| Afc Ladera Ranch | |
|
27522 Antonio Pkwy Ste P3 Ladera Ranch CA 92694-2166 | |
| (714) 337-9393 | |
| Not Available |
| Full Name | Afc Ladera Ranch |
|---|---|
| Speciality | Clinic/Center |
| Location | 27522 Antonio Pkwy Ste P3, Ladera Ranch, California |
| Authorized Official Name and Position | Miranda De Luna (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3162147764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Afc Ladera Ranch Po Box 519 Lake Forest CA 92609-0519 Ph: (949) 207-3786 | Afc Ladera Ranch 27522 Antonio Pkwy Ste P3 Ladera Ranch CA 92694-2166 Ph: (714) 337-9393 |
| NPI Number | 1114588704 |
|---|---|
| Provider Enumeration Date | 06/24/2019 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/18/2023 |
| Medicare PECOS PAC ID | 8426388810 |
|---|---|
| Medicare Enrollment ID | O20190927001371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114588704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | () | Primary |
| Provider Name | Gurmander Singh Kohli |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1225066962 PECOS PAC ID: 7113934886 Enrollment ID: I20060321000655 |
| Provider Name | Dan G Raphael |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427182864 PECOS PAC ID: 1355432402 Enrollment ID: I20070803000610 |
| Provider Name | Sanjivan Kohli |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801129663 PECOS PAC ID: 3072642685 Enrollment ID: I20100519000930 |
| Provider Name | Coralee R Koning |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992793525 PECOS PAC ID: 7517098999 Enrollment ID: I20100629000327 |
| Provider Name | Vladislav N Melnichenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528348273 PECOS PAC ID: 3072784420 Enrollment ID: I20120130000845 |
| Provider Name | Edgar O Garza |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184980674 PECOS PAC ID: 1850554452 Enrollment ID: I20120517000684 |
| Provider Name | Arturo Portales |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801035886 PECOS PAC ID: 5597754085 Enrollment ID: I20120608000501 |
| Provider Name | Miranda F De Luna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023235819 PECOS PAC ID: 1557454469 Enrollment ID: I20121219000474 |
| Provider Name | Karizza B Asper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316287055 PECOS PAC ID: 7315168259 Enrollment ID: I20141017002374 |
| Provider Name | Lisa G. Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184083099 PECOS PAC ID: 0648578468 Enrollment ID: I20160412001352 |
| Provider Name | Ahmed Qudaiesat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801350822 PECOS PAC ID: 1052651742 Enrollment ID: I20190315000770 |
| Provider Name | Jaylene T Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720542665 PECOS PAC ID: 9830430198 Enrollment ID: I20190415000887 |
| Provider Name | Sharon Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073073649 PECOS PAC ID: 4688903172 Enrollment ID: I20190909002732 |
| Provider Name | Kelly T Tran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487295549 PECOS PAC ID: 3971938325 Enrollment ID: I20200114000672 |
| Provider Name | Islam G Ibrahim |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700428711 PECOS PAC ID: 5799114732 Enrollment ID: I20200326002619 |
| Provider Name | Feng Xiao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649800913 PECOS PAC ID: 7214366418 Enrollment ID: I20200409002679 |
| Provider Name | Kira Ann Tellache |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104441021 PECOS PAC ID: 9638575863 Enrollment ID: I20210913003092 |
| Provider Name | Parisa Shirkhani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164188975 PECOS PAC ID: 9830589829 Enrollment ID: I20211206002801 |
| Provider Name | Michelle C Tan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952963498 PECOS PAC ID: 6800271636 Enrollment ID: I20220915000995 |
| Provider Name | Layla Shirkhorshidi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114653144 PECOS PAC ID: 7618344938 Enrollment ID: I20221029000273 |
| Provider Name | Antonious J Abraham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003434275 PECOS PAC ID: 3072984673 Enrollment ID: I20230118001725 |
| Provider Name | Sandy Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659945723 PECOS PAC ID: 3274906201 Enrollment ID: I20230222001607 |
| Provider Name | Anthony Manzo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356816920 PECOS PAC ID: 9638539539 Enrollment ID: I20230724001033 |
| Provider Name | Zoe Claire Mascola |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073296448 PECOS PAC ID: 4880046861 Enrollment ID: I20240115001700 |
| Provider Name | Helen Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710619127 PECOS PAC ID: 0547618365 Enrollment ID: I20240819003612 |
| Provider Name | Martha Chavez-rangel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073384608 PECOS PAC ID: 8325562002 Enrollment ID: I20250403003802 |
| Provider Name | Sanaz Esmaeilian Dehaghani |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396578977 PECOS PAC ID: 2062922644 Enrollment ID: I20250611004166 |
| Provider Name | Samrah Mansoor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063581809 PECOS PAC ID: 4981702008 Enrollment ID: I20250630004290 |
| Provider Name | Fady Rezk |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497574230 PECOS PAC ID: 5092221028 Enrollment ID: I20250717003739 |
| Provider Name | Erica M Watts |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881234714 PECOS PAC ID: 1850891680 Enrollment ID: I20250825004153 |
| Provider Name | Genesis Gabriela Diaz-espique |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124998604 PECOS PAC ID: 5193211365 Enrollment ID: I20251226001887 |
Karl J Gebhard MD Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Corporate Dr, Suite 100, Ladera Ranch, CA 92694 Phone: 949-364-9112 Fax: 949-582-2943 |
Opitmal Health Medical Centers Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 999 Corporate Dr Ste 100, Ladera Ranch, CA 92694 Phone: 949-680-1880 |
Summit Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27702 Crown Valley Pkwy, Suite D4-113, Ladera Ranch, CA 92694 Phone: 949-529-2330 Fax: 866-800-5276 |
Kelly E Fordyce MD a Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 777 Corporate Dr Ste 140, Ladera Ranch, CA 92694 Phone: 949-409-4868 Fax: 949-409-4898 |