| Mitra Blair Bahaee, MD | |
| 9850 Genesee Ave Ste 320, La Jolla, CA 92037-1208 | |
| (858) 554-1212 | |
| (858) 795-1195 | 
| Full Name | Mitra Blair Bahaee | 
|---|---|
| Gender | Female | 
| Speciality | Family Medicine | 
| Location | 9850 Genesee Ave Ste 320, La Jolla, California | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1407417736 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 4351044605 (Michigan) | Secondary | 
| 207Q00000X | Family Medicine | A178502 (California) | Primary | 
| Entity Name | Southern California Permanente Medical Group | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 | 
| Entity Name | Monica Perlman Md Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1134309305 PECOS PAC ID: 8820035884 Enrollment ID: O20050411001333 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mitra Blair Bahaee, MD 9850 Genesee Ave Ste 320, La Jolla, CA 92037-1208 Ph: (858) 554-1212 | Mitra Blair Bahaee, MD 9850 Genesee Ave Ste 320, La Jolla, CA 92037-1208 Ph: (858) 554-1212 | 
| Alexa Chavez, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 9300 Campus Point Dr # Mc7196, La Jolla, CA 92037 Phone: 858-657-7539 | |
| Dr. Stacie Sanmiguel, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 9500 Gilman Dr # Mc-0039, La Jolla, CA 92093 Phone: 858-822-4757 Fax: 858-534-7545 | |
| Dr. James Donald Dibdin, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 505 Coast Blvd South # 408, La Jolla, CA 92037 Phone: 858-459-7788 | |
| Dr. Rhodaline Tootell, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9850 Genesee Ave, Ste 320, La Jolla, CA 92037 Phone: 858-554-1212 | |
| Dr. Seymour Myers, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9850 Genesee Ave Ste 320, La Jolla, CA 92037 Phone: 858-554-1212 Fax: 858-554-1222 | |
| Dr. Nicholas Canelo, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9850 Genesee Ave Ste 320, La Jolla, CA 92037 Phone: 858-554-1212 | |
| Dr. Rhona H Fink, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 9898 Genesee Ave, La Jolla, CA 92037 Phone: 858-824-5383 Fax: 858-964-3125 |