| Ucla Family Health Center | |
|
1920 Colorado Ave Santa Monica CA 90404-3414 | |
| (310) 319-4700 | |
| (310) 301-8751 |
| Full Name | Ucla Family Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1920 Colorado Ave, Santa Monica, California |
| Authorized Official Name and Position | Katherine Ann Hale (DIRECTOR OF ACCOUNTING) |
| Authorized Official Contact | 3103015311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ucla Family Health Center 5767 W Century Blvd Suite 400 Los Angeles CA 90045-5631 Ph: (310) 301-8713 | Ucla Family Health Center 1920 Colorado Ave Santa Monica CA 90404-3414 Ph: (310) 319-4700 |
| NPI Number | 1275591802 |
|---|---|
| Provider Enumeration Date | 05/03/2006 |
| Last Update Date | 03/26/2024 |
| Medicare PECOS PAC ID | 9739083866 |
|---|---|
| Medicare Enrollment ID | O20031120000978 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275591802 | NPI | - | NPPES |
| ZZZP1939Z | Medicaid | CA | |
| GR005503G | Medicaid | CA |
| Provider Name | James P Murray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659307452 PECOS PAC ID: 9537063664 Enrollment ID: I20031120000994 |
| Provider Name | Anne M Arikian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144321522 PECOS PAC ID: 7214839901 Enrollment ID: I20040122001248 |
| Provider Name | David J Wallenstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962417386 PECOS PAC ID: 9537151378 Enrollment ID: I20040331001726 |
| Provider Name | Lynn Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164445532 PECOS PAC ID: 6103807318 Enrollment ID: I20040525000825 |
| Provider Name | Bernard J Katz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750317772 PECOS PAC ID: 5496728735 Enrollment ID: I20040816000884 |
| Provider Name | Lillian Gelberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639192487 PECOS PAC ID: 6901870054 Enrollment ID: I20040824000637 |
| Provider Name | Denise K C Sur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326062134 PECOS PAC ID: 7618993163 Enrollment ID: I20051024000527 |
| Provider Name | Michelle Bholat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104849959 PECOS PAC ID: 1850318296 Enrollment ID: I20051025001094 |
| Provider Name | Nancy Tyre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366465734 PECOS PAC ID: 1850319740 Enrollment ID: I20051109000615 |
| Provider Name | Marissa Vasquez Machuca |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1275549636 PECOS PAC ID: 0941217962 Enrollment ID: I20060316000348 |
| Provider Name | Martin A Quan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285658377 PECOS PAC ID: 1456454040 Enrollment ID: I20070320000559 |
| Provider Name | Stephanie L Canale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619199791 PECOS PAC ID: 4981703949 Enrollment ID: I20070616000065 |
| Provider Name | Gerardo Moreno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689706327 PECOS PAC ID: 6305907619 Enrollment ID: I20081204000913 |
| Provider Name | Ravi Harshad Dave |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871519934 PECOS PAC ID: 1658435243 Enrollment ID: I20090126000750 |
| Provider Name | Daniel T Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386668465 PECOS PAC ID: 0244389609 Enrollment ID: I20090514000467 |
| Provider Name | Derjung Tarn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235153040 PECOS PAC ID: 6608927421 Enrollment ID: I20090707000528 |
| Provider Name | Steven J Shoptaw |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1013245950 PECOS PAC ID: 5294860482 Enrollment ID: I20100312000535 |
| Provider Name | Daniel V Vigil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184795155 PECOS PAC ID: 5092846881 Enrollment ID: I20100622000796 |
| Provider Name | Aurelia Nattiv |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659394021 PECOS PAC ID: 2062545114 Enrollment ID: I20100727000471 |
| Provider Name | Arthur Ohannessian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477713139 PECOS PAC ID: 9931385689 Enrollment ID: I20110516000234 |
| Provider Name | Timothy M Hall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417101965 PECOS PAC ID: 7911183199 Enrollment ID: I20110524000555 |
| Provider Name | Blanca S Campos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104086867 PECOS PAC ID: 9830364173 Enrollment ID: I20111214000811 |
| Provider Name | Monica L Plesa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851525091 PECOS PAC ID: 8224284203 Enrollment ID: I20120807000413 |
| Provider Name | Dustin Z Deyoung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346403953 PECOS PAC ID: 4183858525 Enrollment ID: I20131017001832 |
| Provider Name | Timothy E Weiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992024749 PECOS PAC ID: 7416172028 Enrollment ID: I20140715000798 |
| Provider Name | Joshua T Goldman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689990038 PECOS PAC ID: 2961622808 Enrollment ID: I20140929000280 |
| Provider Name | Joy Hao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245543214 PECOS PAC ID: 7012191778 Enrollment ID: I20141120000415 |
| Provider Name | Calvin J Duffaut |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497056154 PECOS PAC ID: 3173844735 Enrollment ID: I20150608001563 |
| Provider Name | Neha D Chande |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275892119 PECOS PAC ID: 8224340757 Enrollment ID: I20150710002588 |
| Provider Name | Mary Eileen Cronin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518050855 PECOS PAC ID: 4082912431 Enrollment ID: I20160418002340 |
| Provider Name | Anita Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437577046 PECOS PAC ID: 3173893286 Enrollment ID: I20170724000785 |
| Provider Name | Yulsi Lili Fernandez Montero |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1558780106 PECOS PAC ID: 7416220181 Enrollment ID: I20170830003359 |
| Provider Name | Julio Meza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649666470 PECOS PAC ID: 6608131040 Enrollment ID: I20180605003074 |
| Provider Name | Emily Marie Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194137737 PECOS PAC ID: 9133443435 Enrollment ID: I20180702002859 |
| Provider Name | Phillip Charles Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841687860 PECOS PAC ID: 2163778010 Enrollment ID: I20180706000879 |
| Provider Name | Amanda Marie Honsvall Hoefler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154855484 PECOS PAC ID: 3072846559 Enrollment ID: I20210208000658 |
| Provider Name | Brian Patrick Donohoe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669978862 PECOS PAC ID: 6204257579 Enrollment ID: I20210511001124 |
| Provider Name | Danielle Marie Ryba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144727165 PECOS PAC ID: 3072948447 Enrollment ID: I20210614001389 |
| Provider Name | Shaza Hanafy Hummel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326658642 PECOS PAC ID: 3577955137 Enrollment ID: I20220112000856 |
| Provider Name | Olivia Taeko Ishibashi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033670138 PECOS PAC ID: 9638581044 Enrollment ID: I20220516002496 |
| Provider Name | Ann Marie M Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245792712 PECOS PAC ID: 0143609552 Enrollment ID: I20220615001023 |
| Provider Name | Spencer Lillian Brennan Mccaffrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104386069 PECOS PAC ID: 5496168288 Enrollment ID: I20220628003283 |
| Provider Name | Elvin Luccon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699425785 PECOS PAC ID: 9436530813 Enrollment ID: I20220715002118 |
| Provider Name | Erendida Cano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265158448 PECOS PAC ID: 2668849589 Enrollment ID: I20221107002064 |
| Provider Name | Amy Marshall Richards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093212334 PECOS PAC ID: 1254703754 Enrollment ID: I20230209002098 |
| Provider Name | Thalia Minh Thu Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063040921 PECOS PAC ID: 8729446398 Enrollment ID: I20230614002956 |
| Provider Name | Ereni Rose Katsaggelos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902434673 PECOS PAC ID: 3476913336 Enrollment ID: I20230724003365 |
| Provider Name | Frederick Isaac Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245868298 PECOS PAC ID: 5890158596 Enrollment ID: I20230829001166 |
| Provider Name | Geoffrey Gusoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679060917 PECOS PAC ID: 8426481193 Enrollment ID: I20230908002961 |
| Provider Name | Dawn Marie Rago-rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821397381 PECOS PAC ID: 4385099563 Enrollment ID: I20231007000398 |
Vitality&longevity Medical Center A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2221 Lincoln Blvd, Suite 200, Santa Monica, CA 90405 Phone: 310-581-8585 Fax: 320-215-4650 | |
Cynthia Kodama, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2104 Wilshire Blvd, Santa Monica, CA 90403 Phone: 310-882-8258 | |
Premier Medical Group. Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2336 Santa Monica Blvd, Suite 304, Santa Monica, CA 90404 Phone: 310-420-9191 | |
Santa Monica Bay Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 Santa Monica Blvd, 1070, Santa Monica, CA 90404 Phone: 310-315-7900 Fax: 310-315-7931 | |
Santa Monica Bay Physicinas Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1260 15th St, 1501, Santa Monica, CA 90404 Phone: 310-656-1700 Fax: 310-458-1061 | |
Jimmy C. Huang, D.o. A Professional Corp. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2210 Santa Monica Blvd., Suite C, Santa Monica, CA 90404 Phone: 310-828-1708 Fax: 310-828-1705 | |
Joseph J Pinzone M D Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2001 Santa Monica Blvd Ste 1190w, Santa Monica, CA 90404 Phone: 888-580-5900 Fax: 855-510-0119 |