| Sac Arrowhead | |
|
1293 N D St San Bernardino CA 92405-4734 | |
| (909) 382-7100 | |
| (909) 382-7101 |
| Full Name | Sac Arrowhead |
|---|---|
| Speciality | Clinic/Center |
| Location | 1293 N D St, San Bernardino, California |
| Authorized Official Name and Position | Tasha Amick (DIRECTOR OF BILLING) |
| Authorized Official Contact | 9093827180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sac Arrowhead 1454 E 2nd St San Bernardino CA 92408-0118 Ph: (909) 381-1663 | Sac Arrowhead 1293 N D St San Bernardino CA 92405-4734 Ph: (909) 382-7100 |
| NPI Number | 1013935923 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 12/19/2023 |
| Medicare PECOS PAC ID | 4385533579 |
|---|---|
| Medicare Enrollment ID | O20040315000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013935923 | NPI | - | NPPES |
| ENVOY3000 | Other | CA | ENVOY |
| EAP70708F | Other | CA | EAPC |
| CMM70885F | Medicaid | CA |
| Provider Name | William W Jih |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417985581 PECOS PAC ID: 2567357908 Enrollment ID: I20040216001013 |
| Provider Name | Scott Nelson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790876480 PECOS PAC ID: 3476448747 Enrollment ID: I20040216001264 |
| Provider Name | Allison Hensley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891800538 PECOS PAC ID: 5890680813 Enrollment ID: I20040218000907 |
| Provider Name | David Stephen Benjamin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1407941081 PECOS PAC ID: 6305732959 Enrollment ID: I20040223000452 |
| Provider Name | Sharon Riesen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124041744 PECOS PAC ID: 7416848775 Enrollment ID: I20040324000782 |
| Provider Name | Michelle H L Loh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598788275 PECOS PAC ID: 7113818345 Enrollment ID: I20040324001301 |
| Provider Name | Ramiz Fargo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699705509 PECOS PAC ID: 5193710390 Enrollment ID: I20040416001503 |
| Provider Name | Calvin G Hagglov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023048816 PECOS PAC ID: 0042280687 Enrollment ID: I20040729001280 |
| Provider Name | Wesley Phipatanakul |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1932135654 PECOS PAC ID: 9032184460 Enrollment ID: I20040830000733 |
| Provider Name | David J Michelson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043233737 PECOS PAC ID: 5597730846 Enrollment ID: I20040830000925 |
| Provider Name | Nahla Farghalli |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649358128 PECOS PAC ID: 7810951712 Enrollment ID: I20041118001082 |
| Provider Name | Alfred Simental |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1265464077 PECOS PAC ID: 0042102154 Enrollment ID: I20041221000351 |
| Provider Name | Christopher Church |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1932137171 PECOS PAC ID: 5799735494 Enrollment ID: I20050131000556 |
| Provider Name | Amy Donn Young Snodgrass |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720001217 PECOS PAC ID: 1254384696 Enrollment ID: I20050225000520 |
| Provider Name | Tsungju J O-lee |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1265479745 PECOS PAC ID: 4284670936 Enrollment ID: I20050701000917 |
| Provider Name | Kanwaljeet K Maken |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1902823776 PECOS PAC ID: 4284670902 Enrollment ID: I20050705000451 |
| Provider Name | Richard Eric E.j. Madrid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194774158 PECOS PAC ID: 0244269967 Enrollment ID: I20050811000931 |
| Provider Name | Nancy Fernando |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215029251 PECOS PAC ID: 8426065228 Enrollment ID: I20060320000740 |
| Provider Name | Elizabeth M Dameff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093863912 PECOS PAC ID: 1254340136 Enrollment ID: I20060420000693 |
| Provider Name | Robin D Clark |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902826498 PECOS PAC ID: 6709777006 Enrollment ID: I20060510000241 |
| Provider Name | Michael D Conrad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144335704 PECOS PAC ID: 9739190380 Enrollment ID: I20060510000249 |
| Provider Name | Wendy Lee De La Pena |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407890429 PECOS PAC ID: 8527071083 Enrollment ID: I20060728000385 |
| Provider Name | Lucas Restrepo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750325163 PECOS PAC ID: 9739176462 Enrollment ID: I20060810000258 |
| Provider Name | Siegmund Teichman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1801813597 PECOS PAC ID: 8820095060 Enrollment ID: I20061031000280 |
| Provider Name | Hugo A Leon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114030095 PECOS PAC ID: 3779568944 Enrollment ID: I20070423000499 |
| Provider Name | Sarah M Roddy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942220710 PECOS PAC ID: 8921104480 Enrollment ID: I20070501000169 |
| Provider Name | Bryan Eric Tsao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639115900 PECOS PAC ID: 6305859521 Enrollment ID: I20070605000679 |
| Provider Name | Sergio Infante |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1962611897 PECOS PAC ID: 7911006184 Enrollment ID: I20070628000600 |
| Provider Name | Ramesh C Bansal |
|---|---|
| Provider Type | Practitioner - Adult Congenital Heart Disease (achd) |
| Provider Identifiers | NPI Number: 1508884388 PECOS PAC ID: 3971695636 Enrollment ID: I20070825000150 |
| Provider Name | Justin T Hata |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174713168 PECOS PAC ID: 7911093620 Enrollment ID: I20071010000790 |
| Provider Name | Pradipta Ghosh |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1538219936 PECOS PAC ID: 1850473570 Enrollment ID: I20080201000494 |
| Provider Name | Karina Marianne De Dios Torralba |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1588671176 PECOS PAC ID: 9234139924 Enrollment ID: I20080213000261 |
| Provider Name | Emerald B Caruso |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811015209 PECOS PAC ID: 8628153699 Enrollment ID: I20080314000448 |
| Provider Name | Liset N Stoletniy |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1548295116 PECOS PAC ID: 8820169782 Enrollment ID: I20080619000635 |
| Provider Name | Kenneth Jutzy |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073531802 PECOS PAC ID: 8123917036 Enrollment ID: I20080620000426 |
| Provider Name | Travis E Losey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356530208 PECOS PAC ID: 3870665607 Enrollment ID: I20080710000398 |
| Provider Name | Nirav M Mamdani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427240639 PECOS PAC ID: 0547333189 Enrollment ID: I20080715000917 |
| Provider Name | Francis D Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417970286 PECOS PAC ID: 7719050806 Enrollment ID: I20080723000243 |
| Provider Name | Kimberly N Otsuka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376745018 PECOS PAC ID: 2860569886 Enrollment ID: I20080917000369 |
| Provider Name | Veena A Rao |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1831304021 PECOS PAC ID: 8123129632 Enrollment ID: I20081006000243 |
| Provider Name | Andrew Chang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1396702874 PECOS PAC ID: 5193893675 Enrollment ID: I20081010000645 |
| Provider Name | Kathryn D Roth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851468755 PECOS PAC ID: 4385702554 Enrollment ID: I20081017000240 |
| Provider Name | Gregory S Aaen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780898304 PECOS PAC ID: 1456419407 Enrollment ID: I20081021000428 |
| Provider Name | Amir Abdi Pour |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1912187477 PECOS PAC ID: 8022176569 Enrollment ID: I20081028000077 |
| Provider Name | Christi L Wiley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629231147 PECOS PAC ID: 2163581356 Enrollment ID: I20081103000341 |
| Provider Name | Robert W Watrous |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1013084821 PECOS PAC ID: 2062571920 Enrollment ID: I20081106000456 |
| Provider Name | Drew C Cutler |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1851314629 PECOS PAC ID: 8224198601 Enrollment ID: I20081114000300 |
| Provider Name | Althea P Daniel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619997103 PECOS PAC ID: 6002977758 Enrollment ID: I20081212000518 |
| Provider Name | Kathleen M Lau |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164536702 PECOS PAC ID: 5496816183 Enrollment ID: I20081213000157 |
| Provider Name | Donald E Harlan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295802205 PECOS PAC ID: 1557423100 Enrollment ID: I20081216000650 |
| Provider Name | Kristin A Seiberling |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235283250 PECOS PAC ID: 9638231939 Enrollment ID: I20081220000127 |
| Provider Name | Leland M Okubo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568533453 PECOS PAC ID: 4587726310 Enrollment ID: I20090102000353 |
| Provider Name | Wessam K Labib |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1255543831 PECOS PAC ID: 7012090855 Enrollment ID: I20090106000146 |
| Provider Name | Curt L Bouma |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629145537 PECOS PAC ID: 3375606825 Enrollment ID: I20090110000084 |
| Provider Name | Minh-hang Chau |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912007816 PECOS PAC ID: 0648333013 Enrollment ID: I20090112000097 |
| Provider Name | Stephen Ashwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467475228 PECOS PAC ID: 6204990997 Enrollment ID: I20090124000006 |
| Provider Name | Lauren Simon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033137013 PECOS PAC ID: 7810051547 Enrollment ID: I20090126000202 |
| Provider Name | Micheal Allan Kuhn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659394328 PECOS PAC ID: 2961566302 Enrollment ID: I20090129000130 |
| Provider Name | Sonny C Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609897495 PECOS PAC ID: 5597820209 Enrollment ID: I20090212000540 |
| Provider Name | Pushpa Nowrangi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992725741 PECOS PAC ID: 3375690217 Enrollment ID: I20090413000285 |
| Provider Name | Chad Vercio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912116856 PECOS PAC ID: 9032261219 Enrollment ID: I20090720000029 |
| Provider Name | Sum C Cheung |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770799942 PECOS PAC ID: 4183777048 Enrollment ID: I20090725000095 |
| Provider Name | Danielle M Mason |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982882296 PECOS PAC ID: 0840344222 Enrollment ID: I20090819000693 |
| Provider Name | Jennifer A Dunbar |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1730104944 PECOS PAC ID: 4486709136 Enrollment ID: I20090901000316 |
| Provider Name | Anthony Alan Hilliard |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1841262623 PECOS PAC ID: 9234165812 Enrollment ID: I20090909000231 |
| Provider Name | Herbert C Ruckle |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548360415 PECOS PAC ID: 4486551355 Enrollment ID: I20091113000125 |
| Provider Name | Manoj Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770506321 PECOS PAC ID: 4981743176 Enrollment ID: I20091201000403 |
| Provider Name | Douglas R Hegstad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649204009 PECOS PAC ID: 1759294721 Enrollment ID: I20091203000602 |
| Provider Name | Rita D Sheth |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1003996448 PECOS PAC ID: 1153461348 Enrollment ID: I20091219000042 |
| Provider Name | Montri D Wongworawat |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1235175035 PECOS PAC ID: 8426198235 Enrollment ID: I20091229000278 |
| Provider Name | Alma M Palisoc |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1144277526 PECOS PAC ID: 9638175565 Enrollment ID: I20100507000735 |
| Provider Name | Tamara M Shankel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245322205 PECOS PAC ID: 9032248307 Enrollment ID: I20100525000413 |
| Provider Name | Steve Lee |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1346460474 PECOS PAC ID: 9436227535 Enrollment ID: I20100729000905 |
| Provider Name | Chalmer D Mcclure |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518980200 PECOS PAC ID: 6406989961 Enrollment ID: I20100804000449 |
| Provider Name | Ada K Garcia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619903713 PECOS PAC ID: 2769515261 Enrollment ID: I20100804000883 |
| Provider Name | Alexandra M Clark |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770506545 PECOS PAC ID: 9335272673 Enrollment ID: I20100806000218 |
| Provider Name | Richard S. Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912014341 PECOS PAC ID: 5991820821 Enrollment ID: I20100916000255 |
| Provider Name | Samantha Perea |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1811185051 PECOS PAC ID: 3274607254 Enrollment ID: I20100918000323 |
| Provider Name | Hobart H Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528186509 PECOS PAC ID: 3274685763 Enrollment ID: I20100923000382 |
| Provider Name | Daniel Giang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568492635 PECOS PAC ID: 5092732289 Enrollment ID: I20100923001050 |
| Provider Name | Marti F Baum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760562292 PECOS PAC ID: 7517083454 Enrollment ID: I20100928001028 |
| Provider Name | Timothy T Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326254137 PECOS PAC ID: 8921290156 Enrollment ID: I20101006001091 |
| Provider Name | Cheryl P Sanchez-kazi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1437125440 PECOS PAC ID: 9638220924 Enrollment ID: I20101022001114 |
| Provider Name | Diane Lousie Broome |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649341686 PECOS PAC ID: 6406042373 Enrollment ID: I20101118000612 |
| Provider Name | Paresh C Giri |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1346497245 PECOS PAC ID: 1456534700 Enrollment ID: I20110323000641 |
| Provider Name | Forrest C Jellison |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1508073511 PECOS PAC ID: 8022295799 Enrollment ID: I20110606000533 |
| Provider Name | Peter Leung |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952509861 PECOS PAC ID: 3870762958 Enrollment ID: I20110805000413 |
| Provider Name | Kathleen Lima |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336313139 PECOS PAC ID: 0648449454 Enrollment ID: I20110812000276 |
| Provider Name | Bonnie I Chi Lum |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1467598219 PECOS PAC ID: 2365333531 Enrollment ID: I20110831000226 |
| Provider Name | Matthew Fong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346412244 PECOS PAC ID: 7315117157 Enrollment ID: I20110902000351 |
| Provider Name | Barth B Riedel |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1558574491 PECOS PAC ID: 3870764772 Enrollment ID: I20110926000879 |
| Provider Name | Jennifer Li |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285800839 PECOS PAC ID: 7517139256 Enrollment ID: I20110930000561 |
| Provider Name | Priya Krishna |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1730153172 PECOS PAC ID: 9032194923 Enrollment ID: I20111026000259 |
| Provider Name | Jared Inman |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841468063 PECOS PAC ID: 8325198534 Enrollment ID: I20111031000146 |
| Provider Name | Jeffrey Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841453966 PECOS PAC ID: 6800060070 Enrollment ID: I20111128000478 |
| Provider Name | James Crounse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982897237 PECOS PAC ID: 4981870037 Enrollment ID: I20111220000816 |
| Provider Name | Jane Yun |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124225164 PECOS PAC ID: 4789850710 Enrollment ID: I20111222000128 |
| Provider Name | Antoine E Sakr |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1609058106 PECOS PAC ID: 9234106741 Enrollment ID: I20120126000231 |
| Provider Name | Olumide A Danisa |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467413450 PECOS PAC ID: 0648183871 Enrollment ID: I20120302000346 |
| Provider Name | Kevin Codorniz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1871702316 PECOS PAC ID: 9931360278 Enrollment ID: I20120413000499 |
| Provider Name | Kevin C Shannon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356470314 PECOS PAC ID: 3072544782 Enrollment ID: I20120821000322 |
| Provider Name | Silvana M Giannelli |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1821295247 PECOS PAC ID: 6002064227 Enrollment ID: I20120913000274 |
| Provider Name | Juliana Noel Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265788087 PECOS PAC ID: 0042468092 Enrollment ID: I20120917000232 |
| Provider Name | Ara Matthew Anspikian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396945036 PECOS PAC ID: 3476703067 Enrollment ID: I20121016000673 |
| Provider Name | Serafin Tambaoan Lalas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700050515 PECOS PAC ID: 2264683648 Enrollment ID: I20121112000490 |
| Provider Name | Douglas Long Nguyen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184880114 PECOS PAC ID: 5698811230 Enrollment ID: I20121114000034 |
| Provider Name | Andrea C Salcedo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316274707 PECOS PAC ID: 6406007426 Enrollment ID: I20121121000085 |
| Provider Name | Karen C Shannon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669685079 PECOS PAC ID: 7214013309 Enrollment ID: I20121128000199 |
| Provider Name | Lavonne Meadows |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1578705075 PECOS PAC ID: 5890948624 Enrollment ID: I20130103000438 |
| Provider Name | Vinoy S Prasad |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1558528372 PECOS PAC ID: 2062666894 Enrollment ID: I20130204000180 |
| Provider Name | Firas Bannout |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073750014 PECOS PAC ID: 5698929032 Enrollment ID: I20130212000094 |
| Provider Name | Sinora Shrestha Joshi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912247503 PECOS PAC ID: 8022253913 Enrollment ID: I20130325000429 |
| Provider Name | Justin A Dye |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1629212535 PECOS PAC ID: 9335387000 Enrollment ID: I20130608000064 |
| Provider Name | Mary Adeeb Hanna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386988483 PECOS PAC ID: 8628217890 Enrollment ID: I20130621000512 |
| Provider Name | Khazenay Bakhsh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184940033 PECOS PAC ID: 6709028707 Enrollment ID: I20130803000033 |
| Provider Name | Claudia R Carmona |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982847455 PECOS PAC ID: 3678715547 Enrollment ID: I20130806000861 |
| Provider Name | Ariane Marie-mitchell |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1952408965 PECOS PAC ID: 4587724604 Enrollment ID: I20140306001133 |
| Provider Name | Leon Moses Bathini |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538451588 PECOS PAC ID: 5597994756 Enrollment ID: I20140324001511 |
| Provider Name | Wonha Kim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699948265 PECOS PAC ID: 5395968671 Enrollment ID: I20140514002247 |
| Provider Name | Maria Lohr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225239023 PECOS PAC ID: 8022185271 Enrollment ID: I20140522001822 |
| Provider Name | Anas A Alani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154633709 PECOS PAC ID: 6800019589 Enrollment ID: I20140527001939 |
| Provider Name | Gregory Jutzy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184917353 PECOS PAC ID: 5092930818 Enrollment ID: I20140710000578 |
| Provider Name | Heather R Figueroa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518120625 PECOS PAC ID: 1153572029 Enrollment ID: I20140714000989 |
| Provider Name | Gordon L Tan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659662583 PECOS PAC ID: 1951527118 Enrollment ID: I20140723002268 |
| Provider Name | Van T Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538450382 PECOS PAC ID: 6204052335 Enrollment ID: I20140728000396 |
| Provider Name | Shaun H Park |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780974212 PECOS PAC ID: 4981820644 Enrollment ID: I20140801001373 |
| Provider Name | Andrew M O'neill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588911879 PECOS PAC ID: 2365660065 Enrollment ID: I20140821000803 |
| Provider Name | David J Puder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366762106 PECOS PAC ID: 4688892342 Enrollment ID: I20140821002891 |
| Provider Name | Paul C Walker |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1497916464 PECOS PAC ID: 8527208461 Enrollment ID: I20140828000923 |
| Provider Name | Wing Sze E Yung |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619102845 PECOS PAC ID: 7315168184 Enrollment ID: I20141020001350 |
| Provider Name | Brianna K Crawley |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1093974727 PECOS PAC ID: 1951522507 Enrollment ID: I20141023000572 |
| Provider Name | Daniel Patrick Lamb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437438280 PECOS PAC ID: 0345462446 Enrollment ID: I20141105000116 |
| Provider Name | Mohammad R Amini |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982899704 PECOS PAC ID: 7719174069 Enrollment ID: I20141111002384 |
| Provider Name | Evelyn E Chun |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386936748 PECOS PAC ID: 3779705306 Enrollment ID: I20141113002187 |
| Provider Name | James P Larsen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760403547 PECOS PAC ID: 5799858676 Enrollment ID: I20141118000058 |
| Provider Name | Danish S Siddiqui |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1801835111 PECOS PAC ID: 6305807132 Enrollment ID: I20141226000549 |
| Provider Name | Sanaz Amini |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902182421 PECOS PAC ID: 1153644992 Enrollment ID: I20141230002238 |
| Provider Name | Alex Z Mcdonald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801152756 PECOS PAC ID: 5294059424 Enrollment ID: I20150117000318 |
| Provider Name | Jonnell A Myren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104108307 PECOS PAC ID: 1052638848 Enrollment ID: I20150316000010 |
| Provider Name | Gamil Fteeh |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1053543165 PECOS PAC ID: 8729399043 Enrollment ID: I20150612000841 |
| Provider Name | Mitsuhiko Tsukimoto |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447518964 PECOS PAC ID: 6901118108 Enrollment ID: I20150630002836 |
| Provider Name | Kathryn M Davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598997678 PECOS PAC ID: 4587976782 Enrollment ID: I20150630003138 |
| Provider Name | Philip H Tseng |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528201266 PECOS PAC ID: 8729217591 Enrollment ID: I20150707002259 |
| Provider Name | Andrew W Wai |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598057333 PECOS PAC ID: 5193037943 Enrollment ID: I20150707003099 |
| Provider Name | Laren D Tan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1821230467 PECOS PAC ID: 0749592509 Enrollment ID: I20150707003457 |
| Provider Name | Theresa L Labarte |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073830675 PECOS PAC ID: 6103138961 Enrollment ID: I20150708000008 |
| Provider Name | Thomas P Bravo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952629149 PECOS PAC ID: 9537306758 Enrollment ID: I20150708002494 |
| Provider Name | Daniel Srikureja |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235455270 PECOS PAC ID: 5092027730 Enrollment ID: I20150708002710 |
| Provider Name | Vaneet K Sandhu |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1134362163 PECOS PAC ID: 6507179827 Enrollment ID: I20150715002631 |
| Provider Name | Laura Kai Quaye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902299191 PECOS PAC ID: 6406160480 Enrollment ID: I20150804005837 |
| Provider Name | Joshua David Loeb |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235372517 PECOS PAC ID: 3173837168 Enrollment ID: I20150804006067 |
| Provider Name | Courtney Beth Martin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437440146 PECOS PAC ID: 4284948928 Enrollment ID: I20150807015424 |
| Provider Name | Ann D Curtis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235396284 PECOS PAC ID: 0547575177 Enrollment ID: I20150811006148 |
| Provider Name | Tahmeed A Contractor |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1073778726 PECOS PAC ID: 1254646490 Enrollment ID: I20150817001420 |
| Provider Name | Darcy K Trenkle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114217619 PECOS PAC ID: 9638484769 Enrollment ID: I20150818004996 |
| Provider Name | Leanna Marie Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598056939 PECOS PAC ID: 3476869058 Enrollment ID: I20150827000420 |
| Provider Name | Esther Kim |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1891938817 PECOS PAC ID: 8325354970 Enrollment ID: I20150827002777 |
| Provider Name | Corey Brandon Fuller |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1053637694 PECOS PAC ID: 4385950930 Enrollment ID: I20150827002930 |
| Provider Name | Biswas Joshi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1396079935 PECOS PAC ID: 0840506747 Enrollment ID: I20150908001359 |
| Provider Name | Upinder K Jodhka |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396918629 PECOS PAC ID: 5193033603 Enrollment ID: I20151002001500 |
| Provider Name | Ramachandran Pillai Promod Kumar |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194987263 PECOS PAC ID: 7113166901 Enrollment ID: I20151029002776 |
| Provider Name | Ngozi Ezinwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336467380 PECOS PAC ID: 2365674702 Enrollment ID: I20151102001166 |
| Provider Name | Noel S Thakkar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932584737 PECOS PAC ID: 6103136940 Enrollment ID: I20151109000076 |
| Provider Name | Jason Lohr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548337918 PECOS PAC ID: 1052461761 Enrollment ID: I20151204000806 |
| Provider Name | Ihuoma O Chukwueke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316206436 PECOS PAC ID: 2567764525 Enrollment ID: I20160107001502 |
| Provider Name | Brenda J Boyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003280934 PECOS PAC ID: 2365745643 Enrollment ID: I20160120000994 |
| Provider Name | Brenda L Rea |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1477844017 PECOS PAC ID: 4183925340 Enrollment ID: I20160201002776 |
| Provider Name | Viviana E Partida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275902967 PECOS PAC ID: 9931408978 Enrollment ID: I20160426001747 |
| Provider Name | Warren Warren Boling |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1912007790 PECOS PAC ID: 0547245748 Enrollment ID: I20160503001584 |
| Provider Name | Stephen Quinn Lee |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1932470689 PECOS PAC ID: 6608015318 Enrollment ID: I20160512002190 |
| Provider Name | Maretha S Tyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083008254 PECOS PAC ID: 7517256456 Enrollment ID: I20160517001662 |
| Provider Name | Wilson Glenn Thomas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205272747 PECOS PAC ID: 5799075743 Enrollment ID: I20160602001620 |
| Provider Name | Desiree Rochelle Nycholat |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588001416 PECOS PAC ID: 9436441888 Enrollment ID: I20160706001130 |
| Provider Name | Tanya Minasian |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1609188747 PECOS PAC ID: 2567754682 Enrollment ID: I20160711002261 |
| Provider Name | Talha R Memon |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1922410869 PECOS PAC ID: 7810204773 Enrollment ID: I20160722000624 |
| Provider Name | Miguel Lopez-gonzalez |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1376717496 PECOS PAC ID: 9032365176 Enrollment ID: I20160729001971 |
| Provider Name | Daniel Calaguas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902244460 PECOS PAC ID: 0042504193 Enrollment ID: I20160811002197 |
| Provider Name | Hee Chan Park |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043656416 PECOS PAC ID: 6901191824 Enrollment ID: I20160817000258 |
| Provider Name | Namath Hussain |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1285845404 PECOS PAC ID: 4183865769 Enrollment ID: I20160825001005 |
| Provider Name | Daniel Robert Reichert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215907415 PECOS PAC ID: 1052492758 Enrollment ID: I20160831002316 |
| Provider Name | Jennifer Lo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1407114010 PECOS PAC ID: 3971735523 Enrollment ID: I20160906001686 |
| Provider Name | Aditya Bharadwaj |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1871729822 PECOS PAC ID: 8224324306 Enrollment ID: I20160916000245 |
| Provider Name | Jeffrey Taylor Olson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124386198 PECOS PAC ID: 0547557993 Enrollment ID: I20160928001586 |
| Provider Name | Hang T Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851704605 PECOS PAC ID: 4082902770 Enrollment ID: I20161012002325 |
| Provider Name | Timothy Wendell Winter |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1134353444 PECOS PAC ID: 1759552755 Enrollment ID: I20161118001798 |
| Provider Name | Arthur Edward Thiel |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1164461539 PECOS PAC ID: 4981696614 Enrollment ID: I20161123001236 |
| Provider Name | Melin J Narayan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1710291869 PECOS PAC ID: 1052613486 Enrollment ID: I20161206001565 |
| Provider Name | Sabiha Kanchwala |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972715183 PECOS PAC ID: 2365505658 Enrollment ID: I20161209000169 |
| Provider Name | Matthew J Kaptein |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1184995094 PECOS PAC ID: 8325328941 Enrollment ID: I20161216000940 |
| Provider Name | Young Kim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679861694 PECOS PAC ID: 4385873868 Enrollment ID: I20161220001355 |
| Provider Name | Akshat Jain |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700150885 PECOS PAC ID: 8426339615 Enrollment ID: I20161230000551 |
| Provider Name | Erika J Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801037346 PECOS PAC ID: 4284919143 Enrollment ID: I20170316001526 |
| Provider Name | Carolina R Quiroz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942639711 PECOS PAC ID: 5991082489 Enrollment ID: I20170510002938 |
| Provider Name | Jonathan William Smits |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1447679667 PECOS PAC ID: 2466720677 Enrollment ID: I20170612002491 |
| Provider Name | My Van Nguyen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013329499 PECOS PAC ID: 2567730252 Enrollment ID: I20170621002673 |
| Provider Name | Jayaram Chandrasekar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386986479 PECOS PAC ID: 2163791542 Enrollment ID: I20170627003363 |
| Provider Name | Hana Kazbour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326468166 PECOS PAC ID: 5395014773 Enrollment ID: I20170628000218 |
| Provider Name | Dmitry Abramov |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1649439670 PECOS PAC ID: 7618145194 Enrollment ID: I20170629002742 |
| Provider Name | Shammah Ontario Nehemiah Williams |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134419427 PECOS PAC ID: 2668619263 Enrollment ID: I20170703001176 |
| Provider Name | Richard Robison |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1376783068 PECOS PAC ID: 9537388723 Enrollment ID: I20170703001927 |
| Provider Name | Maged F Melek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154674877 PECOS PAC ID: 6608090394 Enrollment ID: I20170706002567 |
| Provider Name | Purvi J. Parwani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164658951 PECOS PAC ID: 5496050809 Enrollment ID: I20170707000935 |
| Provider Name | Christina Downey |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1558625285 PECOS PAC ID: 3971813247 Enrollment ID: I20170717003439 |
| Provider Name | Eugene Pak |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1407891658 PECOS PAC ID: 9234148420 Enrollment ID: I20170720003274 |
| Provider Name | Janessa Ann James |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205246501 PECOS PAC ID: 0143590208 Enrollment ID: I20170721001921 |
| Provider Name | Priscilla Chee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245599588 PECOS PAC ID: 7618247446 Enrollment ID: I20170726003026 |
| Provider Name | Lorraine Reverson Ray |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295179620 PECOS PAC ID: 3577875830 Enrollment ID: I20170823003405 |
| Provider Name | Matheni Sathananthan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1467698001 PECOS PAC ID: 4688727043 Enrollment ID: I20170830003769 |
| Provider Name | Rahul Bhardwaj |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1730318452 PECOS PAC ID: 0446523096 Enrollment ID: I20170905000647 |
| Provider Name | Niranjan Jeganathan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1578724977 PECOS PAC ID: 0547430720 Enrollment ID: I20170918003344 |
| Provider Name | Gabrielle A. Pina |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285053330 PECOS PAC ID: 8527332147 Enrollment ID: I20170920004115 |
| Provider Name | Lauren Elisabeth Orona |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245642990 PECOS PAC ID: 6901170380 Enrollment ID: I20170923000260 |
| Provider Name | Bryan J Hill |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396061651 PECOS PAC ID: 6406159789 Enrollment ID: I20171009002979 |
| Provider Name | Karen Studer |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1003133786 PECOS PAC ID: 8820304595 Enrollment ID: I20171023001120 |
| Provider Name | Dafne Tatiana Moretta |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1568753986 PECOS PAC ID: 2668619453 Enrollment ID: I20171026003409 |
| Provider Name | Maria L Lasam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881138907 PECOS PAC ID: 4880964378 Enrollment ID: I20171114003317 |
| Provider Name | Sunitha Lena Nune |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1275829533 PECOS PAC ID: 0446539944 Enrollment ID: I20171205002542 |
| Provider Name | Sena Cantas Orsdemir |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1497037915 PECOS PAC ID: 8325266000 Enrollment ID: I20180109003514 |
| Provider Name | Sunil K Jain |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1477750602 PECOS PAC ID: 2163679820 Enrollment ID: I20180119002299 |
| Provider Name | Dionicia Munique Macias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922417385 PECOS PAC ID: 9133489701 Enrollment ID: I20180131001158 |
| Provider Name | Russell L Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659624948 PECOS PAC ID: 8224390380 Enrollment ID: I20180329002126 |
| Provider Name | Timothy Yen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871988907 PECOS PAC ID: 6608130810 Enrollment ID: I20180515002065 |
| Provider Name | Cindy F Sihotang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720466154 PECOS PAC ID: 0446522973 Enrollment ID: I20180517002525 |
| Provider Name | Joshua Geeming Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992182885 PECOS PAC ID: 3971868696 Enrollment ID: I20180530002544 |
| Provider Name | Pharez Dishon Rolle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477964427 PECOS PAC ID: 7911252192 Enrollment ID: I20180611002725 |
| Provider Name | Benjamin D Bradford |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1629336128 PECOS PAC ID: 7719264829 Enrollment ID: I20180615001520 |
| Provider Name | Tiffany Kay D Palomero |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952780215 PECOS PAC ID: 7517212277 Enrollment ID: I20180620002210 |
| Provider Name | Ecler E Jaqua |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1003235235 PECOS PAC ID: 8628357639 Enrollment ID: I20180622002740 |
| Provider Name | Jeffrey Cho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235549429 PECOS PAC ID: 2567765449 Enrollment ID: I20180626001092 |
| Provider Name | Stephanie Cipta Kidd |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1962845602 PECOS PAC ID: 2567718257 Enrollment ID: I20180711001274 |
| Provider Name | Rebecca Lynne Gonzalez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669882189 PECOS PAC ID: 6709132491 Enrollment ID: I20180711001423 |
| Provider Name | Mai-linh Ngoc Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588041859 PECOS PAC ID: 2163701178 Enrollment ID: I20180726003286 |
| Provider Name | Stephen W Yeung |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659663276 PECOS PAC ID: 7517260839 Enrollment ID: I20180820002273 |
| Provider Name | Andrew Byung-min Yoo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215314265 PECOS PAC ID: 5193074904 Enrollment ID: I20180827003205 |
| Provider Name | Rebecca A Rajfer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568720811 PECOS PAC ID: 8123394079 Enrollment ID: I20180831000289 |
| Provider Name | Crystal Nicole Pruitt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215357793 PECOS PAC ID: 9830449453 Enrollment ID: I20180831001555 |
| Provider Name | Baishakhi Choudhury |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1316174733 PECOS PAC ID: 5294058459 Enrollment ID: I20180910002297 |
| Provider Name | Rachel Elizabeth Gelfond Davidge |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013304286 PECOS PAC ID: 8022368927 Enrollment ID: I20180913000862 |
| Provider Name | Tyler Lawrence Ladue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801214861 PECOS PAC ID: 7214152081 Enrollment ID: I20180921001835 |
| Provider Name | Juthamas Kositsawat |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104246016 PECOS PAC ID: 3779835590 Enrollment ID: I20181005001919 |
| Provider Name | Ronald Alan Roiz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528443181 PECOS PAC ID: 2769788033 Enrollment ID: I20181005002065 |
| Provider Name | Mohammad Dastjerdi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508200940 PECOS PAC ID: 7416209929 Enrollment ID: I20181011000803 |
| Provider Name | Pamela Maria Lobo Moreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366824070 PECOS PAC ID: 8921352444 Enrollment ID: I20181119002086 |
| Provider Name | Jennifer Yumi Minami |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205155751 PECOS PAC ID: 2466796230 Enrollment ID: I20181205000717 |
| Provider Name | Janel L Calinisan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336534569 PECOS PAC ID: 2769726298 Enrollment ID: I20181210002524 |
| Provider Name | Krystle Sharna Bekalo Quinlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962977140 PECOS PAC ID: 5799020137 Enrollment ID: I20181213000659 |
| Provider Name | Hua Wang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467890632 PECOS PAC ID: 9032345947 Enrollment ID: I20190212002855 |
| Provider Name | Martha Eufracio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932585007 PECOS PAC ID: 6901145796 Enrollment ID: I20190221001954 |
| Provider Name | Sonia Guilfoos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861763518 PECOS PAC ID: 8729338074 Enrollment ID: I20190311001950 |
| Provider Name | Joel Chapen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588122980 PECOS PAC ID: 7416298419 Enrollment ID: I20190330000005 |
| Provider Name | Peter Bastian |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1710299821 PECOS PAC ID: 7315288818 Enrollment ID: I20190410001855 |
| Provider Name | John Thanasukarn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144674003 PECOS PAC ID: 7810230265 Enrollment ID: I20190528001880 |
| Provider Name | Linda C Njoku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144754763 PECOS PAC ID: 4880927094 Enrollment ID: I20190603002124 |
| Provider Name | Kalyan Ray Parashette |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336316918 PECOS PAC ID: 5799924379 Enrollment ID: I20190612003125 |
| Provider Name | Craig Antone White |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1033597018 PECOS PAC ID: 9638403637 Enrollment ID: I20190625002888 |
| Provider Name | Jennifer Anne Veltman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1356599310 PECOS PAC ID: 6608096680 Enrollment ID: I20190628001488 |
| Provider Name | Tracy Anne Gould |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275989550 PECOS PAC ID: 9234464546 Enrollment ID: I20190709002132 |
| Provider Name | Cori Clumpner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508210568 PECOS PAC ID: 3072848167 Enrollment ID: I20190711001760 |
| Provider Name | Cynthia M Nakoski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649638925 PECOS PAC ID: 4688949894 Enrollment ID: I20190726002097 |
| Provider Name | Sarah Elizabeth Walker |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386054591 PECOS PAC ID: 7810234937 Enrollment ID: I20190815000982 |
| Provider Name | Vikrum Ashok Thimmappa |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1053756452 PECOS PAC ID: 4789912296 Enrollment ID: I20190821004849 |
| Provider Name | Donna Marie Lien |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1528478989 PECOS PAC ID: 6709114010 Enrollment ID: I20190826000036 |
| Provider Name | Howard Wenhung Lan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316206832 PECOS PAC ID: 2466780655 Enrollment ID: I20190826003990 |
| Provider Name | Jennifer Carroll Fuller |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1902149933 PECOS PAC ID: 5991920811 Enrollment ID: I20190903001911 |
| Provider Name | Connie Yue |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1740608199 PECOS PAC ID: 5799015160 Enrollment ID: I20190927000347 |
| Provider Name | Harry Dao |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1568696789 PECOS PAC ID: 5698921641 Enrollment ID: I20190930000935 |
| Provider Name | Mohammad A A Sharif |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1295968733 PECOS PAC ID: 6709003353 Enrollment ID: I20191003003749 |
| Provider Name | Stephanie Laroche Fegale |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558749382 PECOS PAC ID: 1153652714 Enrollment ID: I20191011001722 |
| Provider Name | Eric J Steele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174984066 PECOS PAC ID: 5799074076 Enrollment ID: I20191016003032 |
| Provider Name | Shauna Chi-yee Cheung |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053730192 PECOS PAC ID: 6103181086 Enrollment ID: I20191018001223 |
| Provider Name | Laurin Marine Weisenthal Cristiano |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548674773 PECOS PAC ID: 5597096727 Enrollment ID: I20191018001771 |
| Provider Name | Elizabeth A Park |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760515886 PECOS PAC ID: 2860824976 Enrollment ID: I20191111003082 |
| Provider Name | Sherri English |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710340195 PECOS PAC ID: 5294026514 Enrollment ID: I20191118001875 |
| Provider Name | Jamie L Snyder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730294356 PECOS PAC ID: 4284827551 Enrollment ID: I20191125002932 |
| Provider Name | Nickolas Lloyd Lind |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689864340 PECOS PAC ID: 5890120257 Enrollment ID: I20200114001059 |
| Provider Name | Joshua J Masih |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407494750 PECOS PAC ID: 0446686067 Enrollment ID: I20200130000662 |
| Provider Name | Alma R Vazquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275167926 PECOS PAC ID: 4183053713 Enrollment ID: I20200402003419 |
| Provider Name | Maleeha Ahmad |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1538535612 PECOS PAC ID: 8123336369 Enrollment ID: I20200406001837 |
| Provider Name | Antoin Douglawi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1215317847 PECOS PAC ID: 4880905215 Enrollment ID: I20200511001669 |
| Provider Name | Vallent Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730612821 PECOS PAC ID: 0749601078 Enrollment ID: I20200522000188 |
| Provider Name | Cherine Heesun Kim |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1578943189 PECOS PAC ID: 7719309988 Enrollment ID: I20200616001423 |
| Provider Name | Kelly Alyssa Jeu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497288724 PECOS PAC ID: 2961824107 Enrollment ID: I20200617001201 |
| Provider Name | Peter Demuth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831622034 PECOS PAC ID: 5193147726 Enrollment ID: I20200626001113 |
| Provider Name | Charles Casassa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316328677 PECOS PAC ID: 8426470055 Enrollment ID: I20200626001265 |
| Provider Name | Mallory Cohen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306263587 PECOS PAC ID: 7911200522 Enrollment ID: I20200629001758 |
| Provider Name | Nancy Baker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194085860 PECOS PAC ID: 6204075724 Enrollment ID: I20200630002007 |
| Provider Name | Jodiann T Ledford |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881910149 PECOS PAC ID: 3870810047 Enrollment ID: I20200709000659 |
| Provider Name | Yuan Fang Liu |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1962845834 PECOS PAC ID: 4880938612 Enrollment ID: I20200709002646 |
| Provider Name | Khanh Kim Nguyen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1093134173 PECOS PAC ID: 1355676115 Enrollment ID: I20200713000752 |
| Provider Name | Ahmed L Seliem |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1104187368 PECOS PAC ID: 3971813858 Enrollment ID: I20200714001427 |
| Provider Name | Kristin Carr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750768362 PECOS PAC ID: 7517218399 Enrollment ID: I20200723000302 |
| Provider Name | Dheeraj Yalamanchili |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1366965345 PECOS PAC ID: 3375967227 Enrollment ID: I20200723003690 |
| Provider Name | Michael Andaya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548790926 PECOS PAC ID: 1456775345 Enrollment ID: I20200724001500 |
| Provider Name | Abdalhamid F Al Harash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962790618 PECOS PAC ID: 4789809120 Enrollment ID: I20200724001798 |
| Provider Name | Negar Hosseinifar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982059366 PECOS PAC ID: 9032534417 Enrollment ID: I20200731002361 |
| Provider Name | Ashley N Elsensohn |
|---|---|
| Provider Type | Practitioner - Micrographic Dermatologic Surgery (mds) |
| Provider Identifiers | NPI Number: 1467847905 PECOS PAC ID: 4284907791 Enrollment ID: I20200810000129 |
| Provider Name | Lakshmi Lakshmanan Ganesan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1821356288 PECOS PAC ID: 6800212523 Enrollment ID: I20200812001757 |
| Provider Name | Sisi Tian |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1447510854 PECOS PAC ID: 4880963222 Enrollment ID: I20200902000392 |
| Provider Name | Giv Heidari Bateni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265847214 PECOS PAC ID: 3476859539 Enrollment ID: I20200922002636 |
| Provider Name | Sayna Norouzi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1649666041 PECOS PAC ID: 4385947399 Enrollment ID: I20200928001106 |
| Provider Name | Kelsey L Cherepuschak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043690910 PECOS PAC ID: 5193145068 Enrollment ID: I20201014001863 |
| Provider Name | Alpha Shanika Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801425145 PECOS PAC ID: 2961812300 Enrollment ID: I20201113000971 |
| Provider Name | Adley Chris Dason |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1609224369 PECOS PAC ID: 8224449889 Enrollment ID: I20201203000473 |
| Provider Name | Starla N Lyles-mckelvy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023303922 PECOS PAC ID: 2961815527 Enrollment ID: I20201229000915 |
| Provider Name | Robin Ruth Hrdina Schoen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164953162 PECOS PAC ID: 8426461583 Enrollment ID: I20210108001784 |
| Provider Name | Diane Ducthihuc Tran |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1962665786 PECOS PAC ID: 9739470873 Enrollment ID: I20210525001418 |
| Provider Name | Robert Chi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073040481 PECOS PAC ID: 3870992720 Enrollment ID: I20210525002593 |
| Provider Name | Hector Miguel Almanzar-ramos |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326544958 PECOS PAC ID: 6204235922 Enrollment ID: I20210601001253 |
| Provider Name | Eric Tsongshien Tsay |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1275911364 PECOS PAC ID: 8224437850 Enrollment ID: I20210601001913 |
| Provider Name | Stephanie Gondra-sanabria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114423266 PECOS PAC ID: 3870992316 Enrollment ID: I20210603000372 |
| Provider Name | Derek Jamal Mccalla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417484437 PECOS PAC ID: 3072912468 Enrollment ID: I20210604002858 |
| Provider Name | Gautam Nagendra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265827802 PECOS PAC ID: 3173923463 Enrollment ID: I20210608001217 |
| Provider Name | Allyssa Dann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508356304 PECOS PAC ID: 5991105629 Enrollment ID: I20210616002701 |
| Provider Name | Kwame Boateng Agyeman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821521527 PECOS PAC ID: 9931509569 Enrollment ID: I20210617002970 |
| Provider Name | Pedro Alvarez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043717218 PECOS PAC ID: 7113328899 Enrollment ID: I20210701002449 |
| Provider Name | Stacey K Bernardo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821594086 PECOS PAC ID: 5597168666 Enrollment ID: I20210727002412 |
| Provider Name | Jaspal Singh Hothi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1750510293 PECOS PAC ID: 7214220581 Enrollment ID: I20210802001689 |
| Provider Name | Daniel Kenneth Joe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760917835 PECOS PAC ID: 6709280423 Enrollment ID: I20210803001687 |
| Provider Name | Patrick E Phelan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083771398 PECOS PAC ID: 5597809400 Enrollment ID: I20210810002816 |
| Provider Name | Jason Chen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407241375 PECOS PAC ID: 9335458629 Enrollment ID: I20210811001527 |
| Provider Name | Vincent-arthur Aruiza Yoro-bacay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336412063 PECOS PAC ID: 5799189882 Enrollment ID: I20210811003800 |
| Provider Name | Ronica Rajesh Yalamanchili |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1124474382 PECOS PAC ID: 2567737265 Enrollment ID: I20210812002319 |
| Provider Name | Christine Elizabeth Hermann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861998122 PECOS PAC ID: 1456756246 Enrollment ID: I20210817001220 |
| Provider Name | Brian Andrew Schneiderman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134504368 PECOS PAC ID: 6406276500 Enrollment ID: I20210817002929 |
| Provider Name | Jessica Marie White |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356636450 PECOS PAC ID: 9739584434 Enrollment ID: I20210818002105 |
| Provider Name | Rodolfo Silva |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1396177127 PECOS PAC ID: 2769887710 Enrollment ID: I20210830000708 |
| Provider Name | Judith Haejin Oh Leonor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437511516 PECOS PAC ID: 9638576531 Enrollment ID: I20210920002292 |
| Provider Name | Jessica Villarreal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760864847 PECOS PAC ID: 9537566450 Enrollment ID: I20210920003242 |
| Provider Name | Heather W E Latham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548691736 PECOS PAC ID: 5890915961 Enrollment ID: I20210921003728 |
| Provider Name | Nadiya Shalin Thomas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316618218 PECOS PAC ID: 8628476462 Enrollment ID: I20211008002799 |
| Provider Name | Nour Alhoda Parsa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053725366 PECOS PAC ID: 9739426834 Enrollment ID: I20211201001764 |
| Provider Name | Ronela Kimberly Moldovan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780356295 PECOS PAC ID: 5890185615 Enrollment ID: I20211209000164 |
| Provider Name | Mitchell Jon Hrdina Schoen |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1659802767 PECOS PAC ID: 2860882628 Enrollment ID: I20211209002020 |
| Provider Name | Eugene Wei-kang Liu |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700049376 PECOS PAC ID: 5395092282 Enrollment ID: I20211229000644 |
| Provider Name | Anne Oh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245737071 PECOS PAC ID: 9133511512 Enrollment ID: I20220114000887 |
| Provider Name | Ali Mahdavi Fard |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1346737178 PECOS PAC ID: 3173861655 Enrollment ID: I20220511001796 |
| Provider Name | Tania Arous |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114468360 PECOS PAC ID: 6103204565 Enrollment ID: I20220526000971 |
| Provider Name | Sandra Qaseem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629083191 PECOS PAC ID: 8325099393 Enrollment ID: I20220607002761 |
| Provider Name | Carvy Floyd Oabel Luceno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245895945 PECOS PAC ID: 3476932633 Enrollment ID: I20220617000718 |
| Provider Name | Bianca Rebolledo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396277703 PECOS PAC ID: 6305225095 Enrollment ID: I20220627002903 |
| Provider Name | Tyler Cottrell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295269702 PECOS PAC ID: 2769862689 Enrollment ID: I20220708001684 |
| Provider Name | Brittany Nicole Chow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043874647 PECOS PAC ID: 2466832332 Enrollment ID: I20220708003293 |
| Provider Name | Meljorie-eleonore Castillon Launio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003300450 PECOS PAC ID: 5294116653 Enrollment ID: I20220715001441 |
| Provider Name | Afzal Mohammad Sheikh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538612403 PECOS PAC ID: 7517297880 Enrollment ID: I20220715001947 |
| Provider Name | Josianne Bailey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033772546 PECOS PAC ID: 1557742814 Enrollment ID: I20220718001923 |
| Provider Name | Diem Kieu Thi Tran |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1790168987 PECOS PAC ID: 8123327251 Enrollment ID: I20220725000750 |
| Provider Name | Martin Hofmann |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1831586783 PECOS PAC ID: 9739452343 Enrollment ID: I20220804001370 |
| Provider Name | Tarek El Ahmadieh |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1487066098 PECOS PAC ID: 1355724212 Enrollment ID: I20220810002920 |
| Provider Name | Nolan D Wangsnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861019564 PECOS PAC ID: 7416330261 Enrollment ID: I20220811002799 |
| Provider Name | Sunny Bang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225692874 PECOS PAC ID: 0749663474 Enrollment ID: I20220812002953 |
| Provider Name | Joseph D Peterson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1467800276 PECOS PAC ID: 7618260837 Enrollment ID: I20220815003122 |
| Provider Name | Samira Monavvari |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023515004 PECOS PAC ID: 6103200183 Enrollment ID: I20220825002826 |
| Provider Name | John D King |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1306228010 PECOS PAC ID: 3678867561 Enrollment ID: I20220907002691 |
| Provider Name | Heather Gillespie |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1346380748 PECOS PAC ID: 3971609736 Enrollment ID: I20220913000004 |
| Provider Name | Alvaro Galvis |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417344631 PECOS PAC ID: 9537474812 Enrollment ID: I20220914000887 |
| Provider Name | Belliny Meljean Phaeton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699265629 PECOS PAC ID: 4587040654 Enrollment ID: I20220928000562 |
| Provider Name | Montserrat Montesinos De Perez Milicua |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497281380 PECOS PAC ID: 0941686828 Enrollment ID: I20220929002101 |
| Provider Name | Dante Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134788862 PECOS PAC ID: 5294102406 Enrollment ID: I20221101000852 |
| Provider Name | Laura Elena Istrate |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538693262 PECOS PAC ID: 1658741996 Enrollment ID: I20230103002462 |
| Provider Name | Amanda Deanne Tenefrancia Lim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508390204 PECOS PAC ID: 6002280757 Enrollment ID: I20230320001046 |
| Provider Name | Nytasha Ad Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467927350 PECOS PAC ID: 8527430784 Enrollment ID: I20230427003025 |
| Provider Name | Irving E Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164117917 PECOS PAC ID: 3072979459 Enrollment ID: I20230510002576 |
| Provider Name | Hamza Durrani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093195315 PECOS PAC ID: 4183934763 Enrollment ID: I20230517003456 |
| Provider Name | Jazmin Cole |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871974006 PECOS PAC ID: 3779908165 Enrollment ID: I20230523002784 |
| Provider Name | Jay Kenneth Mattheis |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1154311058 PECOS PAC ID: 6608975693 Enrollment ID: I20230526002305 |
| Provider Name | Eun Jee Lee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497381354 PECOS PAC ID: 6406213982 Enrollment ID: I20230530001111 |
| Provider Name | Patrick Kane Zacharias |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215564034 PECOS PAC ID: 0345607370 Enrollment ID: I20230607001672 |
| Provider Name | Michael Kyungjin Min |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205462108 PECOS PAC ID: 8729445556 Enrollment ID: I20230608002809 |
| Provider Name | Luke Edgson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518585280 PECOS PAC ID: 1850758541 Enrollment ID: I20230612002521 |
| Provider Name | Brian Huy Nguyen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063975340 PECOS PAC ID: 7012375090 Enrollment ID: I20230623000336 |
| Provider Name | Marc Nelson Starkey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477118479 PECOS PAC ID: 3072971993 Enrollment ID: I20230623002416 |
| Provider Name | Ariana Emily Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962997908 PECOS PAC ID: 2961860663 Enrollment ID: I20230627002326 |
| Provider Name | Claire Alexandra Guevara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639559461 PECOS PAC ID: 3971814310 Enrollment ID: I20230706001103 |
| Provider Name | Kristofer John Vance |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124643135 PECOS PAC ID: 3577923044 Enrollment ID: I20230714003192 |
| Provider Name | Trisha Pandey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881214187 PECOS PAC ID: 1658731005 Enrollment ID: I20230717001632 |
| Provider Name | Tanya N Gentry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881197200 PECOS PAC ID: 3476913831 Enrollment ID: I20230717002115 |
| Provider Name | Katharine A Fabro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992356984 PECOS PAC ID: 5193187680 Enrollment ID: I20230815004023 |
| Provider Name | Kristy Valencia |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477255685 PECOS PAC ID: 0547622060 Enrollment ID: I20230816000984 |
| Provider Name | Stephen John Graber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922635143 PECOS PAC ID: 4082077599 Enrollment ID: I20230831001930 |
| Provider Name | Caleb Raymond Ga-jun Ho-a-shoo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205369345 PECOS PAC ID: 0547623738 Enrollment ID: I20230906001960 |
| Provider Name | Michael J Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447329883 PECOS PAC ID: 2365425501 Enrollment ID: I20230908000942 |
| Provider Name | Nadine Grace-abraham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770112781 PECOS PAC ID: 1456715457 Enrollment ID: I20230908002775 |
| Provider Name | Midian L Ambo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598323370 PECOS PAC ID: 9436503364 Enrollment ID: I20230927000840 |
| Provider Name | Benjamin Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396236527 PECOS PAC ID: 2163771601 Enrollment ID: I20231002001593 |
| Provider Name | Hector Carrillo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609587831 PECOS PAC ID: 9931579604 Enrollment ID: I20231004003125 |
| Provider Name | Breanna Tran |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598497570 PECOS PAC ID: 6901282433 Enrollment ID: I20231005001654 |
| Provider Name | Andrew Walter Platt |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1518348036 PECOS PAC ID: 5991009664 Enrollment ID: I20231005002128 |
| Provider Name | Heather R Ferguson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144849175 PECOS PAC ID: 4688020597 Enrollment ID: I20231030001634 |
| Provider Name | Amber L Romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265063416 PECOS PAC ID: 5597113365 Enrollment ID: I20231205000949 |
| Provider Name | Aaron Winter |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871146977 PECOS PAC ID: 7012349905 Enrollment ID: I20240103004512 |
| Provider Name | Jeffrey T Gardner |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1366901324 PECOS PAC ID: 8426388455 Enrollment ID: I20240110002890 |
| Provider Name | Elizabeth Y Ramos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578915807 PECOS PAC ID: 5597100248 Enrollment ID: I20240304002771 |
| Provider Name | Silvia C Caswell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114585148 PECOS PAC ID: 6204271810 Enrollment ID: I20240305001081 |
| Provider Name | Shannon R Kelleher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366881039 PECOS PAC ID: 3678919180 Enrollment ID: I20240306004162 |
| Provider Name | Lorraine M Otero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740723592 PECOS PAC ID: 6103263462 Enrollment ID: I20240321003002 |
| Provider Name | Reynaldo M Gamo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740873652 PECOS PAC ID: 4082051354 Enrollment ID: I20240321003194 |
Shuang Bai, M.d. Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 399 E Highland Ave Ste 502, San Bernardino, CA 92404 Phone: 909-883-3838 Fax: 909-792-5531 | |
Melody Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1873 Commerce Center West, San Bernardino, CA 92408 Phone: 909-890-5511 Fax: 909-890-4599 | |
Sac Norton Community Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1454 E 2nd St, San Bernardino, CA 92408 Phone: 909-382-7100 Fax: 909-382-7136 | |
Dewar Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 399 E Highland Ave Ste 124, San Bernardino, CA 92404 Phone: 909-886-6576 Fax: 909-882-1299 | |
Pliev Management Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 N Arrowhead Ave, San Bernardino, CA 92401 Phone: 909-424-0065 | |
Healthy Preferred Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 475 S Arrowhead Ave, Ste D, San Bernardino, CA 92408 Phone: 909-553-6143 |