| Pine Park Health, Inc | |
|
1144 65th St Ste F Oakland CA 94608-1053 | |
| (510) 929-1400 | |
| (510) 929-1414 |
| Full Name | Pine Park Health, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1144 65th St Ste F, Oakland, California |
| Authorized Official Name and Position | Stephanie Vanzee (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 4694018820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Park Health, Inc Po Box 511250 Los Angeles CA 90051-7805 Ph: (510) 929-1400 | Pine Park Health, Inc 1144 65th St Ste F Oakland CA 94608-1053 Ph: (510) 929-1400 |
| NPI Number | 1346879848 |
|---|---|
| Provider Enumeration Date | 04/06/2020 |
| Last Update Date | 09/07/2023 |
| Medicare PECOS PAC ID | 0345670527 |
|---|---|
| Medicare Enrollment ID | O20200501001068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346879848 | NPI | - | NPPES |
| Provider Name | Denise A Yun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770655508 PECOS PAC ID: 6406888999 Enrollment ID: I20050906000724 |
| Provider Name | Melissa B Vourlitis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235236977 PECOS PAC ID: 4587686852 Enrollment ID: I20051229000756 |
| Provider Name | Carol Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063783066 PECOS PAC ID: 1759681679 Enrollment ID: I20151125001987 |
| Provider Name | Edward Robert Teare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871832287 PECOS PAC ID: 8426294844 Enrollment ID: I20160215000320 |
| Provider Name | Stephanie L Bedolla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265717565 PECOS PAC ID: 2466613153 Enrollment ID: I20160404002223 |
| Provider Name | Michael Feinberg |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841682036 PECOS PAC ID: 8628350501 Enrollment ID: I20170130001584 |
| Provider Name | Kari R Cedillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386989630 PECOS PAC ID: 8123244845 Enrollment ID: I20170502002134 |
| Provider Name | Kendell Michelle Cannon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194016600 PECOS PAC ID: 9234361163 Enrollment ID: I20171018001197 |
| Provider Name | Michael David Genualdi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124482823 PECOS PAC ID: 0143648790 Enrollment ID: I20200914001181 |
| Provider Name | Amanda Nicole Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871199547 PECOS PAC ID: 5698189546 Enrollment ID: I20210210003048 |
| Provider Name | Erin Kathleen Alicia O'hair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710259361 PECOS PAC ID: 3971802919 Enrollment ID: I20210329001089 |
| Provider Name | Roland Pua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215009782 PECOS PAC ID: 2961403035 Enrollment ID: I20220107000433 |
| Provider Name | Harpreet Kaur Bal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760035976 PECOS PAC ID: 7214314418 Enrollment ID: I20220509001851 |
| Provider Name | Rebeccah Tovar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285384321 PECOS PAC ID: 6305223389 Enrollment ID: I20220512001238 |
| Provider Name | Brianna Weller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801542071 PECOS PAC ID: 6204216195 Enrollment ID: I20220709000197 |
| Provider Name | Gary Richmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992469159 PECOS PAC ID: 0143691527 Enrollment ID: I20230123000775 |
| Provider Name | Natalia Terreros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699255653 PECOS PAC ID: 1557609765 Enrollment ID: I20230308002465 |
| Provider Name | Sara Gopsill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831717982 PECOS PAC ID: 4880019561 Enrollment ID: I20230412002923 |
| Provider Name | Shiying Huang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154035095 PECOS PAC ID: 1850757030 Enrollment ID: I20230512001282 |
| Provider Name | Ashton Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053814681 PECOS PAC ID: 2961863931 Enrollment ID: I20230807003528 |
| Provider Name | Connie Choi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598228389 PECOS PAC ID: 5395109458 Enrollment ID: I20230908000745 |
| Provider Name | Hannah Cifuentes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245015601 PECOS PAC ID: 8628422508 Enrollment ID: I20230926002924 |
| Provider Name | Richard Rosen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003813700 PECOS PAC ID: 4688652894 Enrollment ID: I20231206004120 |
| Provider Name | Laura Christine Eichinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801662168 PECOS PAC ID: 8820448913 Enrollment ID: I20240102003250 |
| Provider Name | Barbara Gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154304814 PECOS PAC ID: 8628378080 Enrollment ID: I20240124001978 |
| Provider Name | Jessica Muthoni Ndiritu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205507142 PECOS PAC ID: 9931549276 Enrollment ID: I20240502003632 |
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Clinica La Luna Y El Sol Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4333 Piedmont Ave, Oakland, CA 94611 Phone: 510-594-7400 Fax: 510-594-7402 | |
Treble Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 490 43rd St Unit 106, Oakland, CA 94609 Phone: 800-865-3142 | |
Randall Healthcare Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 350 30th St, #100, Oakland, CA 94609 Phone: 510-342-2239 Fax: 510-380-7143 |