| Uc San Diego Health Community Group | |
|
200 W Arbor Dr San Diego CA 92103-9000 | |
| (858) 657-7000 | |
| Not Available |
| Full Name | Uc San Diego Health Community Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 W Arbor Dr, San Diego, California |
| Authorized Official Name and Position | Michael Dennis Price (DIRECTOR, REVENUE CYCLE & OPERATION) |
| Authorized Official Contact | 8582496752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Uc San Diego Health Community Group File 57326 Los Angeles CA 90074-7326 Ph: (858) 249-7536 | Uc San Diego Health Community Group 200 W Arbor Dr San Diego CA 92103-9000 Ph: (858) 657-7000 |
| NPI Number | 1659864247 |
|---|---|
| Provider Enumeration Date | 06/08/2018 |
| Last Update Date | 10/14/2024 |
| Medicare PECOS PAC ID | 3971849175 |
|---|---|
| Medicare Enrollment ID | O20190109000943 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659864247 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Sean Xavier Neath |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083655484 PECOS PAC ID: 6901708767 Enrollment ID: I20040122000561 |
| Provider Name | Christian M Sloane |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841233145 PECOS PAC ID: 8628970316 Enrollment ID: I20040122001231 |
| Provider Name | Ryan W Stewart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376574749 PECOS PAC ID: 6507768298 Enrollment ID: I20040122001242 |
| Provider Name | Tudor H Hughes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932187127 PECOS PAC ID: 5597658070 Enrollment ID: I20040206000844 |
| Provider Name | Fraidoon F Mostamand |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962433771 PECOS PAC ID: 9234026477 Enrollment ID: I20040302000704 |
| Provider Name | Cynthia A Purviance |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851370555 PECOS PAC ID: 2062301088 Enrollment ID: I20040317000805 |
| Provider Name | Tahir I Bhatti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518915487 PECOS PAC ID: 9537156823 Enrollment ID: I20040428001109 |
| Provider Name | Giovanna Casola |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790721256 PECOS PAC ID: 8224027149 Enrollment ID: I20040506001755 |
| Provider Name | Mini N Pathria |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699739318 PECOS PAC ID: 3173513264 Enrollment ID: I20040512000863 |
| Provider Name | Donald L Resnick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164450938 PECOS PAC ID: 8921098047 Enrollment ID: I20040512001089 |
| Provider Name | Claude B Sirlin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730261793 PECOS PAC ID: 7810987971 Enrollment ID: I20040512001396 |
| Provider Name | Christine B Chung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528033560 PECOS PAC ID: 3476531997 Enrollment ID: I20040712000399 |
| Provider Name | William Ladd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063463230 PECOS PAC ID: 5799771317 Enrollment ID: I20041104000895 |
| Provider Name | Anthony J Medak |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285675116 PECOS PAC ID: 0648220020 Enrollment ID: I20050124000695 |
| Provider Name | Mary K Oboyle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568487999 PECOS PAC ID: 2668424748 Enrollment ID: I20050216000980 |
| Provider Name | Christopher A Kahn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366510661 PECOS PAC ID: 4880639160 Enrollment ID: I20050627001246 |
| Provider Name | Douglas A Ballesteros |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275572372 PECOS PAC ID: 6305882523 Enrollment ID: I20050628001098 |
| Provider Name | Cynthia S Santillan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932132404 PECOS PAC ID: 5294766234 Enrollment ID: I20050829001059 |
| Provider Name | Gary G Ghahremani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114959798 PECOS PAC ID: 8628099264 Enrollment ID: I20051212000460 |
| Provider Name | Shaun D Carstairs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255301602 PECOS PAC ID: 3375565054 Enrollment ID: I20051221000862 |
| Provider Name | Timothy J Corbin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093881443 PECOS PAC ID: 3779505961 Enrollment ID: I20060103000218 |
| Provider Name | Jody L Adams Renteria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518935790 PECOS PAC ID: 5991714412 Enrollment ID: I20060411000807 |
| Provider Name | Shannon Kareen Walsh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558472779 PECOS PAC ID: 7113925033 Enrollment ID: I20061130000559 |
| Provider Name | Andrew M Kahn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841247384 PECOS PAC ID: 6507867645 Enrollment ID: I20070116000560 |
| Provider Name | Shira Varon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619047545 PECOS PAC ID: 2466453519 Enrollment ID: I20070116000624 |
| Provider Name | Yuko Kono |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1982628665 PECOS PAC ID: 0244231975 Enrollment ID: I20070124000240 |
| Provider Name | Katherine Margaret Richman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992898993 PECOS PAC ID: 1759485188 Enrollment ID: I20070324000066 |
| Provider Name | Andrea Osorio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235209495 PECOS PAC ID: 6103920228 Enrollment ID: I20070329000609 |
| Provider Name | Joyce M Havranek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134258957 PECOS PAC ID: 7012017627 Enrollment ID: I20070711001000 |
| Provider Name | William J Sieber |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851413165 PECOS PAC ID: 1759476302 Enrollment ID: I20070927000739 |
| Provider Name | Haydee Ojeda-fournier |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871537191 PECOS PAC ID: 9234179169 Enrollment ID: I20070927001045 |
| Provider Name | Amir H Aminlari |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316964380 PECOS PAC ID: 9436244480 Enrollment ID: I20071004000895 |
| Provider Name | Dolores H Pretorius |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902839418 PECOS PAC ID: 8921196627 Enrollment ID: I20071113000807 |
| Provider Name | Daphne Y Lacoursiere |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316037922 PECOS PAC ID: 1850296070 Enrollment ID: I20080416000687 |
| Provider Name | Sabiha Hussain |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952476327 PECOS PAC ID: 9638245723 Enrollment ID: I20080915000454 |
| Provider Name | Joseph A Tannous |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508819152 PECOS PAC ID: 4385655778 Enrollment ID: I20081002000043 |
| Provider Name | Alicia B Minns |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427226075 PECOS PAC ID: 4981772597 Enrollment ID: I20081009000573 |
| Provider Name | Julie L Le |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689701310 PECOS PAC ID: 8325106206 Enrollment ID: I20081021000784 |
| Provider Name | Andrew C Yen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942499116 PECOS PAC ID: 4789742420 Enrollment ID: I20081023000661 |
| Provider Name | Lucas P Hiller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417160474 PECOS PAC ID: 0446310627 Enrollment ID: I20081118000249 |
| Provider Name | Thomas W Broderick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407878853 PECOS PAC ID: 2264336007 Enrollment ID: I20081119000570 |
| Provider Name | Christian A Tomaszewski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982629408 PECOS PAC ID: 9537222377 Enrollment ID: I20090106000273 |
| Provider Name | Evelyne Fliszar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164449955 PECOS PAC ID: 1153212931 Enrollment ID: I20090107000537 |
| Provider Name | Daniel R Slater |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770650657 PECOS PAC ID: 0749343721 Enrollment ID: I20090117000033 |
| Provider Name | Dudley Elmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568620375 PECOS PAC ID: 0042374910 Enrollment ID: I20090122000146 |
| Provider Name | Christine K Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750483590 PECOS PAC ID: 9638234735 Enrollment ID: I20090224000184 |
| Provider Name | Stephen R Hayden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578506879 PECOS PAC ID: 2466501176 Enrollment ID: I20090528000330 |
| Provider Name | Erin A Gross |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013175009 PECOS PAC ID: 6901959618 Enrollment ID: I20090728000718 |
| Provider Name | Brady K Huang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407860299 PECOS PAC ID: 2264588573 Enrollment ID: I20090928000461 |
| Provider Name | Vaishal M Tolia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013198696 PECOS PAC ID: 2163587890 Enrollment ID: I20091121000062 |
| Provider Name | Charles E Hergesheimer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508892860 PECOS PAC ID: 8820139710 Enrollment ID: I20100114000492 |
| Provider Name | Karen A Cadman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669498754 PECOS PAC ID: 1355484155 Enrollment ID: I20100202000439 |
| Provider Name | Blanca Arzadon Navarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720248180 PECOS PAC ID: 0749323228 Enrollment ID: I20100205000287 |
| Provider Name | Richard F Clark |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477596773 PECOS PAC ID: 1153466529 Enrollment ID: I20100310000296 |
| Provider Name | James P Killeen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841221645 PECOS PAC ID: 6901931245 Enrollment ID: I20100311001022 |
| Provider Name | Colleen J Campbell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669416483 PECOS PAC ID: 7113052465 Enrollment ID: I20100312000009 |
| Provider Name | Karen B Van Hoesen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750322517 PECOS PAC ID: 6901931138 Enrollment ID: I20100312000880 |
| Provider Name | Elaine M Sapiro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578504932 PECOS PAC ID: 2163557398 Enrollment ID: I20100312000898 |
| Provider Name | Gary M Vilke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922042779 PECOS PAC ID: 9830224906 Enrollment ID: I20100315000308 |
| Provider Name | Brian K Snyder |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538102835 PECOS PAC ID: 3678608767 Enrollment ID: I20100315000507 |
| Provider Name | Aaron B Schneir |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467495770 PECOS PAC ID: 1052446168 Enrollment ID: I20100315000720 |
| Provider Name | Theodore Chan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477596856 PECOS PAC ID: 3476688433 Enrollment ID: I20100316000284 |
| Provider Name | Kama Z Guluma |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871526640 PECOS PAC ID: 6406981315 Enrollment ID: I20100317000693 |
| Provider Name | Ian Grover |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073556304 PECOS PAC ID: 9739214388 Enrollment ID: I20100322000094 |
| Provider Name | Binh T Ly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033140843 PECOS PAC ID: 6204962244 Enrollment ID: I20100330000470 |
| Provider Name | Mary D Jaramillo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255361895 PECOS PAC ID: 7618056672 Enrollment ID: I20100506000809 |
| Provider Name | Neil D Levine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992732606 PECOS PAC ID: 0941256002 Enrollment ID: I20100525000306 |
| Provider Name | Vivian Lim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295796753 PECOS PAC ID: 6204967193 Enrollment ID: I20100621000539 |
| Provider Name | Tyson S Ikeda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801970157 PECOS PAC ID: 5597899831 Enrollment ID: I20100823000347 |
| Provider Name | Jamie L Resnik |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558310557 PECOS PAC ID: 1850425141 Enrollment ID: I20100823000892 |
| Provider Name | Jessica M Kingston |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538106372 PECOS PAC ID: 7517081813 Enrollment ID: I20100823001095 |
| Provider Name | Leslie Mukau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578526026 PECOS PAC ID: 1759445463 Enrollment ID: I20100908000403 |
| Provider Name | Leslie M Martin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306895495 PECOS PAC ID: 6608991336 Enrollment ID: I20100917000298 |
| Provider Name | Kathryn M Macaulay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235154618 PECOS PAC ID: 5395861462 Enrollment ID: I20100927000190 |
| Provider Name | Christine B Miller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154346583 PECOS PAC ID: 7618169194 Enrollment ID: I20101004000491 |
| Provider Name | Pamela S Deak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316978554 PECOS PAC ID: 9032302526 Enrollment ID: I20101015000956 |
| Provider Name | Parinaz Abyari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780880260 PECOS PAC ID: 5294921946 Enrollment ID: I20101122000129 |
| Provider Name | Richard Childers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902876220 PECOS PAC ID: 2860675238 Enrollment ID: I20110322000735 |
| Provider Name | Andrew Nguyen |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1720216542 PECOS PAC ID: 2567647555 Enrollment ID: I20110509000119 |
| Provider Name | David S Karow |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932490703 PECOS PAC ID: 3971780792 Enrollment ID: I20110603000493 |
| Provider Name | Gillian Mackay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770702177 PECOS PAC ID: 9830266220 Enrollment ID: I20110622000673 |
| Provider Name | Alma A Harb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538195078 PECOS PAC ID: 3971771551 Enrollment ID: I20110726000741 |
| Provider Name | Natalia Vasiuk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801050737 PECOS PAC ID: 4183895030 Enrollment ID: I20110926000308 |
| Provider Name | Desiree S Leithem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952564320 PECOS PAC ID: 1153583661 Enrollment ID: I20120430000394 |
| Provider Name | Vijay Menon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326276072 PECOS PAC ID: 2860651262 Enrollment ID: I20120607000668 |
| Provider Name | Edward Smitaman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477720092 PECOS PAC ID: 1951566256 Enrollment ID: I20120712000429 |
| Provider Name | Shauna S Conry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285877787 PECOS PAC ID: 2961658372 Enrollment ID: I20120816000858 |
| Provider Name | Anthony M Bielawski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528038346 PECOS PAC ID: 6305099680 Enrollment ID: I20130117000305 |
| Provider Name | Elizabeth Ann Varghese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629319116 PECOS PAC ID: 5092953570 Enrollment ID: I20130522000309 |
| Provider Name | Shelese R Newmark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659515294 PECOS PAC ID: 1052550100 Enrollment ID: I20130620000474 |
| Provider Name | Robert T. Coles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407876691 PECOS PAC ID: 0648202556 Enrollment ID: I20130628000498 |
| Provider Name | Christanne H Coffey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295977742 PECOS PAC ID: 1557501699 Enrollment ID: I20130712000302 |
| Provider Name | Christopher J Coyne |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043590169 PECOS PAC ID: 8325289838 Enrollment ID: I20130725000884 |
| Provider Name | Albert Hsiao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457546244 PECOS PAC ID: 3779724927 Enrollment ID: I20130730000916 |
| Provider Name | Heather A Morris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720272867 PECOS PAC ID: 1254572290 Enrollment ID: I20130802000311 |
| Provider Name | Lisa M Coles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578751129 PECOS PAC ID: 2163597469 Enrollment ID: I20131031001622 |
| Provider Name | Regina M Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154554871 PECOS PAC ID: 0042448698 Enrollment ID: I20140106001134 |
| Provider Name | Maciej Witkos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407086077 PECOS PAC ID: 5193988228 Enrollment ID: I20140121002098 |
| Provider Name | Sunil Partab Jeswani |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1023359494 PECOS PAC ID: 7315160306 Enrollment ID: I20140520001395 |
| Provider Name | Sonja Mack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457604134 PECOS PAC ID: 5698912764 Enrollment ID: I20140603001413 |
| Provider Name | Paulyne Lux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255763942 PECOS PAC ID: 3476777020 Enrollment ID: I20140620002074 |
| Provider Name | Amruti D Borad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598058323 PECOS PAC ID: 4284858796 Enrollment ID: I20140623002746 |
| Provider Name | Anna D Narezkina |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891958773 PECOS PAC ID: 7719104355 Enrollment ID: I20140806000001 |
| Provider Name | Tennille A Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811179898 PECOS PAC ID: 5597848945 Enrollment ID: I20140813000950 |
| Provider Name | Ian B Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023038411 PECOS PAC ID: 7719950930 Enrollment ID: I20140827003016 |
| Provider Name | Charlotte A Sadler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598044117 PECOS PAC ID: 9739300419 Enrollment ID: I20141021003198 |
| Provider Name | Maureen C Ries |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750544516 PECOS PAC ID: 4385809961 Enrollment ID: I20141119002748 |
| Provider Name | Sainab A Warsame |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407253750 PECOS PAC ID: 0143547661 Enrollment ID: I20150323000563 |
| Provider Name | Mohammad Eghtedari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740548734 PECOS PAC ID: 3971723503 Enrollment ID: I20150331002942 |
| Provider Name | Srihari Cidambi Sampath |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780870469 PECOS PAC ID: 2860657301 Enrollment ID: I20150521000430 |
| Provider Name | Srinath C Sampath |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891982328 PECOS PAC ID: 7911163597 Enrollment ID: I20150610000039 |
| Provider Name | Yewah Jung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508187063 PECOS PAC ID: 2163654260 Enrollment ID: I20150710002766 |
| Provider Name | Stephanie Lynn Kleiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700297744 PECOS PAC ID: 0648499210 Enrollment ID: I20150720002887 |
| Provider Name | Michael E Hahn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356573992 PECOS PAC ID: 0143535872 Enrollment ID: I20150810002936 |
| Provider Name | Andrea Leigh Austin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811289093 PECOS PAC ID: 4688989650 Enrollment ID: I20150819009582 |
| Provider Name | Allyson A Kreshak |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194758219 PECOS PAC ID: 5092718528 Enrollment ID: I20150910002595 |
| Provider Name | David P Folsom |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710026612 PECOS PAC ID: 8628114865 Enrollment ID: I20150915003320 |
| Provider Name | Juanita Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790915759 PECOS PAC ID: 3375853344 Enrollment ID: I20151103001112 |
| Provider Name | Elizabeth Christianson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750722666 PECOS PAC ID: 6608174743 Enrollment ID: I20160406000877 |
| Provider Name | Katherine Laurinda Staats |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124465026 PECOS PAC ID: 0840582128 Enrollment ID: I20160706002326 |
| Provider Name | Daniel A Popa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114276706 PECOS PAC ID: 3577856061 Enrollment ID: I20160720002935 |
| Provider Name | Paul M Murphy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295050946 PECOS PAC ID: 5799078614 Enrollment ID: I20160728002657 |
| Provider Name | Jandark Yuseif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114361284 PECOS PAC ID: 0244532224 Enrollment ID: I20161020001899 |
| Provider Name | Jennifer L Farah |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922401751 PECOS PAC ID: 5294045175 Enrollment ID: I20161025001418 |
| Provider Name | Mufaddal Dahodwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053754689 PECOS PAC ID: 6305124199 Enrollment ID: I20161028002166 |
| Provider Name | Danielle Elaina Alfego |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689125965 PECOS PAC ID: 9638450273 Enrollment ID: I20161220000385 |
| Provider Name | Amanda V Nasser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376093310 PECOS PAC ID: 9830471762 Enrollment ID: I20170128000395 |
| Provider Name | Shannon E Hutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932646288 PECOS PAC ID: 2466737416 Enrollment ID: I20170314001607 |
| Provider Name | Kimberlee Ann Bond |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669770939 PECOS PAC ID: 4486930799 Enrollment ID: I20170420001110 |
| Provider Name | Carter J. Mcelroy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114472230 PECOS PAC ID: 9133406309 Enrollment ID: I20170426001750 |
| Provider Name | Cristie Dona Jurf Silverwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093263915 PECOS PAC ID: 4789951583 Enrollment ID: I20170526002018 |
| Provider Name | Joseph P Hayek |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689801342 PECOS PAC ID: 2365674777 Enrollment ID: I20170619002485 |
| Provider Name | Aaron P Heerboth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770922122 PECOS PAC ID: 3274825914 Enrollment ID: I20170622001001 |
| Provider Name | Matthew K Riddle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174865349 PECOS PAC ID: 9638311103 Enrollment ID: I20170707002516 |
| Provider Name | Kathleen Jacobs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275897779 PECOS PAC ID: 5991089138 Enrollment ID: I20170712002017 |
| Provider Name | Clifford Masom |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942649470 PECOS PAC ID: 1850531161 Enrollment ID: I20170713003103 |
| Provider Name | Seth J. Kligerman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386790053 PECOS PAC ID: 9537230693 Enrollment ID: I20170724004010 |
| Provider Name | Christian J Dameff |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790196731 PECOS PAC ID: 5890065734 Enrollment ID: I20170725003328 |
| Provider Name | David Marc Einstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568426211 PECOS PAC ID: 3476452491 Enrollment ID: I20170915002398 |
| Provider Name | Valerie L Waters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770002313 PECOS PAC ID: 8022384767 Enrollment ID: I20171024001927 |
| Provider Name | Janette Elaine Matthess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457694549 PECOS PAC ID: 0648546382 Enrollment ID: I20171024002054 |
| Provider Name | Eric A Yelsa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093775298 PECOS PAC ID: 3870489701 Enrollment ID: I20180306001917 |
| Provider Name | Tiffany Lee Holt |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801398193 PECOS PAC ID: 7810258738 Enrollment ID: I20180309000472 |
| Provider Name | Summer R Davies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679850671 PECOS PAC ID: 5496929440 Enrollment ID: I20180319002205 |
| Provider Name | Carlos Junior Alarid |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629351572 PECOS PAC ID: 6305108630 Enrollment ID: I20180326000522 |
| Provider Name | Lawrence Adam Delasotta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487935748 PECOS PAC ID: 6103189576 Enrollment ID: I20180417002174 |
| Provider Name | Masoud Shiehmorteza |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164724449 PECOS PAC ID: 3274821376 Enrollment ID: I20180517002615 |
| Provider Name | Han T Gao |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023495330 PECOS PAC ID: 0840547808 Enrollment ID: I20180720003199 |
| Provider Name | Neil F. Donner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134269772 PECOS PAC ID: 2163520669 Enrollment ID: I20180724004121 |
| Provider Name | Jorge Luis Alvarado |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538588561 PECOS PAC ID: 2769775915 Enrollment ID: I20180725000964 |
| Provider Name | Frances Rudolf |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821487430 PECOS PAC ID: 5991052789 Enrollment ID: I20180725001891 |
| Provider Name | Jenna N Otter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295116671 PECOS PAC ID: 2668765181 Enrollment ID: I20180730003155 |
| Provider Name | Carl Youngs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598142218 PECOS PAC ID: 5395000467 Enrollment ID: I20180802002247 |
| Provider Name | Jose Angel Soria-lopez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225474034 PECOS PAC ID: 9830315803 Enrollment ID: I20180809006264 |
| Provider Name | Hang My Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184017477 PECOS PAC ID: 4587974621 Enrollment ID: I20180821003217 |
| Provider Name | Breanna L. Lustre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851651236 PECOS PAC ID: 8224343645 Enrollment ID: I20180827000232 |
| Provider Name | Samuel John Galloway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770966988 PECOS PAC ID: 3476804162 Enrollment ID: I20180919001637 |
| Provider Name | Kathryn J Fowler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255457941 PECOS PAC ID: 1951430909 Enrollment ID: I20180919003516 |
| Provider Name | Anna Van Niekerk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265820112 PECOS PAC ID: 9638420136 Enrollment ID: I20180921002816 |
| Provider Name | Dalia Elias |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578940300 PECOS PAC ID: 8022369230 Enrollment ID: I20180927002330 |
| Provider Name | Martin Huy Pham |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1609130921 PECOS PAC ID: 9931473089 Enrollment ID: I20181010001492 |
| Provider Name | Natasha Michon Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356862163 PECOS PAC ID: 9032461512 Enrollment ID: I20181010003931 |
| Provider Name | Aaron J Stirling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588142533 PECOS PAC ID: 1052663317 Enrollment ID: I20181015002143 |
| Provider Name | Anastasie Marie Dunn-pirio |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700177136 PECOS PAC ID: 7315299674 Enrollment ID: I20181015002168 |
| Provider Name | Phuong Uyen T Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760997472 PECOS PAC ID: 3779832951 Enrollment ID: I20181116001138 |
| Provider Name | Edward T Chambers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467499566 PECOS PAC ID: 6608120043 Enrollment ID: I20181121000696 |
| Provider Name | Jennifer Harue Takagi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437549235 PECOS PAC ID: 3375887813 Enrollment ID: I20181210002754 |
| Provider Name | Helena Okhotin Iarovicov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497137632 PECOS PAC ID: 1759626732 Enrollment ID: I20181219001946 |
| Provider Name | Clark The Bach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831579689 PECOS PAC ID: 7719222371 Enrollment ID: I20181231000875 |
| Provider Name | Rachna Subramony |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710286505 PECOS PAC ID: 8820213747 Enrollment ID: I20190118002325 |
| Provider Name | Erin Elizabeth Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760729933 PECOS PAC ID: 4486882974 Enrollment ID: I20190123003530 |
| Provider Name | Tamantha Sue Arlata |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568721934 PECOS PAC ID: 3072831064 Enrollment ID: I20190128001274 |
| Provider Name | Katherine Uvelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548607286 PECOS PAC ID: 3779803846 Enrollment ID: I20190129003555 |
| Provider Name | Jessica Marie Salas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356817431 PECOS PAC ID: 0446598551 Enrollment ID: I20190215001157 |
| Provider Name | Christopher David Rudd |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831539337 PECOS PAC ID: 1557503901 Enrollment ID: I20190227002577 |
| Provider Name | Marla Richard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578720934 PECOS PAC ID: 0345528204 Enrollment ID: I20190318000872 |
| Provider Name | Sarah Nalbandian |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871069922 PECOS PAC ID: 8729329339 Enrollment ID: I20190409001474 |
| Provider Name | Katherine Chin Sin Hui |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376983411 PECOS PAC ID: 2062753361 Enrollment ID: I20190415002637 |
| Provider Name | Evan Laveman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134654148 PECOS PAC ID: 7315288560 Enrollment ID: I20190416002241 |
| Provider Name | Michael A Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194788562 PECOS PAC ID: 4880508423 Enrollment ID: I20190417000113 |
| Provider Name | Benjamin Jeffrey Shleifer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710374681 PECOS PAC ID: 7113201054 Enrollment ID: I20190417002122 |
| Provider Name | Leah Marie Ann Bruno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255741799 PECOS PAC ID: 8224320668 Enrollment ID: I20190424002440 |
| Provider Name | Erin Noste |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871732214 PECOS PAC ID: 5991946329 Enrollment ID: I20190705000846 |
| Provider Name | Maria Pelucio |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164455820 PECOS PAC ID: 3678575552 Enrollment ID: I20190709000764 |
| Provider Name | Guido Klaus Wilhelm Frank |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578608733 PECOS PAC ID: 5294827523 Enrollment ID: I20190715002867 |
| Provider Name | Sam T Ontiveros |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538522396 PECOS PAC ID: 2860786654 Enrollment ID: I20190801000320 |
| Provider Name | Lauren Altschuh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982052650 PECOS PAC ID: 7416284658 Enrollment ID: I20190809001474 |
| Provider Name | Mahmoud Sabha |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457747883 PECOS PAC ID: 2567706450 Enrollment ID: I20190809001561 |
| Provider Name | Hideaki L Tanaka |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124280730 PECOS PAC ID: 9133359870 Enrollment ID: I20190814002556 |
| Provider Name | Danika M Brodak |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619326774 PECOS PAC ID: 9739469313 Enrollment ID: I20190815000526 |
| Provider Name | Edgardo D Dos Santos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558757880 PECOS PAC ID: 6406183250 Enrollment ID: I20190823002931 |
| Provider Name | Jesse Guittard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770979890 PECOS PAC ID: 7618206251 Enrollment ID: I20190909000433 |
| Provider Name | Akeela Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679998827 PECOS PAC ID: 4880907039 Enrollment ID: I20190910000472 |
| Provider Name | Cristina Tate Hernandez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164765046 PECOS PAC ID: 1850686700 Enrollment ID: I20190912002456 |
| Provider Name | Kenneth Todd Rutkowski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629121488 PECOS PAC ID: 5294791646 Enrollment ID: I20190916000187 |
| Provider Name | Priya Srihari |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538515689 PECOS PAC ID: 4981934643 Enrollment ID: I20190923001219 |
| Provider Name | Faith Quenzer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295112670 PECOS PAC ID: 8820328461 Enrollment ID: I20190925001930 |
| Provider Name | Sarah T Gomez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336502269 PECOS PAC ID: 7719273044 Enrollment ID: I20190925002837 |
| Provider Name | Erich A Lidstone |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578958021 PECOS PAC ID: 6800198458 Enrollment ID: I20191002001370 |
| Provider Name | Dean Shehadeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942688429 PECOS PAC ID: 9830421536 Enrollment ID: I20191030001041 |
| Provider Name | Gloria E Worth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689170276 PECOS PAC ID: 5193080331 Enrollment ID: I20191031000731 |
| Provider Name | Stephanie Benjamin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538553466 PECOS PAC ID: 3476985771 Enrollment ID: I20191106003350 |
| Provider Name | Daphne Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497159776 PECOS PAC ID: 6406288620 Enrollment ID: I20191108002145 |
| Provider Name | Elizabeth Ann Mcquinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922512318 PECOS PAC ID: 1557793387 Enrollment ID: I20191118001049 |
| Provider Name | Florencia Lebensohn-chialvo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134788730 PECOS PAC ID: 6901238625 Enrollment ID: I20191119002080 |
| Provider Name | Arthur Phillip Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386195410 PECOS PAC ID: 7416292529 Enrollment ID: I20191120002329 |
| Provider Name | Anna E Morrell |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1467001149 PECOS PAC ID: 4486081643 Enrollment ID: I20200227002121 |
| Provider Name | Pamela A Castro Camero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518328608 PECOS PAC ID: 0345670808 Enrollment ID: I20200423002283 |
| Provider Name | Jessica A Bagby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093161473 PECOS PAC ID: 3072944313 Enrollment ID: I20200520002624 |
| Provider Name | Craig Jerome Kutz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598295925 PECOS PAC ID: 1658792536 Enrollment ID: I20200601002062 |
| Provider Name | Garret A Winkler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336502095 PECOS PAC ID: 6002101664 Enrollment ID: I20200608001856 |
| Provider Name | Charles Murchison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497118038 PECOS PAC ID: 3678994084 Enrollment ID: I20200610001319 |
| Provider Name | William Wright Andrew |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457856916 PECOS PAC ID: 9335561422 Enrollment ID: I20200618000720 |
| Provider Name | Andrew S Goodrich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245688415 PECOS PAC ID: 6103162821 Enrollment ID: I20200619001394 |
| Provider Name | Mackenzie L Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629581764 PECOS PAC ID: 0345663134 Enrollment ID: I20200713002227 |
| Provider Name | Benjamin I Liotta |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396270278 PECOS PAC ID: 0941624464 Enrollment ID: I20200716003120 |
| Provider Name | Heidi A Hutchison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417483587 PECOS PAC ID: 9830468677 Enrollment ID: I20200724000452 |
| Provider Name | Tiffany Marie Castellano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063893063 PECOS PAC ID: 4183933351 Enrollment ID: I20200807001333 |
| Provider Name | Mohammad Monjurul Alam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356574016 PECOS PAC ID: 1355592304 Enrollment ID: I20200831001997 |
| Provider Name | Eric Yuan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922530799 PECOS PAC ID: 5890113427 Enrollment ID: I20200915001016 |
| Provider Name | Sabrina Owens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548792815 PECOS PAC ID: 5890113963 Enrollment ID: I20200922002504 |
| Provider Name | Ali Husain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790073419 PECOS PAC ID: 8426326422 Enrollment ID: I20201002002188 |
| Provider Name | Bryan Michael Bartz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669818993 PECOS PAC ID: 8426478819 Enrollment ID: I20201023002680 |
| Provider Name | Jazel Sambo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043860844 PECOS PAC ID: 4789097635 Enrollment ID: I20210113002522 |
| Provider Name | Michelle Daniel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801879861 PECOS PAC ID: 7719905884 Enrollment ID: I20210308001898 |
| Provider Name | Lisa Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669442182 PECOS PAC ID: 1557252400 Enrollment ID: I20210426002934 |
| Provider Name | Brian J Kwan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124569322 PECOS PAC ID: 5597174284 Enrollment ID: I20210510002373 |
| Provider Name | Nicholas D Black |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154852689 PECOS PAC ID: 2062812514 Enrollment ID: I20210621002079 |
| Provider Name | Justin A Seltzer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447791843 PECOS PAC ID: 3870864606 Enrollment ID: I20210623001154 |
| Provider Name | Michael Self |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053702746 PECOS PAC ID: 6103227152 Enrollment ID: I20210628002472 |
| Provider Name | Salieha Zaheer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235429721 PECOS PAC ID: 9739305384 Enrollment ID: I20210803000903 |
| Provider Name | Jay H Park |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366478372 PECOS PAC ID: 7214977982 Enrollment ID: I20210816000932 |
| Provider Name | Sheeda Saba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134574858 PECOS PAC ID: 8628473576 Enrollment ID: I20210816003537 |
| Provider Name | Sahil Rajesh Vagha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841785656 PECOS PAC ID: 7113322850 Enrollment ID: I20210818004100 |
| Provider Name | Alice Chen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427476597 PECOS PAC ID: 7810211380 Enrollment ID: I20210820002238 |
| Provider Name | Vicente Diaz-gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790745776 PECOS PAC ID: 1557353356 Enrollment ID: I20210825002940 |
| Provider Name | Eden Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245399179 PECOS PAC ID: 9436554557 Enrollment ID: I20210826002658 |
| Provider Name | Lindsey Elizabeth Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033613229 PECOS PAC ID: 4981009966 Enrollment ID: I20210830002146 |
| Provider Name | Rahul Nene |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194257832 PECOS PAC ID: 6305244427 Enrollment ID: I20211004003077 |
| Provider Name | Justin S Cristobal Choudhari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669976643 PECOS PAC ID: 0446648356 Enrollment ID: I20211026002879 |
| Provider Name | Brenna Louise Hogue |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043705296 PECOS PAC ID: 8820487838 Enrollment ID: I20211112001868 |
| Provider Name | Kelly Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033603337 PECOS PAC ID: 6002208170 Enrollment ID: I20220121002082 |
| Provider Name | Casey Satre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588327365 PECOS PAC ID: 5294128047 Enrollment ID: I20220131001927 |
| Provider Name | Tahney Cierra Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518191717 PECOS PAC ID: 0749673457 Enrollment ID: I20220201002052 |
| Provider Name | Jamshid Akhavan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891286464 PECOS PAC ID: 5799184388 Enrollment ID: I20220224001528 |
| Provider Name | Jeiran Javaherian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902395775 PECOS PAC ID: 1951652478 Enrollment ID: I20220325002001 |
| Provider Name | Amanda Kristin Crawford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053738310 PECOS PAC ID: 7810269024 Enrollment ID: I20220518002082 |
| Provider Name | Jeremy Hardin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952861494 PECOS PAC ID: 6507192218 Enrollment ID: I20220620000478 |
| Provider Name | Benjamin Robin Supat |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376772905 PECOS PAC ID: 7517347883 Enrollment ID: I20220704000246 |
| Provider Name | Casey Lee Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871099333 PECOS PAC ID: 2860873171 Enrollment ID: I20220718003437 |
| Provider Name | Michelle Safferman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235690223 PECOS PAC ID: 3072844885 Enrollment ID: I20220720003449 |
| Provider Name | Henrik Galust |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932696093 PECOS PAC ID: 1355722232 Enrollment ID: I20220727001893 |
| Provider Name | Elaine Yu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528564150 PECOS PAC ID: 2365825940 Enrollment ID: I20220815001031 |
| Provider Name | Adam David Breslow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972574085 PECOS PAC ID: 4082099064 Enrollment ID: I20220912000888 |
| Provider Name | Brittany Barker Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306403423 PECOS PAC ID: 1456736461 Enrollment ID: I20220912002136 |
| Provider Name | Victor Mori |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952833303 PECOS PAC ID: 5092190967 Enrollment ID: I20220913001401 |
| Provider Name | Matthew Charles Kuivenhoven |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598259434 PECOS PAC ID: 0042567273 Enrollment ID: I20220927000122 |
| Provider Name | Alex Bronson Laventure |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619327871 PECOS PAC ID: 0042504540 Enrollment ID: I20221005003090 |
| Provider Name | Ariel C. Mason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477016616 PECOS PAC ID: 1254717564 Enrollment ID: I20221010001524 |
| Provider Name | Brittany Drutman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285196832 PECOS PAC ID: 1951779313 Enrollment ID: I20221116002356 |
| Provider Name | Rachelle Diana Sawyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497381495 PECOS PAC ID: 9234510017 Enrollment ID: I20230303001675 |
| Provider Name | Emily Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083081467 PECOS PAC ID: 6002105657 Enrollment ID: I20230413001601 |
| Provider Name | Stephanie Ann Kirkland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083813661 PECOS PAC ID: 4486782596 Enrollment ID: I20230720001376 |
| Provider Name | Shea Breenan Wickland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538519244 PECOS PAC ID: 5991033565 Enrollment ID: I20230823004231 |
| Provider Name | Timothy Burke Judd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932158946 PECOS PAC ID: 3173533957 Enrollment ID: I20230825000872 |
| Provider Name | Luis Alonso Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831727775 PECOS PAC ID: 3375906738 Enrollment ID: I20230831004441 |
| Provider Name | Josefina Torres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922561356 PECOS PAC ID: 7214381573 Enrollment ID: I20230920004440 |
| Provider Name | Courtney Leah Konchan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053940320 PECOS PAC ID: 3870916802 Enrollment ID: I20231010001845 |
| Provider Name | Fariba Hurieh Basali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114556909 PECOS PAC ID: 3779939673 Enrollment ID: I20231030001159 |
| Provider Name | Frank K Truong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356802805 PECOS PAC ID: 4183951643 Enrollment ID: I20231030002667 |
| Provider Name | Michele Kowalski-mcgraw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326104209 PECOS PAC ID: 1153302534 Enrollment ID: I20231219003892 |
| Provider Name | Jennifer Zehe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740642560 PECOS PAC ID: 1355788308 Enrollment ID: I20240326001916 |
Revivify Restorative Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16445 Bernardo Center Dr, San Diego, CA 92128 Phone: 858-429-0099 Fax: 858-676-1172 | |
Nucleus Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4570 Executive Dr Ste 100, San Diego, CA 92121 Phone: 844-838-3322 | |
Moden Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8901 Activity Rd Ste 205, San Diego, CA 92126 Phone: 888-822-1184 Fax: 888-877-3676 | |
Aldiwani Medical Group Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11409 Windy Summit Pl, San Diego, CA 92127 Phone: 832-371-3279 Fax: 619-939-4556 | |
Presidio Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4440 Lamont St, San Diego, CA 92109 Phone: 858-270-7633 Fax: 858-270-7692 | |
Michael L Butera Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6699 Alvarado Rd Ste 2309, San Diego, CA 92120 Phone: 619-286-8803 Fax: 619-286-2344 | |
San Diego Digestive Disease Consultants, Inc. A Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8008 Frost St, Ste 200, San Diego, CA 92123 Phone: 858-292-7527 Fax: 858-292-7804 |