ID: 9032122858 Enrollment ID: I20130814001039 |
| Provider Name | Vincent S Duenas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134430192 PECOS PAC ID: 6901032861 Enrollment ID: I20131122001878 |
| Provider Name | Andrew C Kim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609978618 PECOS PAC ID: 3274604731 Enrollment ID: I20131217000278 |
| Provider Name | Lara A Rhodes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689623399 PECOS PAC ID: 0547266587 Enrollment ID: I20140320000557 |
| Provider Name | Ruben P Arafiles |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659467504 PECOS PAC ID: 0345338828 Enrollment ID: I20140326000072 |
| Provider Name | Sibyl Dgg Crisostomo |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1447588116 PECOS PAC ID: 5193957140 Enrollment ID: I20140407001067 |
| Provider Name | Johnny J Kim |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023097375 PECOS PAC ID: 0143396978 Enrollment ID: I20140505001822 |
| Provider Name | Insaf Ally |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750635801 PECOS PAC ID: 2769612738 Enrollment ID: I20140730000548 |
| Provider Name | Unknown Mallikarjunappa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093996233 PECOS PAC ID: 9436376571 Enrollment ID: I20140813000669 |
| Provider Name | Meagan J Bamba-ada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568874345 PECOS PAC ID: 3072835552 Enrollment ID: I20141212000269 |
| Provider Name | Jeffery D Shay |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1568462513 PECOS PAC ID: 4183674641 Enrollment ID: I20150120002556 |
| Provider Name | Peter Lombard |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1336117217 PECOS PAC ID: 7315998556 Enrollment ID: I20150331002896 |
| Provider Name | Justin S Hale |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629211891 PECOS PAC ID: 1557504073 Enrollment ID: I20150402001229 |
| Provider Name | Russell C Gilbert |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417918798 PECOS PAC ID: 8022025758 Enrollment ID: I20150410002133 |
| Provider Name | Marian C Holland |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700084464 PECOS PAC ID: 9931295631 Enrollment ID: I20150604002107 |
| Provider Name | Jason S Hahn |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1831128149 PECOS PAC ID: 4880653948 Enrollment ID: I20150605000043 |
| Provider Name | Paul C Coty |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1386738862 PECOS PAC ID: 0941494181 Enrollment ID: I20150608003129 |
| Provider Name | William P Vercio |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962658922 PECOS PAC ID: 2769542893 Enrollment ID: I20150810000135 |
| Provider Name | Peter Kh Lim Go |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932202298 PECOS PAC ID: 7517935448 Enrollment ID: I20150818005524 |
| Provider Name | Ann S Fenton |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1144208851 PECOS PAC ID: 9739328451 Enrollment ID: I20151015001000 |
| Provider Name | Isabel C Hill |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1336304468 PECOS PAC ID: 9133438062 Enrollment ID: I20151015002114 |
| Provider Name | Pei-chang Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881929156 PECOS PAC ID: 6507030624 Enrollment ID: I20151021001513 |
| Provider Name | James W Murphy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013074244 PECOS PAC ID: 8123287646 Enrollment ID: I20151030000070 |
| Provider Name | Ronald Innerfield |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1063457950 PECOS PAC ID: 0446222772 Enrollment ID: I20151109000852 |
| Provider Name | Song Chu Ko |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1740205921 PECOS PAC ID: 1557368842 Enrollment ID: I20151109001577 |
| Provider Name | David M Weingarten |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1639336472 PECOS PAC ID: 2365752912 Enrollment ID: I20151110002591 |
| Provider Name | Tyler M Arkless |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235347154 PECOS PAC ID: 9537241245 Enrollment ID: I20151112001402 |
| Provider Name | Sow Alfred Kobayashi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205194578 PECOS PAC ID: 9335459817 Enrollment ID: I20151112002864 |
| Provider Name | Jose Jersey Gonzalez Huertas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063654309 PECOS PAC ID: 0941510325 Enrollment ID: I20151116000808 |
| Provider Name | Noel Leonardo Concepcion |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942243308 PECOS PAC ID: 3577586346 Enrollment ID: I20151120002665 |
| Provider Name | Sheri L Tackett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477855468 PECOS PAC ID: 9537333679 Enrollment ID: I20151130001963 |
| Provider Name | Kevin John Sullivan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245538669 PECOS PAC ID: 6002091493 Enrollment ID: I20151204000780 |
| Provider Name | Gregory K Woodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649563651 PECOS PAC ID: 1557531936 Enrollment ID: I20151204002024 |
| Provider Name | Carl Von Trampe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497953244 PECOS PAC ID: 3274432695 Enrollment ID: I20151208003055 |
| Provider Name | Reynald T Lim |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679549869 PECOS PAC ID: 1153212857 Enrollment ID: I20151214002315 |
| Provider Name | Alessandro A Giambartolomei |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730175241 PECOS PAC ID: 0840185229 Enrollment ID: I20151217002246 |
| Provider Name | Martin A Arrisueno |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427124114 PECOS PAC ID: 0749426310 Enrollment ID: I20151228001789 |
| Provider Name | Wendy S Maclean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801023155 PECOS PAC ID: 1557536687 Enrollment ID: I20151230000585 |
| Provider Name | Richard S Young |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528058161 PECOS PAC ID: 0244255891 Enrollment ID: I20160118000908 |
| Provider Name | Xavier R Packianathan |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1669692059 PECOS PAC ID: 0345327623 Enrollment ID: I20160211002843 |
| Provider Name | Daniel G Hafner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306817366 PECOS PAC ID: 5698728244 Enrollment ID: I20160212002502 |
| Provider Name | Carmelino L Galang |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326070046 PECOS PAC ID: 1254369341 Enrollment ID: I20160218001803 |
| Provider Name | Anthony G Bekkerman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164522819 PECOS PAC ID: 4385643170 Enrollment ID: I20160223002090 |
| Provider Name | Scott R Shay |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1720175847 PECOS PAC ID: 8426008988 Enrollment ID: I20160229001163 |
| Provider Name | Katherine E Kruger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912246174 PECOS PAC ID: 0244457240 Enrollment ID: I20160331001379 |
| Provider Name | Teofila Maria P Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548500291 PECOS PAC ID: 1355648379 Enrollment ID: I20160401001958 |
| Provider Name | Nancy A Lentz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548559149 PECOS PAC ID: 8325360787 Enrollment ID: I20160404001474 |
| Provider Name | Eric M Greenfield |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457558025 PECOS PAC ID: 1355492943 Enrollment ID: I20160502000415 |
| Provider Name | Amber J Vogt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548400682 PECOS PAC ID: 4183750979 Enrollment ID: I20160506000249 |
| Provider Name | Akua Agyeman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831377688 PECOS PAC ID: 0749173474 Enrollment ID: I20160513001962 |
| Provider Name | Daniel Crosby |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851360531 PECOS PAC ID: 0345268884 Enrollment ID: I20160608000803 |
| Provider Name | Ibrahim Khalil Aburiziq |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1134359771 PECOS PAC ID: 3476844234 Enrollment ID: I20160624001857 |
| Provider Name | Najmeh Akhavan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386805356 PECOS PAC ID: 3870761158 Enrollment ID: I20160712000593 |
| Provider Name | Annie U Bordallo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518182187 PECOS PAC ID: 2961499553 Enrollment ID: I20160729000846 |
| Provider Name | Hugo E Koo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588617880 PECOS PAC ID: 0941352249 Enrollment ID: I20160819001645 |
| Provider Name | Kamala Thanapandian |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396984845 PECOS PAC ID: 8022303551 Enrollment ID: I20160823002820 |
| Provider Name | Samir S Ambrale |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1780990382 PECOS PAC ID: 3072815919 Enrollment ID: I20160902001992 |
| Provider Name | Sarah E Baddorf |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588981161 PECOS PAC ID: 5597908970 Enrollment ID: I20160906000743 |
| Provider Name | Gabriel Jed David |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659662542 PECOS PAC ID: 3173757952 Enrollment ID: I20160919000190 |
| Provider Name | Cameron Newell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811252869 PECOS PAC ID: 5698793131 Enrollment ID: I20160921002510 |
| Provider Name | Mariana Lg Cook-huynh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821356247 PECOS PAC ID: 2961720065 Enrollment ID: I20160921002633 |
| Provider Name | Anna B Shapiro |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497044739 PECOS PAC ID: 0345537171 Enrollment ID: I20160922001313 |
| Provider Name | Steven F Hayashida |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1144361239 PECOS PAC ID: 3476575598 Enrollment ID: I20160927000563 |
| Provider Name | Pang Cheng |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346567476 PECOS PAC ID: 2466687249 Enrollment ID: I20160928001200 |
| Provider Name | Shannon Marie Mccrory |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699179531 PECOS PAC ID: 0143546911 Enrollment ID: I20161025002829 |
| Provider Name | Eric G Leveen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487619490 PECOS PAC ID: 5597724708 Enrollment ID: I20161027001514 |
| Provider Name | Bradley J Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366753360 PECOS PAC ID: 1153609920 Enrollment ID: I20161028001662 |
| Provider Name | Michael C Agustin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215248356 PECOS PAC ID: 2163700881 Enrollment ID: I20161101001526 |
| Provider Name | Michele Therese L Yamamoto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083902464 PECOS PAC ID: 3577791565 Enrollment ID: I20161101002413 |
| Provider Name | Nicholas R Villalon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942525332 PECOS PAC ID: 6204063662 Enrollment ID: I20161121001662 |
| Provider Name | Daniel Case |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720124001 PECOS PAC ID: 3870585763 Enrollment ID: I20161201001093 |
| Provider Name | Kathryn M Guffrey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144512252 PECOS PAC ID: 5799906780 Enrollment ID: I20161208002050 |
| Provider Name | Alexander Duncan Wielaard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144438995 PECOS PAC ID: 8325237662 Enrollment ID: I20161213001366 |
| Provider Name | John Y Young |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629120381 PECOS PAC ID: 9133184807 Enrollment ID: I20161213002826 |
| Provider Name | Tiffany Ann Scott |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760613335 PECOS PAC ID: 5991990327 Enrollment ID: I20161215001126 |
| Provider Name | Sangwook Kang |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336537109 PECOS PAC ID: 3779807383 Enrollment ID: I20161228001121 |
| Provider Name | Arturo Talon Santos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205839859 PECOS PAC ID: 0345211660 Enrollment ID: I20161229000658 |
| Provider Name | Gabriel Wardi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720346083 PECOS PAC ID: 7214249754 Enrollment ID: I20161230000546 |
| Provider Name | George G Bocobo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760428221 PECOS PAC ID: 4183653850 Enrollment ID: I20161230000892 |
| Provider Name | Stephen Jory Pomeranz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285639690 PECOS PAC ID: 7618880824 Enrollment ID: I20170113002325 |
| Provider Name | Frankie T Mendiola |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366784647 PECOS PAC ID: 4486871506 Enrollment ID: I20170119001548 |
| Provider Name | Cynthia Evans |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598104564 PECOS PAC ID: 3779887682 Enrollment ID: I20170119001726 |
| Provider Name | Woonjeong K Banks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396996393 PECOS PAC ID: 9638230923 Enrollment ID: I20170120000432 |
| Provider Name | Sarah Haley-wien |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538242292 PECOS PAC ID: 8325144892 Enrollment ID: I20170123002358 |
| Provider Name | Chawat Tongma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780970467 PECOS PAC ID: 2567744725 Enrollment ID: I20170123002929 |
| Provider Name | Brian N Harris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982611950 PECOS PAC ID: 0648252940 Enrollment ID: I20170131001860 |
| Provider Name | Albert P Pesigan |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982064721 PECOS PAC ID: 3274815030 Enrollment ID: I20170202000616 |
| Provider Name | Sheri Foote |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528140621 PECOS PAC ID: 1658371786 Enrollment ID: I20170215001397 |
| Provider Name | Kenneth Tan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306008834 PECOS PAC ID: 1153485438 Enrollment ID: I20170308002673 |
| Provider Name | Jazmin B Refuerzo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114467263 PECOS PAC ID: 5294010674 Enrollment ID: I20170327002212 |
| Provider Name | Steven A Whelpley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104111780 PECOS PAC ID: 0749426328 Enrollment ID: I20170420001573 |
| Provider Name | Jeffrey H Mcdonald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447298716 PECOS PAC ID: 2961435482 Enrollment ID: I20170425000046 |
| Provider Name | Gregory P Burton |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1003884297 PECOS PAC ID: 4981591112 Enrollment ID: I20170505000001 |
| Provider Name | Michael J Torres |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336544006 PECOS PAC ID: 3072820430 Enrollment ID: I20170505000047 |
| Provider Name | Neil G Powell |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1114977477 PECOS PAC ID: 9537244884 Enrollment ID: I20170505001565 |
| Provider Name | Robert C Montana |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649290370 PECOS PAC ID: 1850397282 Enrollment ID: I20170508001185 |
| Provider Name | Martin Fb Springer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447409214 PECOS PAC ID: 5092970442 Enrollment ID: I20170517001930 |
| Provider Name | Robert J Orgill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396017927 PECOS PAC ID: 6002183258 Enrollment ID: I20170522000424 |
| Provider Name | Noel D Silan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1194860676 PECOS PAC ID: 1951398015 Enrollment ID: I20170526000990 |
| Provider Name | William Graf |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568433209 PECOS PAC ID: 6507133303 Enrollment ID: I20170526002045 |
| Provider Name | Amanda River |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538422431 PECOS PAC ID: 2567778186 Enrollment ID: I20170601002620 |
| Provider Name | Langan Robbins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336373307 PECOS PAC ID: 9436397858 Enrollment ID: I20170601002762 |
| Provider Name | Lena M Leishman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487195053 PECOS PAC ID: 2769759125 Enrollment ID: I20170606002594 |
| Provider Name | Daniel A Popa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114276706 PECOS PAC ID: 3577856061 Enrollment ID: I20170609000834 |
| Provider Name | Ji Yeong Kang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790903805 PECOS PAC ID: 6103142781 Enrollment ID: I20170614000925 |
| Provider Name | Nathaniel B Berg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265646806 PECOS PAC ID: 0244129922 Enrollment ID: I20170703001328 |
| Provider Name | Emiliza Cornejo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306387691 PECOS PAC ID: 5193095420 Enrollment ID: I20170719003519 |
| Provider Name | Weerawat Tananusont |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720226202 PECOS PAC ID: 6800065319 Enrollment ID: I20170802002541 |
| Provider Name | Leslie Anne K Chua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063640829 PECOS PAC ID: 2163674896 Enrollment ID: I20170803002426 |
| Provider Name | Sayuri Cheruvu |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1134357213 PECOS PAC ID: 9032356506 Enrollment ID: I20170804002795 |
| Provider Name | Yoshito Okumura |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467740191 PECOS PAC ID: 2062717697 Enrollment ID: I20170807003374 |
| Provider Name | Maria Melinda B Sangalang |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1760497309 PECOS PAC ID: 1850396318 Enrollment ID: I20170808001351 |
| Provider Name | Reza Shams Pirzadeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831419779 PECOS PAC ID: 9032419585 Enrollment ID: I20170823004406 |
| Provider Name | Joseph Wiedermann |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1952334542 PECOS PAC ID: 5092878280 Enrollment ID: I20170824003651 |
| Provider Name | Alejandro R Prieto |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1235191883 PECOS PAC ID: 3072500065 Enrollment ID: I20170824003699 |
| Provider Name | Michelle Mouria |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861648974 PECOS PAC ID: 4486785409 Enrollment ID: I20170828001586 |
| Provider Name | Joel Vanderford |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770787400 PECOS PAC ID: 0345513230 Enrollment ID: I20170828003609 |
| Provider Name | Christian A Eusebio |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457643025 PECOS PAC ID: 3779720685 Enrollment ID: I20170901001411 |
| Provider Name | Raymattie Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235231069 PECOS PAC ID: 3779507553 Enrollment ID: I20170905002893 |
| Provider Name | Surita D Persaud |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427325562 PECOS PAC ID: 2365600772 Enrollment ID: I20170914002543 |
| Provider Name | Hank Curtis Hill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063497097 PECOS PAC ID: 5294794806 Enrollment ID: I20170925002806 |
| Provider Name | Adrian Cora-morges |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568807584 PECOS PAC ID: 7113291337 Enrollment ID: I20170926003362 |
| Provider Name | Alexander S Rackman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255775805 PECOS PAC ID: 1456642800 Enrollment ID: I20171002002831 |
| Provider Name | Mana Dissadee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720390206 PECOS PAC ID: 2466727037 Enrollment ID: I20171006001908 |
| Provider Name | Edward Evans |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083799985 PECOS PAC ID: 7012815046 Enrollment ID: I20171012001003 |
| Provider Name | Timothy Hoon Moon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346654290 PECOS PAC ID: 1153608393 Enrollment ID: I20171012001187 |
| Provider Name | David Joseph Durniak Woska |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518923630 PECOS PAC ID: 1658314109 Enrollment ID: I20171220001984 |
| Provider Name | Shadia Santos Constantine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467610006 PECOS PAC ID: 4789746124 Enrollment ID: I20171226001450 |
| Provider Name | Suwarat Wongjittraporn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619263134 PECOS PAC ID: 6800015231 Enrollment ID: I20180109001845 |
| Provider Name | Ornusa Teerasukjinda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457647760 PECOS PAC ID: 1254550254 Enrollment ID: I20180129001401 |
| Provider Name | Lauren Doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992174122 PECOS PAC ID: 3375823792 Enrollment ID: I20180308002007 |
| Provider Name | Nicole Lp Duenas |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1407356272 PECOS PAC ID: 3577824432 Enrollment ID: I20180309002229 |
| Provider Name | Travis Waller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568705879 PECOS PAC ID: 9830451756 Enrollment ID: I20180313000061 |
| Provider Name | Saurabh Rana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538573068 PECOS PAC ID: 3678846235 Enrollment ID: I20180319002861 |
| Provider Name | Kathleen Jensen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851803845 PECOS PAC ID: 1850653213 Enrollment ID: I20180322001874 |
| Provider Name | Adrian Medina |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669929246 PECOS PAC ID: 8820350820 Enrollment ID: I20180402000664 |
| Provider Name | Raymond James Walsh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306983093 PECOS PAC ID: 6901985860 Enrollment ID: I20180409000501 |
| Provider Name | Eric Russell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215249362 PECOS PAC ID: 9638432453 Enrollment ID: I20180409002388 |
| Provider Name | Kirsten A Blomberg |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1396243366 PECOS PAC ID: 6608139423 Enrollment ID: I20180409002554 |
| Provider Name | Romel Navarro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053389718 PECOS PAC ID: 4284528357 Enrollment ID: I20180416001649 |
| Provider Name | Levi Kitchen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235339383 PECOS PAC ID: 0143467233 Enrollment ID: I20180419002106 |
| Provider Name | Juergen Lang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053471102 PECOS PAC ID: 3375615719 Enrollment ID: I20180420002137 |
| Provider Name | Fil D Barrozo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568406312 PECOS PAC ID: 0749232437 Enrollment ID: I20180424002301 |
| Provider Name | Rene Chalom |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407816481 PECOS PAC ID: 6800874413 Enrollment ID: I20180502001207 |
| Provider Name | Phillip Tutnauer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1346397981 PECOS PAC ID: 3971682550 Enrollment ID: I20180503001773 |
| Provider Name | Dennis Beckworth |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1265460661 PECOS PAC ID: 9335038983 Enrollment ID: I20180601000774 |
| Provider Name | Craig A Settle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417016098 PECOS PAC ID: 4486785474 Enrollment ID: I20180607000727 |
| Provider Name | Jeena Jiyeon Yoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053678581 PECOS PAC ID: 4385999382 Enrollment ID: I20180614002843 |
| Provider Name | Benjamin Lesar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548528003 PECOS PAC ID: 6204123706 Enrollment ID: I20180618000846 |
| Provider Name | Ana Taitano Cruz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184141020 PECOS PAC ID: 4981959590 Enrollment ID: I20180622001959 |
| Provider Name | Sebastian Wright Lara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710240189 PECOS PAC ID: 6103057021 Enrollment ID: I20180703001765 |
| Provider Name | Jose G Hernandez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174677207 PECOS PAC ID: 3476570474 Enrollment ID: I20180703002271 |
| Provider Name | Christopher Adi Tan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912902602 PECOS PAC ID: 2365413853 Enrollment ID: I20180703002921 |
| Provider Name | Vanessa Anne Agpaoa Concina |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336453919 PECOS PAC ID: 7618224775 Enrollment ID: I20180719002816 |
| Provider Name | Dore R Shafransky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750336178 PECOS PAC ID: 4183527336 Enrollment ID: I20180727002786 |
| Provider Name | Cheryll Lueke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528428364 PECOS PAC ID: 1254689664 Enrollment ID: I20180801001829 |
| Provider Name | Verrad Kwasi Owusu Nyame |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1376837476 PECOS PAC ID: 6204126923 Enrollment ID: I20180802003409 |
| Provider Name | Katrina Tan Ibonia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811200124 PECOS PAC ID: 0244588218 Enrollment ID: I20180807004032 |
| Provider Name | Peachy Mae Tadifa Piana-pacheco |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1154617835 PECOS PAC ID: 8921390717 Enrollment ID: I20180820002775 |
| Provider Name | Junriel G Roa |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609267947 PECOS PAC ID: 7517284664 Enrollment ID: I20180823000511 |
| Provider Name | Joseph Boice |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1538471057 PECOS PAC ID: 9638438583 Enrollment ID: I20180823002797 |
| Provider Name | Ana Milena Sanchez Varela |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972765048 PECOS PAC ID: 0547519340 Enrollment ID: I20180827002801 |
| Provider Name | Paul Smith Villaire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124327739 PECOS PAC ID: 5193085678 Enrollment ID: I20180919002574 |
| Provider Name | Carla Torres Haddock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710473996 PECOS PAC ID: 8224380936 Enrollment ID: I20181008003094 |
| Provider Name | Gavin Ford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376772996 PECOS PAC ID: 6507188422 Enrollment ID: I20181009000976 |
| Provider Name | Marianys Delgado Alazo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275062150 PECOS PAC ID: 4082966460 Enrollment ID: I20181012001221 |
| Provider Name | Zachary Pruhs |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1760537641 PECOS PAC ID: 4082865357 Enrollment ID: I20181015001668 |
| Provider Name | David Griffith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194724013 PECOS PAC ID: 6305872656 Enrollment ID: I20181019002200 |
| Provider Name | Joseph H Helm |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184067837 PECOS PAC ID: 5698094043 Enrollment ID: I20181029000260 |
| Provider Name | Scott Allen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912347725 PECOS PAC ID: 7911251905 Enrollment ID: I20181109001027 |
| Provider Name | Richard M Hester |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275595126 PECOS PAC ID: 0446211502 Enrollment ID: I20181117000365 |
| Provider Name | Chad Michael Springer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265751861 PECOS PAC ID: 8628388394 Enrollment ID: I20181119002928 |
| Provider Name | Laura Alfstad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295149151 PECOS PAC ID: 4284951971 Enrollment ID: I20181204002964 |
| Provider Name | Stacy Martin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891748315 PECOS PAC ID: 1557460706 Enrollment ID: I20190115000256 |
| Provider Name | Elliot Mitchell Ross |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427135516 PECOS PAC ID: 8426318759 Enrollment ID: I20190123003809 |
| Provider Name | Richard Slama |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699191635 PECOS PAC ID: 9638416456 Enrollment ID: I20190131001693 |
| Provider Name | Elisabeth Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861977266 PECOS PAC ID: 3375882137 Enrollment ID: I20190222001624 |
| Provider Name | Nat Dumrongmongcolgul |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891082665 PECOS PAC ID: 5092054585 Enrollment ID: I20190227002387 |
| Provider Name | John William Cruz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881086668 PECOS PAC ID: 1850698549 Enrollment ID: I20190228000597 |
| Provider Name | Wasin Ahuja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932584588 PECOS PAC ID: 4587962758 Enrollment ID: I20190311000682 |
| Provider Name | James I Gragg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326426610 PECOS PAC ID: 8527308071 Enrollment ID: I20190319002300 |
| Provider Name | Brandon R Hill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245521350 PECOS PAC ID: 4587883525 Enrollment ID: I20190320001143 |
| Provider Name | Courtney Lomboy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346713187 PECOS PAC ID: 7719227974 Enrollment ID: I20190326000638 |
| Provider Name | Christopher S Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649449653 PECOS PAC ID: 3173670197 Enrollment ID: I20190416003258 |
| Provider Name | Melissa C Helm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598222465 PECOS PAC ID: 4486997483 Enrollment ID: I20190514003237 |
| Provider Name | Lilia Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912475872 PECOS PAC ID: 4587907969 Enrollment ID: I20190529000479 |
| Provider Name | Chen I Huang |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1184720807 PECOS PAC ID: 9335194752 Enrollment ID: I20190530000920 |
| Provider Name | Victoria Kamakea Ballares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245725167 PECOS PAC ID: 8123351152 Enrollment ID: I20190606001768 |
| Provider Name | Curt Ritchey Canine |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932586971 PECOS PAC ID: 4082947932 Enrollment ID: I20190606003053 |
| Provider Name | Sarah E Bumps |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366737405 PECOS PAC ID: 6305179821 Enrollment ID: I20190614000568 |
| Provider Name | Ruth Compton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831484047 PECOS PAC ID: 9133452568 Enrollment ID: I20190617003020 |
| Provider Name | Rebecca Kay Carney Calisch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093906406 PECOS PAC ID: 6901995752 Enrollment ID: I20190625000434 |
| Provider Name | Kanak Naidu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336224799 PECOS PAC ID: 5092983759 Enrollment ID: I20190625003962 |
| Provider Name | Cherry Ann Lopez Alamares |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427613660 PECOS PAC ID: 6800120569 Enrollment ID: I20190701001853 |
| Provider Name | Marina Ng |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265993737 PECOS PAC ID: 8921332479 Enrollment ID: I20190703000247 |
| Provider Name | Lorrance L Majewski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588074678 PECOS PAC ID: 9830467737 Enrollment ID: I20190719001794 |
| Provider Name | Louis H Grass |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114298338 PECOS PAC ID: 2668730326 Enrollment ID: I20190730004354 |
| Provider Name | Lawrence Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841670304 PECOS PAC ID: 3678885506 Enrollment ID: I20190829003099 |
| Provider Name | Paul Freeman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548605694 PECOS PAC ID: 2466769781 Enrollment ID: I20191009000220 |
| Provider Name | Bryan A Zorko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821436775 PECOS PAC ID: 9133418700 Enrollment ID: I20191031002156 |
| Provider Name | Daniel Moges |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700238722 PECOS PAC ID: 1759682354 Enrollment ID: I20191104003062 |
| Provider Name | Stace T Bradshaw |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760472138 PECOS PAC ID: 9335183664 Enrollment ID: I20191115000823 |
| Provider Name | Paul S Llobet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518020502 PECOS PAC ID: 5193826543 Enrollment ID: I20191115001798 |
| Provider Name | Kevin W. Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194957688 PECOS PAC ID: 2466688270 Enrollment ID: I20191115002819 |
| Provider Name | Bradley John Kinney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851662936 PECOS PAC ID: 5496189300 Enrollment ID: I20200101000000 |
| Provider Name | Katherine Biggs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881086502 PECOS PAC ID: 3476988064 Enrollment ID: I20200108000873 |
| Provider Name | Grady Ausbur Fortner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043636202 PECOS PAC ID: 8123351574 Enrollment ID: I20200123000534 |
| Provider Name | Robert Gross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487654240 PECOS PAC ID: 8729083563 Enrollment ID: I20200131002807 |
| Provider Name | Anshu Shukla |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588981518 PECOS PAC ID: 1052621927 Enrollment ID: I20200131002809 |
| Provider Name | Suresh Mukherji |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326129453 PECOS PAC ID: 9335280387 Enrollment ID: I20200201000005 |
| Provider Name | Pamela Caslowitz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285626770 PECOS PAC ID: 1557350220 Enrollment ID: I20200201000007 |
| Provider Name | Sarah Walden Brubaker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831553494 PECOS PAC ID: 5597191932 Enrollment ID: I20200204000956 |
| Provider Name | Emmanuel A Omoba |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346342342 PECOS PAC ID: 7517868938 Enrollment ID: I20200206001092 |
| Provider Name | Andrew Troy Loomis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467724054 PECOS PAC ID: 0345572988 Enrollment ID: I20200221002635 |
| Provider Name | Jay Radhakrishnan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245266972 PECOS PAC ID: 1759378243 Enrollment ID: I20200224002339 |
| Provider Name | John Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376607150 PECOS PAC ID: 3779675525 Enrollment ID: I20200227000793 |
| Provider Name | Holly A Llobet |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1851597785 PECOS PAC ID: 2860562386 Enrollment ID: I20200302002164 |
| Provider Name | Robert Palusinski |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770750044 PECOS PAC ID: 5294902912 Enrollment ID: I20200306001406 |
| Provider Name | Andrew Elliott Blakley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992288989 PECOS PAC ID: 0345678439 Enrollment ID: I20200324002566 |
| Provider Name | Benjamin James Archer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790028561 PECOS PAC ID: 9335578194 Enrollment ID: I20200331001476 |
| Provider Name | Andrew J Mcdonnell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912968025 PECOS PAC ID: 3779557590 Enrollment ID: I20200424000699 |
| Provider Name | Jonne Allen D Mallari |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699305656 PECOS PAC ID: 3870924095 Enrollment ID: I20200504000141 |
| Provider Name | Daniel Le |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588603252 PECOS PAC ID: 5294762670 Enrollment ID: I20200522001198 |
| Provider Name | Jehn Reiko Quililan Mallari |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730709163 PECOS PAC ID: 5991126815 Enrollment ID: I20200602001010 |
| Provider Name | Timothy Mark Riesenberger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689616302 PECOS PAC ID: 2062457047 Enrollment ID: I20200615002582 |
| Provider Name | Matthew S Klocek |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1134462161 PECOS PAC ID: 5395003537 Enrollment ID: I20200624000601 |
| Provider Name | Elizabeth Tan-chiu |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1538113931 PECOS PAC ID: 6709985757 Enrollment ID: I20200629000418 |
| Provider Name | Edison P Manaloto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801327341 PECOS PAC ID: 5496178063 Enrollment ID: I20200715000927 |
| Provider Name | Ria Arlina C. Calata |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760751903 PECOS PAC ID: 8022245232 Enrollment ID: I20200724000142 |
| Provider Name | Nicholas L Bandy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982947784 PECOS PAC ID: 3577792514 Enrollment ID: I20200803001074 |
| Provider Name | Stephen Griffith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902883200 PECOS PAC ID: 0749173110 Enrollment ID: I20200806000349 |
| Provider Name | Hyun Song |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255422606 PECOS PAC ID: 1951394592 Enrollment ID: I20200813001798 |
| Provider Name | Amjad A Safvi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093707457 PECOS PAC ID: 7012809650 Enrollment ID: I20200813003010 |
| Provider Name | Steven P Braff |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558302794 PECOS PAC ID: 4284536582 Enrollment ID: I20200818001338 |
| Provider Name | Jonathon Thorp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720344732 PECOS PAC ID: 4981853736 Enrollment ID: I20200819002692 |
| Provider Name | Harlan G Herr |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1043269699 PECOS PAC ID: 9638081771 Enrollment ID: I20200826003132 |
| Provider Name | Nina N Thai |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356645865 PECOS PAC ID: 8224214481 Enrollment ID: I20200901003570 |
| Provider Name | Lawrence L Williams |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386907129 PECOS PAC ID: 5799917209 Enrollment ID: I20201104002309 |
| Provider Name | Linda Kay Carney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356317929 PECOS PAC ID: 6800848565 Enrollment ID: I20201222002531 |
| Provider Name | Jonathan Kim |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023270774 PECOS PAC ID: 6406025956 Enrollment ID: I20201230000830 |
| Provider Name | Brian D James |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376905570 PECOS PAC ID: 6507159621 Enrollment ID: I20210113002065 |
| Provider Name | Dennis Burton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043298417 PECOS PAC ID: 7416857388 Enrollment ID: I20210114000436 |
| Provider Name | Oleg Odin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1851704076 PECOS PAC ID: 5890080550 Enrollment ID: I20210114001312 |
| Provider Name | Wende Buras |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376500587 PECOS PAC ID: 6204807985 Enrollment ID: I20210116000134 |
| Provider Name | Chi-chan Lee |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1831515865 PECOS PAC ID: 2961754411 Enrollment ID: I20210121002176 |
| Provider Name | Barbara A Hum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699709618 PECOS PAC ID: 6709820376 Enrollment ID: I20210202001060 |
| Provider Name | Tammy M Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861550865 PECOS PAC ID: 0244256196 Enrollment ID: I20210210002679 |
| Provider Name | Warren S Krackov |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689641136 PECOS PAC ID: 0547230476 Enrollment ID: I20210217002429 |
| Provider Name | Kelly Gray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912248477 PECOS PAC ID: 0749531689 Enrollment ID: I20210224001238 |
| Provider Name | Charmaine Gregory |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033156773 PECOS PAC ID: 0345271268 Enrollment ID: I20210224001903 |
| Provider Name | Matthew Chanin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063410868 PECOS PAC ID: 1254335441 Enrollment ID: I20210305000654 |
| Provider Name | Gale Sisney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659330124 PECOS PAC ID: 9931173853 Enrollment ID: I20210308002076 |
| Provider Name | Eric W Spak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053525170 PECOS PAC ID: 8628084027 Enrollment ID: I20210325002790 |
| Provider Name | Susan Gale Dobbs |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467567768 PECOS PAC ID: 2365414802 Enrollment ID: I20210331001096 |
| Provider Name | Patrick Moon |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790198679 PECOS PAC ID: 7315355302 Enrollment ID: I20210412001205 |
| Provider Name | Jon A Buras |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699723957 PECOS PAC ID: 6608854534 Enrollment ID: I20210427002294 |
| Provider Name | Bryan Christopher Bansil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386220531 PECOS PAC ID: 3678982675 Enrollment ID: I20210504000581 |
| Provider Name | Sophana Karnchanasorn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710165303 PECOS PAC ID: 6800933276 Enrollment ID: I20210514002091 |
| Provider Name | Emily Raetz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740630482 PECOS PAC ID: 3779994801 Enrollment ID: I20210526001701 |
| Provider Name | John Stewart Hunt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487004099 PECOS PAC ID: 8022417591 Enrollment ID: I20210603001409 |
| Provider Name | Gary Roark |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922083450 PECOS PAC ID: 5496761884 Enrollment ID: I20210603001936 |
| Provider Name | Taylor M Miles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043665987 PECOS PAC ID: 5890032353 Enrollment ID: I20210615002076 |
| Provider Name | Mariana Vigiola Cruz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104184944 PECOS PAC ID: 4183953672 Enrollment ID: I20210622001147 |
| Provider Name | John Yolwa Walsh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659909422 PECOS PAC ID: 8325463268 Enrollment ID: I20210922003681 |
| Provider Name | Byeori Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659867406 PECOS PAC ID: 5698172823 Enrollment ID: I20210930000950 |
| Provider Name | Matthew Bauer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043730542 PECOS PAC ID: 8921350778 Enrollment ID: I20211001001136 |
| Provider Name | Adele Tse |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740517499 PECOS PAC ID: 3779749692 Enrollment ID: I20211005000370 |
| Provider Name | Duncan Thomas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568948610 PECOS PAC ID: 4486989589 Enrollment ID: I20211007002866 |
| Provider Name | Felipe Grimaldo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609167139 PECOS PAC ID: 8820393341 Enrollment ID: I20211027002739 |
| Provider Name | Carl Tahn |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1508961319 PECOS PAC ID: 0547158941 Enrollment ID: I20211220002563 |
| Provider Name | Gilda Gomez |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1235321753 PECOS PAC ID: 0446337752 Enrollment ID: I20211221000523 |
| Provider Name | Todd Zisholtz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386675809 PECOS PAC ID: 1850391475 Enrollment ID: I20211228002396 |
| Provider Name | Megan Halliday |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801327440 PECOS PAC ID: 5496156200 Enrollment ID: I20220131001521 |
| Provider Name | Jon Kerr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609036094 PECOS PAC ID: 8325219462 Enrollment ID: I20220412001283 |
| Provider Name | Matthew Dybas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326579319 PECOS PAC ID: 5294156352 Enrollment ID: I20220519001263 |
| Provider Name | Allyson Jarvis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891115408 PECOS PAC ID: 1951684505 Enrollment ID: I20220621001744 |
| Provider Name | Dare Adewumi |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1265605091 PECOS PAC ID: 9133347446 Enrollment ID: I20220713000516 |
| Provider Name | Aziz Edward Sabeti |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285366013 PECOS PAC ID: 8527441088 Enrollment ID: I20220816001060 |
| Provider Name | Charles P Pluto |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619173721 PECOS PAC ID: 5395969315 Enrollment ID: I20220817002875 |
| Provider Name | Amy Strowbridge |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1366534653 PECOS PAC ID: 1951403351 Enrollment ID: I20220906003246 |
| Provider Name | Corey Amman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336374529 PECOS PAC ID: 7810149796 Enrollment ID: I20220922000418 |
| Provider Name | Alexander Janson Salazar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265845507 PECOS PAC ID: 7810373040 Enrollment ID: I20220926002065 |
| Provider Name | Kamil Talal Jaber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255714820 PECOS PAC ID: 6406107705 Enrollment ID: I20221004001845 |
| Provider Name | Katherine Marie Kelley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770926131 PECOS PAC ID: 8921308990 Enrollment ID: I20221010001303 |
| Provider Name | Louise Gutierrez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346446275 PECOS PAC ID: 6103011135 Enrollment ID: I20221110000254 |
| Provider Name | Umair Saleem |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548528029 PECOS PAC ID: 3072896018 Enrollment ID: I20221111000392 |
| Provider Name | Stanley Ilchul Kim |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1306940705 PECOS PAC ID: 2163566175 Enrollment ID: I20221122001920 |
| Provider Name | James H Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518491307 PECOS PAC ID: 9638597131 Enrollment ID: I20221229001042 |
| Provider Name | Samer Shuaib |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1720294440 PECOS PAC ID: 3971785965 Enrollment ID: I20221229002392 |
| Provider Name | Jeffrey Biberston |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790109866 PECOS PAC ID: 3173824562 Enrollment ID: I20221230001522 |
| Provider Name | Rada Ivanov |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790782613 PECOS PAC ID: 6709911480 Enrollment ID: I20230103000390 |
| Provider Name | Rachel Libby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487018461 PECOS PAC ID: 8325376759 Enrollment ID: I20230103001651 |
| Provider Name | Allan Xu Zhang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811301021 PECOS PAC ID: 7214350305 Enrollment ID: I20230116000816 |
| Provider Name | Michael J Golden |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952527012 PECOS PAC ID: 9032353313 Enrollment ID: I20230117000664 |
| Provider Name | Santosh N Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841440021 PECOS PAC ID: 2668612342 Enrollment ID: I20230118002432 |
| Provider Name | Andrew D Healey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194141689 PECOS PAC ID: 8123325180 Enrollment ID: I20230125002345 |
| Provider Name | Geneva Lyn Lei |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013628197 PECOS PAC ID: 9234500281 Enrollment ID: I20230130001991 |
| Provider Name | Ari Katerelos |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1861607418 PECOS PAC ID: 2365636099 Enrollment ID: I20230201002560 |
| Provider Name | Moneeb Ehtesham |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1346413929 PECOS PAC ID: 8820302672 Enrollment ID: I20230202000685 |
| Provider Name | Johnathan Hays |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366654162 PECOS PAC ID: 5698825867 Enrollment ID: I20230220001372 |
| Provider Name | Gamaliel Jesse Ferrer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912460734 PECOS PAC ID: 1759616865 Enrollment ID: I20230306000502 |
| Provider Name | Keitaroh Takeda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184076135 PECOS PAC ID: 1951774322 Enrollment ID: I20230306001591 |
| Provider Name | Katharine Liu |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073264495 PECOS PAC ID: 9830582220 Enrollment ID: I20230314002291 |
| Provider Name | Raymond Long |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396055299 PECOS PAC ID: 5193983138 Enrollment ID: I20230315002921 |
| Provider Name | Wei-hsien Hou |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1184986879 PECOS PAC ID: 1850684010 Enrollment ID: I20230321001163 |
| Provider Name | Scott Carmody Dulebohn |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1528009198 PECOS PAC ID: 2668480658 Enrollment ID: I20230406002298 |
| Provider Name | Jirapat Teerakanok |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1174906002 PECOS PAC ID: 5890084420 Enrollment ID: I20230410000852 |
| Provider Name | Xue Ming |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346314507 PECOS PAC ID: 2062600992 Enrollment ID: I20230411001909 |
| Provider Name | Shiela Kaye Crisostomo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710587712 PECOS PAC ID: 2466861760 Enrollment ID: I20230419001929 |
| Provider Name | Honorio Valdes Murua |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558306928 PECOS PAC ID: 7719978741 Enrollment ID: I20230426002621 |
| Provider Name | Nathaniel Loo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861791329 PECOS PAC ID: 3173815651 Enrollment ID: I20230619001670 |
| Provider Name | Gerald K Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013928225 PECOS PAC ID: 6204818271 Enrollment ID: I20230621001661 |
| Provider Name | Naho Hattori |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407380603 PECOS PAC ID: 2567739980 Enrollment ID: I20230622001780 |
| Provider Name | Jose J Fernandez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003894726 PECOS PAC ID: 6800895483 Enrollment ID: I20230705003497 |
| Provider Name | John Reinier Favor Narvaez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396131850 PECOS PAC ID: 7012377658 Enrollment ID: I20230714001291 |
| Provider Name | Michelle Song Healey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215347828 PECOS PAC ID: 0143559559 Enrollment ID: I20230718000521 |
| Provider Name | Bishoy Elbebawy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093176901 PECOS PAC ID: 9931494051 Enrollment ID: I20230731000769 |
| Provider Name | Luc Dupont Jasmin |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1083623193 PECOS PAC ID: 1355360256 Enrollment ID: I20230731000772 |
| Provider Name | Christopher R Tainter |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1962660803 PECOS PAC ID: 3375716731 Enrollment ID: I20230905001357 |
| Provider Name | Jonathan Jaksha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871555649 PECOS PAC ID: 3274632054 Enrollment ID: I20230906002811 |
| Provider Name | Kyle Hirschman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801175401 PECOS PAC ID: 2466686126 Enrollment ID: I20230908001931 |
| Provider Name | William F Ryan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1497715189 PECOS PAC ID: 1951585207 Enrollment ID: I20230921002126 |
| Provider Name | Kathryn Cambron |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396749867 PECOS PAC ID: 8224016530 Enrollment ID: I20230922003261 |
| Provider Name | Timothy Conner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750385357 PECOS PAC ID: 6709784119 Enrollment ID: I20230927003762 |
| Provider Name | Mohammed Quraishi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871545269 PECOS PAC ID: 8123030814 Enrollment ID: I20230927003823 |
| Provider Name | Karen G Phillips |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801992813 PECOS PAC ID: 8729024161 Enrollment ID: I20230928002558 |
| Provider Name | Surendra Pawar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427098797 PECOS PAC ID: 8325011018 Enrollment ID: I20230928002989 |
| Provider Name | Kevin W Marcum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619166675 PECOS PAC ID: 0042480303 Enrollment ID: I20230928003441 |
| Provider Name | Jason E Rogers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366885840 PECOS PAC ID: 4789927260 Enrollment ID: I20230929000797 |
| Provider Name | Colin Thompson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467615252 PECOS PAC ID: 5597982694 Enrollment ID: I20230929002765 |
| Provider Name | Norman M Jacobs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407856214 PECOS PAC ID: 8022917517 Enrollment ID: I20231001000012 |
| Provider Name | Steven Todd Mccormack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023000338 PECOS PAC ID: 4183651987 Enrollment ID: I20231001000040 |
| Provider Name | Stanley R Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003802968 PECOS PAC ID: 4082527205 Enrollment ID: I20231002000393 |
| Provider Name | Shannon L St. Clair |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881030997 PECOS PAC ID: 3678714268 Enrollment ID: I20231002001736 |
| Provider Name | James Day |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558892059 PECOS PAC ID: 5193133155 Enrollment ID: I20231002001964 |
| Provider Name | Jarret Kuo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720228778 PECOS PAC ID: 0446495626 Enrollment ID: I20231002002894 |
| Provider Name | Maheswara Satya Golla |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1154761716 PECOS PAC ID: 9739519455 Enrollment ID: I20231004001470 |
| Provider Name | Aaron Thomas Ranck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972256295 PECOS PAC ID: 0042665473 Enrollment ID: I20231004003895 |
| Provider Name | Sean Feinberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104273549 PECOS PAC ID: 3476952557 Enrollment ID: I20231005000502 |
| Provider Name | Andrew Ciccarelli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407893738 PECOS PAC ID: 9436162302 Enrollment ID: I20231008000188 |
| Provider Name | Jennifer Huckabee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689017345 PECOS PAC ID: 3375885551 Enrollment ID: I20231010002476 |
| Provider Name | Arjun Balakumar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619504115 PECOS PAC ID: 5294180105 Enrollment ID: I20231012003226 |
| Provider Name | Matthew Middendorf |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629305784 PECOS PAC ID: 5698024750 Enrollment ID: I20231020000660 |
| Provider Name | Leslie Rea Kallevang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699238550 PECOS PAC ID: 0345575429 Enrollment ID: I20231023003592 |
| Provider Name | Loretta Settonni |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023011137 PECOS PAC ID: 7214824762 Enrollment ID: I20231024000480 |
| Provider Name | Shawn T Stone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891040689 PECOS PAC ID: 6103103569 Enrollment ID: I20231025002003 |
| Provider Name | Mohsin Iqbal Pasha |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316479926 PECOS PAC ID: 6305247677 Enrollment ID: I20231108002215 |
| Provider Name | Ghassan Samaha |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083063531 PECOS PAC ID: 9830434372 Enrollment ID: I20231113003415 |
| Provider Name | Scott Logan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154321867 PECOS PAC ID: 1355249319 Enrollment ID: I20231120003562 |
| Provider Name | Daniel Douzjian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669834602 PECOS PAC ID: 5294152427 Enrollment ID: I20231129001745 |
| Provider Name | Yuyang Zhang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538304035 PECOS PAC ID: 4880833615 Enrollment ID: I20231212002797 |
| Provider Name | Neil Partain |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053360057 PECOS PAC ID: 2264670215 Enrollment ID: I20231213002005 |
| Provider Name | Marie Lourdes Ynson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881915239 PECOS PAC ID: 1153564075 Enrollment ID: I20231218001316 |
| Provider Name | Praveena Madapathi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205462330 PECOS PAC ID: 2567812365 Enrollment ID: I20231220000310 |
| Provider Name | Theresa Gille |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1063474336 PECOS PAC ID: 7911144019 Enrollment ID: I20231222002594 |
| Provider Name | Linfei Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770236093 PECOS PAC ID: 9638529175 Enrollment ID: I20231227000550 |
| Provider Name | John T Haggerty |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427395326 PECOS PAC ID: 7214301613 Enrollment ID: I20240104001957 |
| Provider Name | Dorry Lynn Gascon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831167170 PECOS PAC ID: 9133108178 Enrollment ID: I20240209001262 |
| Provider Name | Robert Koch |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1972598597 PECOS PAC ID: 4789640475 Enrollment ID: I20240210000744 |
| Provider Name | Adam D Evans |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053748822 PECOS PAC ID: 0446573943 Enrollment ID: I20240319000113 |
| Provider Name | Michael Wilson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568652147 PECOS PAC ID: 3577638204 Enrollment ID: I20240319003399 |
| Provider Name | David Bodne |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316944697 PECOS PAC ID: 6204936206 Enrollment ID: I20240321000824 |
| Provider Name | Anthony Rowe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518120575 PECOS PAC ID: 8921246273 Enrollment ID: I20240327000637 |
| Provider Name | Muneer Janak Desai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376516021 PECOS PAC ID: 4688645591 Enrollment ID: I20240327002287 |
| Provider Name | Peter Britt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023012010 PECOS PAC ID: 1850376096 Enrollment ID: I20240409002622 |
| Provider Name | Steven L Woolley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831189935 PECOS PAC ID: 4082895321 Enrollment ID: I20240409003257 |
| Provider Name | Christopher Martin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891787339 PECOS PAC ID: 0446274161 Enrollment ID: I20240412002020 |
| Provider Name | Zhengran Jiang |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790281178 PECOS PAC ID: 4587026505 Enrollment ID: I20240418001742 |
| Provider Name | Dustin L Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033439492 PECOS PAC ID: 7012104763 Enrollment ID: I20240419003545 |
| Provider Name | Nathan D Bennington |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972777589 PECOS PAC ID: 2668641820 Enrollment ID: I20240423000796 |
| Provider Name | Robert B Roach |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295725398 PECOS PAC ID: 7416140082 Enrollment ID: I20240423001231 |
| Provider Name | Andrew James Medenbach |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033560354 PECOS PAC ID: 8426499492 Enrollment ID: I20240508004084 |
| Provider Name | Axel Rosengart |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629129606 PECOS PAC ID: 2567477359 Enrollment ID: I20240516002202 |
| Provider Name | Mohamad Ghraowi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1942201439 PECOS PAC ID: 1456255751 Enrollment ID: I20240520000157 |
| Provider Name | Michael James Ellett Monson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1275852584 PECOS PAC ID: 3870720535 Enrollment ID: I20240520003015 |
| Provider Name | Kitty Victoria |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1871917633 PECOS PAC ID: 1052682069 Enrollment ID: I20240530004285 |
| Provider Name | Samantha Rachel Scardilli |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1770164857 PECOS PAC ID: 8820439128 Enrollment ID: I20240605002734 |
| Provider Name | Camille Gonzales |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1568216752 PECOS PAC ID: 5799227229 Enrollment ID: I20240611004322 |
| Provider Name | Eric Victor Knight |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1932662574 PECOS PAC ID: 4082156526 Enrollment ID: I20240611004799 |
Harmon Doctors Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2214 Army Drive, Harmon, Dededo, GU 96929 Phone: 671-637-1777 Fax: 671-637-4385 | |
Blue Ocean Medical Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 655 Harmon Loop Rd Ste 108, Dededo, GU 96929 Phone: 671-633-4447 | |
Blue Continent Healthcare Guam Medical City Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 Route 3, Dededo, GU 96929 Phone: 671-645-5500 | |
International Health Providers, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 655 Harmon Loop Rd, Suite 108, Dededo, GU 96929 Phone: 671-929-6214 | |
Northern Region Comm. Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 W Santa Monica Ave, Dededo, GU 96929 Phone: 671-635-7492 Fax: 671-635-7493 | |
Central Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 W Marine Corps Dr, Dededo, GU 96929 Phone: 671-637-8112 Fax: 671-637-8113 |