| Palomar Health Medical Group | |
|
15611 Pomerado Rd, Suite 400, Poway, CA 92064-2437 | |
| (858) 675-3100 | |
| (858) 673-5187 |
| Full Name | Palomar Health Medical Group |
|---|---|
| Type | Facility |
| Speciality | Family Medicine |
| Location | 15611 Pomerado Rd, Poway, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649500141 | NPI | - | NPPES |
| DQ5588 | Other | CA | MEDICARE RAILROAD |
| Provider Name | Bradley Bailey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780690677 PECOS PAC ID: 5799699427 Enrollment ID: I20031117000923 |
| Provider Name | Anatoly J Bulkin |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1275593154 PECOS PAC ID: 0345141438 Enrollment ID: I20040120001053 |
| Provider Name | Jeffrey R Lozier |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1225004450 PECOS PAC ID: 7810882495 Enrollment ID: I20040220001154 |
| Provider Name | Thomas R Knutson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962409938 PECOS PAC ID: 4587553490 Enrollment ID: I20040310001386 |
| Provider Name | William Michael Dunn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871512111 PECOS PAC ID: 8628967809 Enrollment ID: I20040315000574 |
| Provider Name | Branislav Cizmar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679554372 PECOS PAC ID: 5395731525 Enrollment ID: I20040422001582 |
| Provider Name | Julian N Anthony |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1841392552 PECOS PAC ID: 2163419797 Enrollment ID: I20040427000716 |
| Provider Name | Emi Misao Latham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871594903 PECOS PAC ID: 5395735641 Enrollment ID: I20040517001477 |
| Provider Name | Errajith R Desilva |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1083712236 PECOS PAC ID: 9335110501 Enrollment ID: I20040807000265 |
| Provider Name | John R Harper |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1720098205 PECOS PAC ID: 6305819582 Enrollment ID: I20040816001297 |
| Provider Name | Rod D Serry |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1912945130 PECOS PAC ID: 7315903168 Enrollment ID: I20041203000565 |
| Provider Name | Isela Penunuri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548295439 PECOS PAC ID: 7315903994 Enrollment ID: I20041206000527 |
| Provider Name | Hamed Bayat |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356344196 PECOS PAC ID: 0244298503 Enrollment ID: I20050113001056 |
| Provider Name | Philip C Mathis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942200399 PECOS PAC ID: 6002868262 Enrollment ID: I20050215001141 |
| Provider Name | Theophilos E Yphantides |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215031752 PECOS PAC ID: 6406897685 Enrollment ID: I20050518000429 |
| Provider Name | James S Otoshi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1679681027 PECOS PAC ID: 8325092117 Enrollment ID: I20050614000537 |
| Provider Name | Kenneth G Trestman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1346358793 PECOS PAC ID: 2264476951 Enrollment ID: I20050614000568 |
| Provider Name | Frank D Bender |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912015363 PECOS PAC ID: 2769426444 Enrollment ID: I20050614000581 |
| Provider Name | David M Illich |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1528125754 PECOS PAC ID: 9638106875 Enrollment ID: I20050720000247 |
| Provider Name | Patrick Fitzgerald |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1790882728 PECOS PAC ID: 5294767802 Enrollment ID: I20050906000526 |
| Provider Name | Roy R Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568487973 PECOS PAC ID: 5799718110 Enrollment ID: I20050915001109 |
| Provider Name | Michelle Kim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457328825 PECOS PAC ID: 7315962628 Enrollment ID: I20051005001244 |
| Provider Name | Dennis M Mamaril |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508832601 PECOS PAC ID: 5294723250 Enrollment ID: I20051019000959 |
| Provider Name | Richard L Putnam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861468027 PECOS PAC ID: 8123034626 Enrollment ID: I20060221000513 |
| Provider Name | Shanoe Cutts |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417994252 PECOS PAC ID: 7719904275 Enrollment ID: I20060929000334 |
| Provider Name | Philip J Balikian |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407803687 PECOS PAC ID: 0143239491 Enrollment ID: I20070201000657 |
| Provider Name | Maram F Zakko |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972579068 PECOS PAC ID: 1951356013 Enrollment ID: I20070216000422 |
| Provider Name | Ellen A Blando |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396711644 PECOS PAC ID: 3577669704 Enrollment ID: I20070504000472 |
| Provider Name | Steve W Zgliniec |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1033246608 PECOS PAC ID: 1557469889 Enrollment ID: I20070608000591 |
| Provider Name | Belinda A Dure-smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487620662 PECOS PAC ID: 6406957034 Enrollment ID: I20070725000697 |
| Provider Name | Alejandro Paz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760400386 PECOS PAC ID: 8527970284 Enrollment ID: I20070806000456 |
| Provider Name | John Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376607150 PECOS PAC ID: 3779675525 Enrollment ID: I20070905000717 |
| Provider Name | Camille V Santos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699971184 PECOS PAC ID: 8820184328 Enrollment ID: I20071015000165 |
| Provider Name | Roger B Schechter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346257649 PECOS PAC ID: 4587750666 Enrollment ID: I20071020000084 |
| Provider Name | David D Wine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811985542 PECOS PAC ID: 6002710563 Enrollment ID: I20071101000740 |
| Provider Name | Paul B Volpp |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1225186232 PECOS PAC ID: 1557459534 Enrollment ID: I20071109000199 |
| Provider Name | David J Carty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205802568 PECOS PAC ID: 9739277245 Enrollment ID: I20071116000555 |
| Provider Name | David A Hustosky |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275509473 PECOS PAC ID: 6406944784 Enrollment ID: I20071120000479 |
| Provider Name | Susan Meram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588630735 PECOS PAC ID: 0941398119 Enrollment ID: I20071121000587 |
| Provider Name | Yuan H Lin |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1487650412 PECOS PAC ID: 6507955135 Enrollment ID: I20071205000320 |
| Provider Name | Larry A Presant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790751956 PECOS PAC ID: 5395835482 Enrollment ID: I20071212000777 |
| Provider Name | Brian T Tabila |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1306032792 PECOS PAC ID: 3577643071 Enrollment ID: I20080109000877 |
| Provider Name | Todd D Wells |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952377806 PECOS PAC ID: 2062593957 Enrollment ID: I20080116000842 |
| Provider Name | Joseph Fiore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619983830 PECOS PAC ID: 3072696582 Enrollment ID: I20080206000702 |
| Provider Name | Adam S Fierer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205831161 PECOS PAC ID: 1557431194 Enrollment ID: I20080609000270 |
| Provider Name | Matthew Horn |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912015637 PECOS PAC ID: 5092898080 Enrollment ID: I20080619000714 |
| Provider Name | Jay R Grove |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912971334 PECOS PAC ID: 0941373930 Enrollment ID: I20080724000261 |
| Provider Name | Navinder S Sawhney |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1619174133 PECOS PAC ID: 6204995285 Enrollment ID: I20081105000575 |
| Provider Name | Robert D Frost |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114044633 PECOS PAC ID: 2961562913 Enrollment ID: I20081120000218 |
| Provider Name | Louis Maletz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013983055 PECOS PAC ID: 0547321028 Enrollment ID: I20081202000585 |
| Provider Name | Kevin C Owsley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992714406 PECOS PAC ID: 8022170695 Enrollment ID: I20081217000056 |
| Provider Name | Mohinderpal S Thaper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295795037 PECOS PAC ID: 3971520354 Enrollment ID: I20090427000576 |
| Provider Name | Veena A Prabhakar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902874761 PECOS PAC ID: 7214082809 Enrollment ID: I20090903000211 |
| Provider Name | Adnan M Zahid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285821207 PECOS PAC ID: 0941398374 Enrollment ID: I20090904000218 |
| Provider Name | Eric Michael Emont |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1376626754 PECOS PAC ID: 6305992595 Enrollment ID: I20090912000043 |
| Provider Name | David A Bridgeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134147986 PECOS PAC ID: 5991617656 Enrollment ID: I20091016000302 |
| Provider Name | Jeffrey B Petersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699794735 PECOS PAC ID: 1153468574 Enrollment ID: I20091016000317 |
| Provider Name | Scott D Flinn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184694598 PECOS PAC ID: 2860533866 Enrollment ID: I20100113000552 |
| Provider Name | Yusra Mir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932435757 PECOS PAC ID: 3577691120 Enrollment ID: I20100503000456 |
| Provider Name | Stuart N Graham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083680060 PECOS PAC ID: 5698677565 Enrollment ID: I20100616000906 |
| Provider Name | Jeremy Stupin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780883496 PECOS PAC ID: 3375676836 Enrollment ID: I20100804000355 |
| Provider Name | Soumya G. Rao |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1033388616 PECOS PAC ID: 9436283793 Enrollment ID: I20100823000570 |
| Provider Name | Gregory L Paranay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659396356 PECOS PAC ID: 7416971551 Enrollment ID: I20100830000886 |
| Provider Name | Jeffrey I Gorwit |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891798658 PECOS PAC ID: 0143345553 Enrollment ID: I20100908000920 |
| Provider Name | Christopher R Gilbert |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487657243 PECOS PAC ID: 3173715356 Enrollment ID: I20101006000433 |
| Provider Name | Mikhail R Malek |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1467455212 PECOS PAC ID: 7618160847 Enrollment ID: I20101020001467 |
| Provider Name | Daniel F Mulvihill |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124021969 PECOS PAC ID: 3173716305 Enrollment ID: I20101028001213 |
| Provider Name | Kiran R Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245491208 PECOS PAC ID: 2264500586 Enrollment ID: I20101109001267 |
| Provider Name | Charles Md Hardison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538475793 PECOS PAC ID: 1850322470 Enrollment ID: I20101115001390 |
| Provider Name | Mark Haberman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497780563 PECOS PAC ID: 6800708561 Enrollment ID: I20101207000215 |
| Provider Name | James M Bried |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891809257 PECOS PAC ID: 5991860447 Enrollment ID: I20110202000342 |
| Provider Name | Brad S Cohen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164536538 PECOS PAC ID: 5698766152 Enrollment ID: I20110203001152 |
| Provider Name | Arush A Patel |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1487892352 PECOS PAC ID: 9931383536 Enrollment ID: I20110406000176 |
| Provider Name | Minu Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316085632 PECOS PAC ID: 3870639909 Enrollment ID: I20110408000423 |
| Provider Name | Nasrin Arbabi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881655462 PECOS PAC ID: 0648457952 Enrollment ID: I20110613000768 |
| Provider Name | Apryl D Pidding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518259936 PECOS PAC ID: 4082891858 Enrollment ID: I20110728000140 |
| Provider Name | Rebecca A Samuels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821288069 PECOS PAC ID: 4981732526 Enrollment ID: I20110805000149 |
| Provider Name | Lorra Marie Sharp |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689689176 PECOS PAC ID: 8022141639 Enrollment ID: I20111101000110 |
| Provider Name | Damon Cobb |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851435598 PECOS PAC ID: 5799889861 Enrollment ID: I20120105000256 |
| Provider Name | Tiffany A Ebersohl |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467605725 PECOS PAC ID: 0749447316 Enrollment ID: I20120209000249 |
| Provider Name | Mark Leland Kadden |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093784597 PECOS PAC ID: 9133174295 Enrollment ID: I20120322000560 |
| Provider Name | Thomas L Kolt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841223807 PECOS PAC ID: 3870587983 Enrollment ID: I20120327000832 |
| Provider Name | Amy C Trewella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376513119 PECOS PAC ID: 6901062033 Enrollment ID: I20120718000297 |
| Provider Name | Daniel Barba |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407128580 PECOS PAC ID: 1951567262 Enrollment ID: I20120731000420 |
| Provider Name | Douglas Green |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164635173 PECOS PAC ID: 0042489668 Enrollment ID: I20130110000588 |
| Provider Name | Karen J Hanna |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184687337 PECOS PAC ID: 6608977848 Enrollment ID: I20130206000471 |
| Provider Name | Hardeep Singh Phull |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1306103510 PECOS PAC ID: 5294974218 Enrollment ID: I20130622000038 |
| Provider Name | Alexander Tae-shik Chang |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1376860056 PECOS PAC ID: 3870733744 Enrollment ID: I20130717000660 |
| Provider Name | Nadine E Graven |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295899847 PECOS PAC ID: 1456594977 Enrollment ID: I20130903000588 |
| Provider Name | Kenesha P Colson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912333840 PECOS PAC ID: 8820225204 Enrollment ID: I20131210000732 |
| Provider Name | Dennis Nemceff |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1427371228 PECOS PAC ID: 3577791649 Enrollment ID: I20140117000103 |
| Provider Name | Andrew K Chen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134357007 PECOS PAC ID: 6002046596 Enrollment ID: I20140228001766 |
| Provider Name | Amy M Marin |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1801234349 PECOS PAC ID: 7618109125 Enrollment ID: I20140416001307 |
| Provider Name | Trisha E Blakesley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902228711 PECOS PAC ID: 3072745470 Enrollment ID: I20140417002165 |
| Provider Name | Heather M Cones |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1649550435 PECOS PAC ID: 6103049226 Enrollment ID: I20140519000776 |
| Provider Name | Ken Stanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356493720 PECOS PAC ID: 8022031467 Enrollment ID: I20140605001722 |
| Provider Name | Kimberly M Barmack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881018067 PECOS PAC ID: 7416171178 Enrollment ID: I20140619001127 |
| Provider Name | Amanda M Caparso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003046004 PECOS PAC ID: 3072795087 Enrollment ID: I20140709002729 |
| Provider Name | Diane M Scott |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1992786347 PECOS PAC ID: 6507045457 Enrollment ID: I20140903000109 |
| Provider Name | Natalia Babkina |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396066635 PECOS PAC ID: 6305068941 Enrollment ID: I20141114000406 |
| Provider Name | Paul W Hinshaw |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215170717 PECOS PAC ID: 5890928048 Enrollment ID: I20150122000566 |
| Provider Name | Ludmilla N. Ionescu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568498145 PECOS PAC ID: 6709812167 Enrollment ID: I20150127002149 |
| Provider Name | Ariel Palanca |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629203971 PECOS PAC ID: 9931423696 Enrollment ID: I20150128002198 |
| Provider Name | Jerry Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871543199 PECOS PAC ID: 7416979273 Enrollment ID: I20150202000905 |
| Provider Name | Sadaf Najand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669769717 PECOS PAC ID: 8921323288 Enrollment ID: I20150207000003 |
| Provider Name | Joseph Garvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437499704 PECOS PAC ID: 6103141239 Enrollment ID: I20150213000326 |
| Provider Name | Amar M Amin |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1316181225 PECOS PAC ID: 3678889722 Enrollment ID: I20150903001518 |
| Provider Name | Sonal Khattri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013997303 PECOS PAC ID: 7517902612 Enrollment ID: I20151001003250 |
| Provider Name | Eric Frey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891091682 PECOS PAC ID: 1355650227 Enrollment ID: I20151014003269 |
| Provider Name | Jory Adam |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922269521 PECOS PAC ID: 1052322088 Enrollment ID: I20151103000281 |
| Provider Name | Saurabh Shah |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1790717957 PECOS PAC ID: 1153395041 Enrollment ID: I20160729001755 |
| Provider Name | Saba Hamiduzzaman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1700011004 PECOS PAC ID: 6608162375 Enrollment ID: I20160906001689 |
| Provider Name | Anapatricia Najera-higareda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013462852 PECOS PAC ID: 7810285335 Enrollment ID: I20161014001809 |
| Provider Name | Rachel Elizabeth Krochmal |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326117920 PECOS PAC ID: 8224226618 Enrollment ID: I20161229000053 |
| Provider Name | Simon G Tanksley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407084098 PECOS PAC ID: 0941459796 Enrollment ID: I20170130002176 |
| Provider Name | Elizabeth Saez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558819649 PECOS PAC ID: 2062794829 Enrollment ID: I20170131002226 |
| Provider Name | Aaron A Cho |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790758548 PECOS PAC ID: 7012290505 Enrollment ID: I20170207001970 |
| Provider Name | Frank Kuo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922418797 PECOS PAC ID: 6406075803 Enrollment ID: I20170509001856 |
| Provider Name | Anita Ojha Hammad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952361396 PECOS PAC ID: 8820035348 Enrollment ID: I20170602002220 |
| Provider Name | Steven T Popper |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1679849012 PECOS PAC ID: 9436371606 Enrollment ID: I20170803001150 |
| Provider Name | Maryam Balouch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215201108 PECOS PAC ID: 4183902372 Enrollment ID: I20170825002730 |
| Provider Name | Patrick A Armstrong |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1588008775 PECOS PAC ID: 1658644539 Enrollment ID: I20170829003535 |
| Provider Name | Paul C Jou |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1356608319 PECOS PAC ID: 9234434671 Enrollment ID: I20170830001437 |
| Provider Name | Christopher Toensing |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376801332 PECOS PAC ID: 6800037672 Enrollment ID: I20170831003062 |
| Provider Name | Christopher T Vanichsarn |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1851658173 PECOS PAC ID: 1658686191 Enrollment ID: I20170928000099 |
| Provider Name | Kimberly Denise Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811400708 PECOS PAC ID: 1759640485 Enrollment ID: I20180125001636 |
| Provider Name | Cherry M Deolaso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174030712 PECOS PAC ID: 0749541464 Enrollment ID: I20180220003040 |
| Provider Name | Mohamad Ahmadi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992207062 PECOS PAC ID: 2264794478 Enrollment ID: I20180328002840 |
| Provider Name | Tammam Beydoun |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1033349014 PECOS PAC ID: 0840501524 Enrollment ID: I20180404002695 |
| Provider Name | Christine J Healey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1437353562 PECOS PAC ID: 0446515316 Enrollment ID: I20180523002124 |
| Provider Name | Mohammed Sa Suhail |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215279682 PECOS PAC ID: 2769747039 Enrollment ID: I20180607002382 |
| Provider Name | Manu K Singh |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1114338753 PECOS PAC ID: 9436404233 Enrollment ID: I20180619003345 |
| Provider Name | Young E Lee |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1285833764 PECOS PAC ID: 9436447349 Enrollment ID: I20180731002671 |
| Provider Name | Alaa Beydoun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841552833 PECOS PAC ID: 4385942770 Enrollment ID: I20180828000083 |
| Provider Name | Ankaj Khosla |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1033485859 PECOS PAC ID: 6608127527 Enrollment ID: I20180914002716 |
| Provider Name | Adam E Freiwald |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912367830 PECOS PAC ID: 9335445584 Enrollment ID: I20181109001861 |
| Provider Name | George S Knapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124500012 PECOS PAC ID: 7315281052 Enrollment ID: I20181206000513 |
| Provider Name | Susan C Farrish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588649602 PECOS PAC ID: 4486999141 Enrollment ID: I20181227001425 |
| Provider Name | Jessica Marie Salas-gaerlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356817431 PECOS PAC ID: 0446598551 Enrollment ID: I20190215001157 |
| Provider Name | Sadaf Farasat |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1255696407 PECOS PAC ID: 5092095190 Enrollment ID: I20190304000696 |
| Provider Name | Ngoc X Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184668105 PECOS PAC ID: 6709879141 Enrollment ID: I20190506002581 |
| Provider Name | Cathleen E Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720587561 PECOS PAC ID: 4880936111 Enrollment ID: I20190507000180 |
| Provider Name | Michele Grace V Quan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629462882 PECOS PAC ID: 9436486701 Enrollment ID: I20190808002639 |
| Provider Name | Ariane-jane Flores |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992273957 PECOS PAC ID: 3476880485 Enrollment ID: I20190814002306 |
| Provider Name | Rochelle B Bui |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942747951 PECOS PAC ID: 5193087948 Enrollment ID: I20190920000853 |
| Provider Name | Igor Sister |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518149467 PECOS PAC ID: 4981787975 Enrollment ID: I20191018000408 |
| Provider Name | Youstina Soliman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497036560 PECOS PAC ID: 6305168212 Enrollment ID: I20191104001613 |
| Provider Name | Matthew David Louis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316395726 PECOS PAC ID: 9739511015 Enrollment ID: I20191107003380 |
| Provider Name | Judith S Meyers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538637194 PECOS PAC ID: 4385076520 Enrollment ID: I20191108002746 |
| Provider Name | Mary Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265837025 PECOS PAC ID: 1850725227 Enrollment ID: I20191218002571 |
| Provider Name | Katelyn Harding |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225689318 PECOS PAC ID: 7113351248 Enrollment ID: I20191226001601 |
| Provider Name | Mariette A Macrander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679828438 PECOS PAC ID: 6608099262 Enrollment ID: I20200225002864 |
| Provider Name | Alexandra J Chatfield |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215584628 PECOS PAC ID: 4486082484 Enrollment ID: I20200324003443 |
| Provider Name | Amy E Hartwell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376180505 PECOS PAC ID: 8527496785 Enrollment ID: I20200406003426 |
| Provider Name | Vasken Keleshian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770947384 PECOS PAC ID: 3779875273 Enrollment ID: I20200504000870 |
| Provider Name | Ayda Dashtaei |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497146120 PECOS PAC ID: 4587974274 Enrollment ID: I20200707003407 |
| Provider Name | Sammer Jazbeh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770825457 PECOS PAC ID: 9436469756 Enrollment ID: I20200731002369 |
| Provider Name | Brittany Lynn Raymond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679084321 PECOS PAC ID: 0143581678 Enrollment ID: I20200807002607 |
| Provider Name | Levi Benjamin Williamson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932672615 PECOS PAC ID: 4789001884 Enrollment ID: I20200903002717 |
| Provider Name | Marina V Levin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023209798 PECOS PAC ID: 6305938150 Enrollment ID: I20200909002442 |
| Provider Name | Tamrah J Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386257210 PECOS PAC ID: 8325451578 Enrollment ID: I20210106002419 |
| Provider Name | Alexis M Ehler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902496946 PECOS PAC ID: 2860800083 Enrollment ID: I20210427002984 |
| Provider Name | Allison M Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083226245 PECOS PAC ID: 8224447917 Enrollment ID: I20210510002337 |
| Provider Name | Sean David Burn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669852844 PECOS PAC ID: 7810328754 Enrollment ID: I20210708000570 |
| Provider Name | Omar Nabil Kallas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003201336 PECOS PAC ID: 1850703760 Enrollment ID: I20210803002696 |
| Provider Name | Alvin K Shieh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316322100 PECOS PAC ID: 2961833686 Enrollment ID: I20210804003838 |
| Provider Name | Tony Ting Chen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245684497 PECOS PAC ID: 3173815461 Enrollment ID: I20210811002863 |
| Provider Name | Darrell Wu |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1598921272 PECOS PAC ID: 4486059664 Enrollment ID: I20211108001181 |
| Provider Name | Karen Lee Manchester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801225941 PECOS PAC ID: 2365831112 Enrollment ID: I20211116002179 |
| Provider Name | Nicholas Ray Spear |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144985128 PECOS PAC ID: 4082005202 Enrollment ID: I20211223001594 |
| Provider Name | Angie Shammo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679110464 PECOS PAC ID: 2668800822 Enrollment ID: I20220315001973 |
| Provider Name | Jeffrey Bonenfant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780094755 PECOS PAC ID: 7517344690 Enrollment ID: I20220510002629 |
| Provider Name | Kyle Patrick Green |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194246041 PECOS PAC ID: 1254718182 Enrollment ID: I20220516002011 |
| Provider Name | Sarah Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326796210 PECOS PAC ID: 9830579242 Enrollment ID: I20220701000864 |
| Provider Name | Alec Jeffrey Larson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598400772 PECOS PAC ID: 9234510322 Enrollment ID: I20220720003717 |
| Provider Name | Christina Blanchard |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1619606969 PECOS PAC ID: 6709260904 Enrollment ID: I20220907003827 |
| Provider Name | Monika Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336809771 PECOS PAC ID: 6800271529 Enrollment ID: I20220916001183 |
| Provider Name | Jamie Kroesch Lidster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538633219 PECOS PAC ID: 5092191866 Enrollment ID: I20220930002127 |
| Provider Name | Erin Danielle Wiltchik |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1518498757 PECOS PAC ID: 0840676250 Enrollment ID: I20221007000438 |
| Provider Name | Jonathan Read Bear |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1770849523 PECOS PAC ID: 0749513638 Enrollment ID: I20230216002109 |
| Provider Name | Amanda J. Ahmadi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639889983 PECOS PAC ID: 8426423401 Enrollment ID: I20230404002380 |
| Provider Name | Abigail Joyce Brion Ibarra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063102648 PECOS PAC ID: 6608234083 Enrollment ID: I20230615003778 |
| Provider Name | Matthew G. Weber |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073099438 PECOS PAC ID: 7214396571 Enrollment ID: I20230705000545 |
| Provider Name | Omar Velasco |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275845570 PECOS PAC ID: 5991060188 Enrollment ID: I20230712001444 |
| Provider Name | Muneeb Choudry |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1518924323 PECOS PAC ID: 6002860764 Enrollment ID: I20230828000912 |
| Provider Name | Jefferey Raunig |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043603863 PECOS PAC ID: 6305291642 Enrollment ID: I20231006000996 |
| Provider Name | Stephanie E Leblang |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033677489 PECOS PAC ID: 8921337221 Enrollment ID: I20231108001371 |
| Provider Name | Katherine Stewart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215480637 PECOS PAC ID: 4880974013 Enrollment ID: I20231128001164 |
| Provider Name | Justin Bergh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336646751 PECOS PAC ID: 6406230622 Enrollment ID: I20231206002057 |
| Provider Name | Ramesh Subedi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912155532 PECOS PAC ID: 5092867192 Enrollment ID: I20240423000929 |
| Provider Name | Jocelyn Yang |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1164116026 PECOS PAC ID: 5991146227 Enrollment ID: I20240516003382 |
| Provider Name | Elias Jason Fanous |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528528569 PECOS PAC ID: 0547601700 Enrollment ID: I20240518000620 |
| Provider Name | Kevin Gerry Lin |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1043707714 PECOS PAC ID: 1355887258 Enrollment ID: I20240729000115 |
| Provider Name | Jeremy Le |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1598285868 PECOS PAC ID: 0941746747 Enrollment ID: I20240729000296 |
| Provider Name | Hailey Baker |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1558927947 PECOS PAC ID: 2466786256 Enrollment ID: I20240816001816 |
| Provider Name | Agustin Borjon |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1124472311 PECOS PAC ID: 1759829096 Enrollment ID: I20240816003128 |
| Provider Name | Cole Cameron Stasek |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1619528353 PECOS PAC ID: 7416370945 Enrollment ID: I20250324002166 |
| Provider Name | Carol Grace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649234139 PECOS PAC ID: 8123092087 Enrollment ID: I20250630001706 |
| Provider Name | Hadi Safavi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508124686 PECOS PAC ID: 4284943739 Enrollment ID: I20250710004343 |
| Provider Name | Tracy Vandewater |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1023512332 PECOS PAC ID: 9032466396 Enrollment ID: I20251024002265 |
| Provider Name | Charles Rinehart |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1891174504 PECOS PAC ID: 6901271683 Enrollment ID: I20260105002688 |
| Provider Name | Yajahira Yuremi Romero |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235879628 PECOS PAC ID: 5597251983 Enrollment ID: I20260106002042 |
| Provider Name | Karan Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114663275 PECOS PAC ID: 9335626043 Enrollment ID: I20260123002631 |
| Provider Name | Rami Jirjis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1720584584 PECOS PAC ID: 8527323906 Enrollment ID: I20260217004313 |
| Provider Name | Alexis Crawford |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083349955 PECOS PAC ID: 0446609648 Enrollment ID: I20260302001344 |
| Mailing Address | Practice Location Address |
|---|---|
| Palomar Health Medical Group Po Box 51739, Los Angeles, CA 90051-6039 Ph: (858) 675-3100 | Palomar Health Medical Group 15611 Pomerado Rd, Suite 400, Poway, CA 92064-2437 Ph: (858) 675-3100 |