| San Diego American Indian Health Center | |
|
2630 1st Ave San Diego CA 92103-6599 | |
| (619) 234-2158 | |
| (619) 234-0206 |
| Full Name | San Diego American Indian Health Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2630 1st Ave, San Diego, California |
| Authorized Official Name and Position | Joseph Bulfer (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6192342158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Diego American Indian Health Center 2630 1st Ave San Diego CA 92103-6599 Ph: (619) 234-2158 | San Diego American Indian Health Center 2630 1st Ave San Diego CA 92103-6599 Ph: (619) 234-2158 |
| NPI Number | 1003902917 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 04/18/2014 |
| Medicare PECOS PAC ID | 9830096411 |
|---|---|
| Medicare Enrollment ID | O20031212000923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003902917 | NPI | - | NPPES |
| FHC70019F | Medicaid | CA | |
| BCP70019F | Medicaid | CA | |
| EAPC70019F | Medicaid | CA | |
| HAP70019F | Medicaid | CA |
| Provider Name | Peter S Hein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497803282 PECOS PAC ID: 6507815677 Enrollment ID: I20050114000695 |
| Provider Name | Jonathan L Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184954455 PECOS PAC ID: 6800833526 Enrollment ID: I20050414000423 |
| Provider Name | Max Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285750356 PECOS PAC ID: 7214973031 Enrollment ID: I20050701000566 |
| Provider Name | Peter A Tilton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538258694 PECOS PAC ID: 5193723161 Enrollment ID: I20061129000545 |
| Provider Name | Gary J Pace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326105313 PECOS PAC ID: 6901808260 Enrollment ID: I20070215000505 |
| Provider Name | Naomi B Lake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215084116 PECOS PAC ID: 6305943432 Enrollment ID: I20070523000707 |
| Provider Name | Constance A Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477600195 PECOS PAC ID: 9739288515 Enrollment ID: I20070619000647 |
| Provider Name | Rebekah A Barratt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609060276 PECOS PAC ID: 3274719828 Enrollment ID: I20110516000394 |
| Provider Name | Melissa E Deer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043415888 PECOS PAC ID: 0547413072 Enrollment ID: I20130114000288 |
| Provider Name | Young S Suh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710239223 PECOS PAC ID: 9931340742 Enrollment ID: I20130720000069 |
| Provider Name | Shirin Alonzo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225318041 PECOS PAC ID: 6709011216 Enrollment ID: I20131108000031 |
| Provider Name | Sarah A Pai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255762167 PECOS PAC ID: 5193948081 Enrollment ID: I20140521002507 |
| Provider Name | Donald Weiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780770560 PECOS PAC ID: 8426246323 Enrollment ID: I20140611002350 |
| Provider Name | Shaun M Austin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801024393 PECOS PAC ID: 4587812243 Enrollment ID: I20140826002568 |
| Provider Name | Michelle M O'leary Searles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407229172 PECOS PAC ID: 7113229246 Enrollment ID: I20160107000066 |
| Provider Name | Rhoda G Carino Diokno |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629109483 PECOS PAC ID: 5597054569 Enrollment ID: I20160513001262 |
| 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 | Luis F Clement |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235364712 PECOS PAC ID: 1052699709 Enrollment ID: I20161031001950 |
| Provider Name | Rodel V Lumanog |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124574819 PECOS PAC ID: 8426338674 Enrollment ID: I20161206001371 |
| Provider Name | Jaimie Devine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003350943 PECOS PAC ID: 1153608781 Enrollment ID: I20170508001301 |
| Provider Name | Kristina Paal Mouradian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891234464 PECOS PAC ID: 6305110644 Enrollment ID: I20170925003006 |
| Provider Name | Catherine Ajala-staats |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376053413 PECOS PAC ID: 1355603580 Enrollment ID: I20180327002253 |
| Provider Name | Marion A Ruth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740789288 PECOS PAC ID: 3678817731 Enrollment ID: I20181130002091 |
| Provider Name | Heather Mak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033430863 PECOS PAC ID: 0143564922 Enrollment ID: I20181205001405 |
| Provider Name | Catherine Ann Haralson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336595206 PECOS PAC ID: 5991040032 Enrollment ID: I20181218004002 |
| Provider Name | Dyana Eidelstein |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700448362 PECOS PAC ID: 0244664019 Enrollment ID: I20200103000000 |
| Provider Name | Jason K Liu |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1043467202 PECOS PAC ID: 7911215975 Enrollment ID: I20200103001666 |
| Provider Name | Kim Janetzky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720287576 PECOS PAC ID: 9931537719 Enrollment ID: I20200309001991 |
| Provider Name | Robert Reed Henley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225355290 PECOS PAC ID: 9739219452 Enrollment ID: I20200507002625 |
| Provider Name | Stephanie Joyce Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396358024 PECOS PAC ID: 2365854452 Enrollment ID: I20201214003009 |
| Provider Name | Katherine Anne Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215543426 PECOS PAC ID: 9032521034 Enrollment ID: I20201216001213 |
| Provider Name | Kelly Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013420801 PECOS PAC ID: 0446518211 Enrollment ID: I20210114001214 |
| Provider Name | Harjot Singh Chawla |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1659662757 PECOS PAC ID: 4981010931 Enrollment ID: I20210317000933 |
| Provider Name | Natalie Renee Saldivar |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1659747061 PECOS PAC ID: 4082018163 Enrollment ID: I20210811003187 |
| Provider Name | Kusi Hilda Peralta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669856365 PECOS PAC ID: 5991100612 Enrollment ID: I20210818003219 |
| Provider Name | Rebeca Villalobos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184224396 PECOS PAC ID: 7113316399 Enrollment ID: I20211109001748 |
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