| Synovation Medical Group | |
|
1017 S Fair Oaks Ave Pasadena CA 91105-2621 | |
| (626) 403-6200 | |
| (626) 403-2580 |
| Full Name | Synovation Medical Group |
|---|---|
| Speciality | Pain Medicine |
| Location | 1017 S Fair Oaks Ave, Pasadena, California |
| Authorized Official Name and Position | Clayton A. Varga (CEO) |
| Authorized Official Contact | 6266961400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Synovation Medical Group 10565 Civic Center Dr Ste 250 Rancho Cucamonga CA 91730-3854 Ph: (909) 493-3800 | Synovation Medical Group 1017 S Fair Oaks Ave Pasadena CA 91105-2621 Ph: (626) 403-6200 |
| NPI Number | 1497747356 |
|---|---|
| Provider Enumeration Date | 08/17/2005 |
| Last Update Date | 03/14/2025 |
| Certification Date | 03/14/2025 |
| Medicare PECOS PAC ID | 8123917713 |
|---|---|
| Medicare Enrollment ID | O20040311001539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497747356 | NPI | - | NPPES |
| 00G528590 | Medicaid | CA |
| Provider Name | Alexander a Krakovsky |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1023096443 PECOS PAC ID: 5698670800 Enrollment ID: I20031201000807 |
| Provider Name | Jesus H Lao |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1275571010 PECOS PAC ID: 8820987399 Enrollment ID: I20040312000510 |
| Provider Name | Marc E Lynch |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1760488621 PECOS PAC ID: 6507853397 Enrollment ID: I20040426000850 |
| Provider Name | Caryn J Axtell-kelly |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700815958 PECOS PAC ID: 5890782692 Enrollment ID: I20040426000907 |
| Provider Name | Philip Corrado |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326159997 PECOS PAC ID: 4183696099 Enrollment ID: I20040811000492 |
| Provider Name | Evan R Minkoff |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1831150739 PECOS PAC ID: 6901718055 Enrollment ID: I20050201001050 |
| Provider Name | Hyung S Kim |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1609885581 PECOS PAC ID: 0042246514 Enrollment ID: I20050715000406 |
| Provider Name | Andrew G Seltzer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811079338 PECOS PAC ID: 9830124189 Enrollment ID: I20051005000684 |
| Provider Name | Jerrold C Bustos |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1942251384 PECOS PAC ID: 7719998897 Enrollment ID: I20060606000306 |
| Provider Name | Samuel E Samalin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255433082 PECOS PAC ID: 3870592744 Enrollment ID: I20061204000568 |
| Provider Name | Lois M Luetmer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932284577 PECOS PAC ID: 3678572054 Enrollment ID: I20061212000670 |
| Provider Name | Keong Joung |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1447456918 PECOS PAC ID: 6608957352 Enrollment ID: I20080118000480 |
| Provider Name | Jonathan David Grossman |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1225242332 PECOS PAC ID: 4880780717 Enrollment ID: I20081126000188 |
| Provider Name | Bijan Hoorfar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598927501 PECOS PAC ID: 0547321374 Enrollment ID: I20081211000268 |
| Provider Name | David Louis Flood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255472718 PECOS PAC ID: 2567364243 Enrollment ID: I20090227000531 |
| Provider Name | Traci R Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346234671 PECOS PAC ID: 2860419389 Enrollment ID: I20090501000481 |
| Provider Name | Clayton a Varga |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1629060694 PECOS PAC ID: 3678462124 Enrollment ID: I20090520000099 |
| Provider Name | Shiu-kwan Fok |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1104974062 PECOS PAC ID: 4880744200 Enrollment ID: I20090605000353 |
| Provider Name | Danielle Z Anastasiu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891911038 PECOS PAC ID: 4880747955 Enrollment ID: I20090806000780 |
| Provider Name | Susan a Font |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689857229 PECOS PAC ID: 1759422298 Enrollment ID: I20100106000604 |
| Provider Name | William M Barreto |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1053526285 PECOS PAC ID: 2668513961 Enrollment ID: I20100108000523 |
| Provider Name | Ann C Bolander |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1538259122 PECOS PAC ID: 5294798104 Enrollment ID: I20100301000109 |
| Provider Name | Brian T Vanfossen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396072500 PECOS PAC ID: 8325179609 Enrollment ID: I20100630000595 |
| Provider Name | Reed L Levine |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1386844868 PECOS PAC ID: 2466585773 Enrollment ID: I20100805001080 |
| Provider Name | Ryan C Peterson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669613816 PECOS PAC ID: 0547442956 Enrollment ID: I20110307000488 |
| Provider Name | Nouriel Niamehr |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1679881346 PECOS PAC ID: 6103097274 Enrollment ID: I20110921000307 |
| Provider Name | Khurram J Khan |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1417164062 PECOS PAC ID: 9133227275 Enrollment ID: I20111114000232 |
| Provider Name | Deina I Stewart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154491074 PECOS PAC ID: 1850308297 Enrollment ID: I20111121000554 |
| Provider Name | Virginia M Mabasa |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922082924 PECOS PAC ID: 2264699065 Enrollment ID: I20120207000212 |
| Provider Name | Jerome C Marcos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538462999 PECOS PAC ID: 0143484626 Enrollment ID: I20120613000354 |
| Provider Name | David S Moore |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467608786 PECOS PAC ID: 9032361167 Enrollment ID: I20121218000235 |
| Provider Name | Michelle Dajdumrongwood |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568720902 PECOS PAC ID: 7113171398 Enrollment ID: I20130218000326 |
| Provider Name | Ronald Joseph Cervantes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427035609 PECOS PAC ID: 2466697321 Enrollment ID: I20130325000222 |
| Provider Name | Henry a Richardson |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1407052459 PECOS PAC ID: 0749425635 Enrollment ID: I20130325000441 |
| Provider Name | Karen M Jersey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700150695 PECOS PAC ID: 9830335348 Enrollment ID: I20130429000129 |
| Provider Name | Seung-hee Moon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740526763 PECOS PAC ID: 1355589037 Enrollment ID: I20130608000171 |
| Provider Name | Angela J Cochran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316155310 PECOS PAC ID: 2860631728 Enrollment ID: I20130625000785 |
| Provider Name | Aileen S Estrada |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770831521 PECOS PAC ID: 0648411579 Enrollment ID: I20130718000578 |
| Provider Name | Rosanna J Carrillo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043439557 PECOS PAC ID: 6709028806 Enrollment ID: I20130819000666 |
| Provider Name | Ken Hsin |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1225202542 PECOS PAC ID: 4486880820 Enrollment ID: I20131113001624 |
| Provider Name | Casey J Fisher |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1275780686 PECOS PAC ID: 2062648876 Enrollment ID: I20131127001269 |
| Provider Name | Juliet E Fliegel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295936201 PECOS PAC ID: 6507092194 Enrollment ID: I20131204002017 |
| Provider Name | Paige M Myers Mcnamara |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427368786 PECOS PAC ID: 6709000789 Enrollment ID: I20140612002127 |
| Provider Name | Reekesh R Patel |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1043446982 PECOS PAC ID: 1759524374 Enrollment ID: I20140710000989 |
| Provider Name | Sharron L Thompson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1669462883 PECOS PAC ID: 1658334131 Enrollment ID: I20140810000005 |
| Provider Name | Mauro Zappaterra |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1013233576 PECOS PAC ID: 1759508880 Enrollment ID: I20140813000454 |
| Provider Name | Melissa a Brito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730580853 PECOS PAC ID: 9739404799 Enrollment ID: I20150213001686 |
| Provider Name | Kevin Lee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104216183 PECOS PAC ID: 2264750892 Enrollment ID: I20150413000021 |
| Provider Name | Patricia Lutfy |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1497024061 PECOS PAC ID: 1355656943 Enrollment ID: I20150811004817 |
| Provider Name | Vibha Agrawal |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1528196045 PECOS PAC ID: 0143384164 Enrollment ID: I20150902003366 |
| Provider Name | Robert M Paul |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972811412 PECOS PAC ID: 2365626892 Enrollment ID: I20151007003235 |
| Provider Name | Leoncio Paciente Yap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508299942 PECOS PAC ID: 7315257227 Enrollment ID: I20151105000709 |
| Provider Name | Heather Grace Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427426386 PECOS PAC ID: 7012217789 Enrollment ID: I20151202000545 |
| Provider Name | Roger J Mignosa |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1255627691 PECOS PAC ID: 4880997386 Enrollment ID: I20160115001295 |
| Provider Name | Elizabeth a Shouse |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760848659 PECOS PAC ID: 4880997063 Enrollment ID: I20160121001581 |
| Provider Name | Renee N Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972984839 PECOS PAC ID: 1951605468 Enrollment ID: I20160203001997 |
| Provider Name | Yvonne D Jones- Wicks |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477646610 PECOS PAC ID: 0042285603 Enrollment ID: I20160204001583 |
| Provider Name | Seyed Amir Tahaei |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1275845133 PECOS PAC ID: 5597989871 Enrollment ID: I20160328001940 |
| Provider Name | Naveed Natanzi |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1184068926 PECOS PAC ID: 0143538785 Enrollment ID: I20160825002490 |
| Provider Name | Benjamin a Leshin |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1891055091 PECOS PAC ID: 4880981224 Enrollment ID: I20160928001314 |
| Provider Name | Robert Dinenberg |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1841436706 PECOS PAC ID: 5698063659 Enrollment ID: I20161007000786 |
| Provider Name | Annette Marie Ramos-haggan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285091991 PECOS PAC ID: 6305130014 Enrollment ID: I20161007001302 |
| Provider Name | Elena Shostak |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831644020 PECOS PAC ID: 6002104338 Enrollment ID: I20161019001031 |
| Provider Name | Elizabeth Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205384310 PECOS PAC ID: 6800174749 Enrollment ID: I20161028000581 |
| Provider Name | Rebecca Duran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760722342 PECOS PAC ID: 6305143926 Enrollment ID: I20161206000727 |
| Provider Name | Courtney L Farrar |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124577952 PECOS PAC ID: 0042590036 Enrollment ID: I20161208002181 |
| Provider Name | Beverly L Wike |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437281219 PECOS PAC ID: 4789964370 Enrollment ID: I20161219000977 |
| Provider Name | Keimi PT Lew |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669920740 PECOS PAC ID: 7517248859 Enrollment ID: I20161229000327 |
| Provider Name | Rebecca a Ponce |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336687367 PECOS PAC ID: 6800171752 Enrollment ID: I20170316001327 |
| Provider Name | Shveta Jain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1598024226 PECOS PAC ID: 6608169669 Enrollment ID: I20170322002541 |
| Provider Name | Yurong Lu |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295196061 PECOS PAC ID: 7012294192 Enrollment ID: I20170426002766 |
| Provider Name | Nader Sawiris |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1720304207 PECOS PAC ID: 3870711559 Enrollment ID: I20170613002456 |
| Provider Name | Sarun Soon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972039444 PECOS PAC ID: 6406124106 Enrollment ID: I20170621002971 |
| Provider Name | John Scott Adams |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1093004061 PECOS PAC ID: 3072814110 Enrollment ID: I20170817001802 |
| Provider Name | Arin Vahan Abramian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487033213 PECOS PAC ID: 5991928939 Enrollment ID: I20171013002304 |
| Provider Name | Orah Mahtov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184133944 PECOS PAC ID: 6901164540 Enrollment ID: I20180103000859 |
| Provider Name | Veronika Johana Weller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013451194 PECOS PAC ID: 0143589689 Enrollment ID: I20180109001669 |
| Provider Name | Robin G Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649773227 PECOS PAC ID: 2769746205 Enrollment ID: I20180508002701 |
| Provider Name | Michela S Termechi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437696226 PECOS PAC ID: 4385990217 Enrollment ID: I20180709001470 |
| Provider Name | Jeila Marie Kakavand |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790127298 PECOS PAC ID: 5890926562 Enrollment ID: I20180820003658 |
| Provider Name | Hripsime Avagyan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790122687 PECOS PAC ID: 6002166139 Enrollment ID: I20180911000899 |
| Provider Name | Abhishek Patel |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1780944918 PECOS PAC ID: 9032469002 Enrollment ID: I20180912002729 |
| Provider Name | Ryan D Mattie |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1245615350 PECOS PAC ID: 5890048672 Enrollment ID: I20181024001529 |
| Provider Name | Kevin Jiang |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1134480510 PECOS PAC ID: 8921308933 Enrollment ID: I20181211003732 |
| Provider Name | Robert M Deleon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023507324 PECOS PAC ID: 8729325352 Enrollment ID: I20190122002405 |
| Provider Name | Sumera Chaggan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144702887 PECOS PAC ID: 6305185117 Enrollment ID: I20190221002740 |
| Provider Name | Donald L Hamby |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1750726485 PECOS PAC ID: 4183984362 Enrollment ID: I20190315002317 |
| Provider Name | Brittany Angelica Jarrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558781112 PECOS PAC ID: 3173836921 Enrollment ID: I20190613001823 |
| Provider Name | Kenneth O Ejiogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639647019 PECOS PAC ID: 5597099028 Enrollment ID: I20190702003455 |
| Provider Name | Edgar Fernando a Abad |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982784542 PECOS PAC ID: 7416284112 Enrollment ID: I20190802001662 |
| Provider Name | Brandon O Dairo |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1689092470 PECOS PAC ID: 3779810171 Enrollment ID: I20190807004033 |
| Provider Name | Mahnaz Entezaralmahdi |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1881005445 PECOS PAC ID: 5193070357 Enrollment ID: I20190912002522 |
| Provider Name | Danah Majorie F Lucasan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669030987 PECOS PAC ID: 6800228164 Enrollment ID: I20191107002383 |
| Provider Name | Christy M Anthony |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1467867440 PECOS PAC ID: 6103130182 Enrollment ID: I20200106003035 |
| Provider Name | Delisa a Dimpudus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851939979 PECOS PAC ID: 8022432582 Enrollment ID: I20200710000613 |
| Provider Name | Uyen H Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346803152 PECOS PAC ID: 4284059767 Enrollment ID: I20200730002625 |
| Provider Name | Zair Arshad Shah |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1205282837 PECOS PAC ID: 0840617783 Enrollment ID: I20200824002816 |
| Provider Name | Ngoc B Truong |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1841634797 PECOS PAC ID: 3779901608 Enrollment ID: I20200901003501 |
| Provider Name | Christina L Vidanez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740827872 PECOS PAC ID: 8426462763 Enrollment ID: I20210128001418 |
| Provider Name | Behnoosh Behdad Rahavard |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1114396371 PECOS PAC ID: 8325333289 Enrollment ID: I20210212002354 |
| Provider Name | Jeffrey Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255937363 PECOS PAC ID: 9133535891 Enrollment ID: I20210304001966 |
| Provider Name | Tammy T Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326682428 PECOS PAC ID: 3476952151 Enrollment ID: I20210528002369 |
| Provider Name | Derek J Wright |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629674858 PECOS PAC ID: 7113320128 Enrollment ID: I20210728003882 |
| Provider Name | Alexandria C Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104496850 PECOS PAC ID: 0244637510 Enrollment ID: I20210929001969 |
| Provider Name | Keerstin N Beitter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477129302 PECOS PAC ID: 9830597707 Enrollment ID: I20211006002838 |
| Provider Name | Mirtha a Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811567142 PECOS PAC ID: 6002204146 Enrollment ID: I20211022001271 |
| Provider Name | Amy N Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265022438 PECOS PAC ID: 0749678753 Enrollment ID: I20211025001637 |
| Provider Name | Parisa Shirkhani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164188975 PECOS PAC ID: 9830589829 Enrollment ID: I20211206002801 |
| Provider Name | Jinseo Choi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386302479 PECOS PAC ID: 7517359334 Enrollment ID: I20220127001956 |
| Provider Name | Torrence H Puck |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528685054 PECOS PAC ID: 3870988777 Enrollment ID: I20220310002739 |
| Provider Name | Madeleine a Fernandez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619612033 PECOS PAC ID: 2264811686 Enrollment ID: I20220615001319 |
| Provider Name | Merian M Apolinario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881347516 PECOS PAC ID: 5092194993 Enrollment ID: I20220623002227 |
| Provider Name | Kaitlyn L Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982360913 PECOS PAC ID: 2668854399 Enrollment ID: I20220727003999 |
| Provider Name | Mark Anthony Cole |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770761868 PECOS PAC ID: 1557747177 Enrollment ID: I20221005003296 |
| Provider Name | Zandri Terlep |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306573480 PECOS PAC ID: 7911374160 Enrollment ID: I20221101002742 |
| Provider Name | Dezy Mani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235704750 PECOS PAC ID: 5193193167 Enrollment ID: I20221122002766 |
| Provider Name | Jelena Soni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063880235 PECOS PAC ID: 0749590313 Enrollment ID: I20230222002942 |
| Provider Name | Pragya B Gupta |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1740243609 PECOS PAC ID: 5294719365 Enrollment ID: I20230330000998 |
| Provider Name | Alex Ing Fan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659086783 PECOS PAC ID: 8628433893 Enrollment ID: I20230424002183 |
| Provider Name | Sowmya Krishnan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164110219 PECOS PAC ID: 9234599812 Enrollment ID: I20230713003277 |
| Provider Name | Laura M Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790473163 PECOS PAC ID: 4284097809 Enrollment ID: I20230830002231 |
| Provider Name | Hovhannes Ghazaryan |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1851910665 PECOS PAC ID: 1951765965 Enrollment ID: I20230908003550 |
| Provider Name | Cindy Sieun an |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801579420 PECOS PAC ID: 7113371261 Enrollment ID: I20230925000364 |
| Provider Name | Christina M Jaeger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245929470 PECOS PAC ID: 3476904509 Enrollment ID: I20240112001669 |
| Provider Name | Matthew G Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588434658 PECOS PAC ID: 9032558697 Enrollment ID: I20240415003744 |
| Provider Name | Alice Costen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629047543 PECOS PAC ID: 0042278632 Enrollment ID: I20240419001942 |
| Provider Name | Orena Massachi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417638115 PECOS PAC ID: 0143660803 Enrollment ID: I20240429000168 |
| Provider Name | Yasuko Ono |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831878875 PECOS PAC ID: 9638510019 Enrollment ID: I20240516001227 |
| Provider Name | Yamin Sallowm |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1699138008 PECOS PAC ID: 7517251762 Enrollment ID: I20240530002410 |
| Provider Name | Frances Antoinette C Pobre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992572622 PECOS PAC ID: 9133666365 Enrollment ID: I20240805003572 |
| Provider Name | Oluseyi a Obadeyi |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1972182459 PECOS PAC ID: 4688112832 Enrollment ID: I20240819003004 |
| Provider Name | Katherine D Greenwalt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639763675 PECOS PAC ID: 2668911264 Enrollment ID: I20240827003579 |
| Provider Name | Ijose Beverly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689097065 PECOS PAC ID: 8729527866 Enrollment ID: I20240903002673 |
| Provider Name | Natalie D Christensen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376261495 PECOS PAC ID: 8527507664 Enrollment ID: I20240903002768 |
| Provider Name | Kayla a Arantowicz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669186581 PECOS PAC ID: 9335673342 Enrollment ID: I20241113003923 |
| Provider Name | Tara M Schueller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316767650 PECOS PAC ID: 2365968054 Enrollment ID: I20250424003942 |
| Provider Name | Gabriel Sanchez |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1447887658 PECOS PAC ID: 9931628369 Enrollment ID: I20250528003350 |
| Provider Name | Jasmin M Colansong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184440752 PECOS PAC ID: 9133630338 Enrollment ID: I20250616001111 |
| Provider Name | Minnah E Cho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790277515 PECOS PAC ID: 5991218083 Enrollment ID: I20250701004193 |
| Provider Name | Rachel Adelpour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811615677 PECOS PAC ID: 9032623467 Enrollment ID: I20250708004466 |
| Provider Name | Michael T Finnern |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1083975916 PECOS PAC ID: 7719389816 Enrollment ID: I20250830000282 |
| Provider Name | Xuhua Huang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588377667 PECOS PAC ID: 1951892389 Enrollment ID: I20251113003444 |
| Provider Name | Ricardo D Silvera |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255667192 PECOS PAC ID: 9436318391 Enrollment ID: I20251206000127 |
| Provider Name | Miranda N Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386524932 PECOS PAC ID: 3173016177 Enrollment ID: I20251206000287 |
| Provider Name | Patricia J Jeng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194526400 PECOS PAC ID: 8426543778 Enrollment ID: I20251223003989 |
Brightview Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 S Lake Ave Ste 300, Pasadena, CA 91101 Phone: 626-410-0299 |
Ys Licensed Clinical Social Worker, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16 N Marengo Ave Ste 418, Pasadena, CA 91101 Phone: 818-925-8623 |
Fuller Psychological and Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 North Oakland Avenue, Pasadena, CA 91101 Phone: 626-584-5555 Fax: 626-584-5558 |
Dedicato Treatment Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 N Altadena Dr Ste 401, Pasadena, CA 91107 Phone: 626-921-0113 Fax: 626-921-0214 |
Erin Viray Therapy Practic Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2810 E Del Mar Blvd Ste 7, Pasadena, CA 91107 Phone: 562-666-9055 |
D'veal Family & Youth Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2750 E Washington Blvd, Suite 230, 240, 250, 260, Pasadena, CA 91107 Phone: 626-296-8900 Fax: 626-405-8973 |