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200 E Anaheim St Wilmington CA 90744 | |
| (310) 522-8700 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 E Anaheim St, Wilmington, California |
| Authorized Official Name and Position | Christopher Tak Lau (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6264576900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2550 W Main St Ste 301 Alhambra CA 91801-1694 Ph: (626) 457-6900 | 200 E Anaheim St Wilmington CA 90744 Ph: (310) 522-8700 |
| NPI Number | 1700097540 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 06/12/2023 |
| Medicare PECOS PAC ID | 5193710275 |
|---|---|
| Medicare Enrollment ID | O20040417000619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700097540 | NPI | - | NPPES |
| CMM71121F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Kami Adibi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548211436 PECOS PAC ID: 2163314352 Enrollment ID: I20040324001709 |
| Provider Name | Christopher T Lau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548365968 PECOS PAC ID: 3173518255 Enrollment ID: I20040417000633 |
| Provider Name | Karlon H Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144325473 PECOS PAC ID: 5092706184 Enrollment ID: I20040518001602 |
| Provider Name | Nolasco M Cristobal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609818152 PECOS PAC ID: 4789647314 Enrollment ID: I20041104001219 |
| Provider Name | Ricardo E Huete |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184630683 PECOS PAC ID: 0648229450 Enrollment ID: I20050119000762 |
| Provider Name | Janice L Hull |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841248820 PECOS PAC ID: 7810927134 Enrollment ID: I20050816001309 |
| Provider Name | Thomas J Cachur |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225037047 PECOS PAC ID: 1355367491 Enrollment ID: I20051018001251 |
| Provider Name | Stefanie A Varela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447322672 PECOS PAC ID: 7214015015 Enrollment ID: I20080418000546 |
| Provider Name | Claudia Ramos-smulevich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811980634 PECOS PAC ID: 1052479243 Enrollment ID: I20081016000147 |
| Provider Name | Jose T Aranez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740255330 PECOS PAC ID: 2961448287 Enrollment ID: I20090311000719 |
| Provider Name | Rene J Trabanino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700086337 PECOS PAC ID: 5092857342 Enrollment ID: I20100125000299 |
| Provider Name | Danielle D Brum Pavan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386879807 PECOS PAC ID: 8426188541 Enrollment ID: I20100615000811 |
| Provider Name | Elsa Maria Hartwick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558375022 PECOS PAC ID: 7810025525 Enrollment ID: I20101103000052 |
| Provider Name | Rabin Mizrahi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124124920 PECOS PAC ID: 2466632872 Enrollment ID: I20110202000031 |
| Provider Name | Mohammed Emamian |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780780577 PECOS PAC ID: 7618157025 Enrollment ID: I20110228000214 |
| Provider Name | Gilda Ngo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922238880 PECOS PAC ID: 0244418168 Enrollment ID: I20110624000102 |
| Provider Name | Blanca S Campos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104086867 PECOS PAC ID: 9830364173 Enrollment ID: I20111214000811 |
| Provider Name | Fataneh Amidi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134357981 PECOS PAC ID: 6507026416 Enrollment ID: I20120330000482 |
| Provider Name | Kenneth Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831149475 PECOS PAC ID: 6002076726 Enrollment ID: I20120404000231 |
| Provider Name | Ali Parsaeian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528229374 PECOS PAC ID: 0648319145 Enrollment ID: I20120809000722 |
| Provider Name | Ruben A Munoz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265771356 PECOS PAC ID: 2961647672 Enrollment ID: I20130401000137 |
| Provider Name | Marissa R Cabral |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306072277 PECOS PAC ID: 5698076784 Enrollment ID: I20151215000382 |
| Provider Name | Lee M Panman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841240181 PECOS PAC ID: 4486957891 Enrollment ID: I20160119001576 |
| Provider Name | Maya E Wille |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427370733 PECOS PAC ID: 5890098206 Enrollment ID: I20160119001710 |
| Provider Name | Esperanza Ramirez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669767521 PECOS PAC ID: 7517258239 Enrollment ID: I20160627001944 |
| Provider Name | Wayley Dragon Louie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942463534 PECOS PAC ID: 5092060327 Enrollment ID: I20180608002384 |
| Provider Name | Sarah A. Nago |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942491287 PECOS PAC ID: 0941556922 Enrollment ID: I20180705001044 |
| Provider Name | Santosh Kumar Sundaresan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447579370 PECOS PAC ID: 2860745189 Enrollment ID: I20181101003384 |
| Provider Name | Freddy Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902240229 PECOS PAC ID: 3173863743 Enrollment ID: I20190318001242 |
| Provider Name | Jeremiah Lawrence Pamer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669826392 PECOS PAC ID: 5597091843 Enrollment ID: I20190725000145 |
| Provider Name | Ngan-thuy D Pham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619074309 PECOS PAC ID: 7618203712 Enrollment ID: I20190726002746 |
| Provider Name | Josephine Marlene Servin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053435016 PECOS PAC ID: 1052648318 Enrollment ID: I20190808002310 |
| Provider Name | Maria Isabel Linares Valderrama |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1659739324 PECOS PAC ID: 7416286703 Enrollment ID: I20190911003828 |
| Provider Name | Andrew Kim |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1922485408 PECOS PAC ID: 7719218320 Enrollment ID: I20191014000911 |
| Provider Name | Dunia Lizzeth Ponce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770617755 PECOS PAC ID: 6406289537 Enrollment ID: I20191204000837 |
| Provider Name | Andrew Folick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285088328 PECOS PAC ID: 0042640013 Enrollment ID: I20200415003632 |
| Provider Name | Phung Chi Nim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235660937 PECOS PAC ID: 1557784337 Enrollment ID: I20200713001660 |
| Provider Name | Yeniss Araceli Paez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962832261 PECOS PAC ID: 1658787064 Enrollment ID: I20210310000883 |
| Provider Name | Abdullah Siddiqui |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598184459 PECOS PAC ID: 4688964844 Enrollment ID: I20210526001846 |
| Provider Name | Anokhi U Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568993152 PECOS PAC ID: 7113260639 Enrollment ID: I20210607002752 |
| Provider Name | Xin Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033573241 PECOS PAC ID: 3375943947 Enrollment ID: I20210618000909 |
| Provider Name | Karla Pamela Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588257554 PECOS PAC ID: 8022410315 Enrollment ID: I20210708003048 |
| Provider Name | Kara Faye Cunningham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205323334 PECOS PAC ID: 5799189353 Enrollment ID: I20210804003469 |
| Provider Name | Jacqueline Lucero Delatorre |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1629684295 PECOS PAC ID: 0941610901 Enrollment ID: I20211004002856 |
| Provider Name | Lareina Rodriguez Pedriquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720266984 PECOS PAC ID: 0446435622 Enrollment ID: I20220627001094 |
| Provider Name | Lesley Vanessa Carrillo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1225760358 PECOS PAC ID: 1355717497 Enrollment ID: I20221014001816 |
| Provider Name | Arielle Tucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376005637 PECOS PAC ID: 3476920067 Enrollment ID: I20221111000360 |
| Provider Name | Karina Guzman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144341710 PECOS PAC ID: 1850763665 Enrollment ID: I20230203001738 |
| Provider Name | Jose S Medina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821551748 PECOS PAC ID: 1153654199 Enrollment ID: I20230411002507 |
| Provider Name | Sandeep Arora |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1487371530 PECOS PAC ID: 9133590672 Enrollment ID: I20230419000704 |
| Provider Name | Marissa Diora Trinidad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740817691 PECOS PAC ID: 8921473687 Enrollment ID: I20230616001725 |
| Provider Name | Aliza Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780215988 PECOS PAC ID: 8729437066 Enrollment ID: I20231212000792 |
| Provider Name | Michael Thomas Tarkey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780116848 PECOS PAC ID: 7416227764 Enrollment ID: I20240105001289 |
| Provider Name | Azucena Arias Limon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003681057 PECOS PAC ID: 5395181069 Enrollment ID: I20240315003505 |
| Provider Name | Olga B Tyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225748791 PECOS PAC ID: 0244686871 Enrollment ID: I20240405002571 |
| Provider Name | Jasmin Emeli Bonilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902505464 PECOS PAC ID: 4284076597 Enrollment ID: I20240531000694 |
| Provider Name | Lourdes Carolina Gomez |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1104498328 PECOS PAC ID: 6305289877 Enrollment ID: I20240723003810 |
| Provider Name | Reza Mohebi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891292280 PECOS PAC ID: 0143601039 Enrollment ID: I20240724001512 |
| Provider Name | Christian Alexander Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174100911 PECOS PAC ID: 1355888710 Enrollment ID: I20240802000619 |
| Provider Name | Paula Celine Trepman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922561018 PECOS PAC ID: 2365773181 Enrollment ID: I20240808004480 |
| Provider Name | Isabella Joy Mortola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548005523 PECOS PAC ID: 8022558618 Enrollment ID: I20240910002472 |
| Provider Name | Karla J Gomez |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1528845633 PECOS PAC ID: 7911350426 Enrollment ID: I20240919002777 |
| Provider Name | Karen Ma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114759446 PECOS PAC ID: 0648704718 Enrollment ID: I20241112001894 |
| Provider Name | Nellie Skillen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649090457 PECOS PAC ID: 9830623578 Enrollment ID: I20241118000494 |
Harbor Comprehensive Health Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 803 Figueroa St, Wilmington, CA 90744 Phone: 310-830-0863 Fax: 310-830-0863 | |
Wilmington Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1122 W Anaheim St, Wilmington, CA 90744 Phone: 310-549-5760 | |
Nationwide Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1322 N Avalon Blvd, Wilmington, CA 90744 Phone: 310-513-1300 Fax: 310-513-1311 | |
United Physician Multispecialty Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1037 E Pacific Coast Hwy, Wilmington, CA 90744 Phone: 310-549-6950 | |