| Community Health Centers Oceano | |
|
1981 Cienaga St Oceano CA 93445-9029 | |
| (805) 270-0025 | |
| (805) 270-0030 |
| Full Name | Community Health Centers Oceano |
|---|---|
| Speciality | Clinic/Center |
| Location | 1981 Cienaga St, Oceano, California |
| Authorized Official Name and Position | Barbara Allen (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 8053618014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Centers Oceano 2050 S Blosser Rd Santa Maria CA 93458-7310 Ph: (805) 361-8028 | Community Health Centers Oceano 1981 Cienaga St Oceano CA 93445-9029 Ph: (805) 270-0025 |
| NPI Number | 1336166248 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 01/23/2019 |
| Medicare PECOS PAC ID | 7416868120 |
|---|---|
| Medicare Enrollment ID | O20040115001161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336166248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Justin Salerno |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710995022 PECOS PAC ID: 8527965896 Enrollment ID: I20040223001312 |
| Provider Name | Luis R Diaz |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1154417244 PECOS PAC ID: 9335039734 Enrollment ID: I20040318001126 |
| Provider Name | Barbara Defirmian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215150040 PECOS PAC ID: 9335131929 Enrollment ID: I20040401001805 |
| Provider Name | Richard A Sikes |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811921430 PECOS PAC ID: 1658365408 Enrollment ID: I20040413001653 |
| Provider Name | Bethany Blacketer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487764833 PECOS PAC ID: 7416944236 Enrollment ID: I20040426001063 |
| Provider Name | George Cury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083643878 PECOS PAC ID: 0143201277 Enrollment ID: I20040525001799 |
| Provider Name | W Damian Kramer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1316962335 PECOS PAC ID: 4183605892 Enrollment ID: I20040527001357 |
| Provider Name | Steve R Clarke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861519415 PECOS PAC ID: 7517942626 Enrollment ID: I20040622001632 |
| Provider Name | Ruth E Gray |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1285655654 PECOS PAC ID: 1557341708 Enrollment ID: I20040720001314 |
| Provider Name | Jimmy Mack Baker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912054487 PECOS PAC ID: 9234101460 Enrollment ID: I20040809001111 |
| Provider Name | Lilia Tovar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609809854 PECOS PAC ID: 5698749562 Enrollment ID: I20040825000975 |
| Provider Name | John A Khan-variba |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861427528 PECOS PAC ID: 6305805698 Enrollment ID: I20041004000226 |
| Provider Name | Rodolfo A Castillo-ruiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174549182 PECOS PAC ID: 5395707723 Enrollment ID: I20041028000704 |
| Provider Name | Denise E Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609896760 PECOS PAC ID: 6305809682 Enrollment ID: I20041108000801 |
| Provider Name | Andre M Acebo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083647051 PECOS PAC ID: 5890758932 Enrollment ID: I20041109000853 |
| Provider Name | Maria M Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114940863 PECOS PAC ID: 0345203329 Enrollment ID: I20041110000746 |
| Provider Name | Natasha M Raja |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235122292 PECOS PAC ID: 4385602960 Enrollment ID: I20041229000450 |
| Provider Name | Shan Jeffrey Thomas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821017294 PECOS PAC ID: 8022919737 Enrollment ID: I20050331001256 |
| Provider Name | Cluthbert Charles |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1831231646 PECOS PAC ID: 8628019395 Enrollment ID: I20050512001041 |
| Provider Name | Joel Correa |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1033130620 PECOS PAC ID: 5698701191 Enrollment ID: I20050715000738 |
| Provider Name | Joseph C Pon |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1568461689 PECOS PAC ID: 2567498918 Enrollment ID: I20050715001149 |
| Provider Name | Barry Eibschutz |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1164464566 PECOS PAC ID: 0941233167 Enrollment ID: I20050916000877 |
| Provider Name | Daniel Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265430144 PECOS PAC ID: 1254357189 Enrollment ID: I20051020000405 |
| Provider Name | Leslie G Kasanoff |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1063579985 PECOS PAC ID: 0143249490 Enrollment ID: I20051115001131 |
| Provider Name | Bradley Idelshon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538125745 PECOS PAC ID: 6002836087 Enrollment ID: I20051206000385 |
| Provider Name | Miguel D Camacho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093746364 PECOS PAC ID: 3870515471 Enrollment ID: I20051223000159 |
| Provider Name | Reshma Mahmood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881625069 PECOS PAC ID: 1355364167 Enrollment ID: I20060106000897 |
| Provider Name | Hugo Arnulfo Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154315851 PECOS PAC ID: 6800808775 Enrollment ID: I20060613000233 |
| Provider Name | Christopher Evan Demartini |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1982643433 PECOS PAC ID: 2062425168 Enrollment ID: I20060712000298 |
| Provider Name | Lisa M Madala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841203692 PECOS PAC ID: 1951306208 Enrollment ID: I20060920000461 |
| Provider Name | Satish Raj |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558311134 PECOS PAC ID: 2668493644 Enrollment ID: I20061023000530 |
| Provider Name | Elana C Harway |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679506612 PECOS PAC ID: 3476550062 Enrollment ID: I20061024000266 |
| Provider Name | Donald Halsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811917537 PECOS PAC ID: 0345215299 Enrollment ID: I20061103000513 |
| Provider Name | Simona D Pop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275564874 PECOS PAC ID: 9537168380 Enrollment ID: I20061205000725 |
| Provider Name | Adrian Kay Ayers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881774495 PECOS PAC ID: 7517968159 Enrollment ID: I20070124000416 |
| Provider Name | Robert L Mcghie |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730184367 PECOS PAC ID: 2860493327 Enrollment ID: I20070125000403 |
| Provider Name | Gary Spunt |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1609960152 PECOS PAC ID: 6103828314 Enrollment ID: I20070131000699 |
| Provider Name | James Michael Davis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1295881738 PECOS PAC ID: 0547262941 Enrollment ID: I20070214000304 |
| Provider Name | Jennifer M Sale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710025465 PECOS PAC ID: 3779681606 Enrollment ID: I20070531000174 |
| Provider Name | Bala K Bhat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780603514 PECOS PAC ID: 5597858704 Enrollment ID: I20070904000736 |
| Provider Name | Laura J Herzberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801989371 PECOS PAC ID: 2062502875 Enrollment ID: I20071217000847 |
| Provider Name | Victor M Guerrero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972596963 PECOS PAC ID: 7113007287 Enrollment ID: I20071231000603 |
| Provider Name | Genevieve A Manzo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1205919883 PECOS PAC ID: 0143305128 Enrollment ID: I20080314000498 |
| Provider Name | Lawrence S Paikoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386694404 PECOS PAC ID: 8426130758 Enrollment ID: I20080505000845 |
| Provider Name | Amgad G Salib |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831380278 PECOS PAC ID: 1658450101 Enrollment ID: I20080508000418 |
| Provider Name | Mark F Miller |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1629063946 PECOS PAC ID: 7214007715 Enrollment ID: I20080624000483 |
| Provider Name | Neelima A Vegesna |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770795759 PECOS PAC ID: 0244308773 Enrollment ID: I20081009000780 |
| Provider Name | Natalia V Schwartz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528297710 PECOS PAC ID: 8527105444 Enrollment ID: I20091027000211 |
| Provider Name | Daniel L Willis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699946376 PECOS PAC ID: 3274670799 Enrollment ID: I20091102000172 |
| Provider Name | Philip F Wichmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326000803 PECOS PAC ID: 5092853846 Enrollment ID: I20091116000215 |
| Provider Name | Janina M Meissner-frisk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023050796 PECOS PAC ID: 8527023555 Enrollment ID: I20091204000151 |
| Provider Name | Richard Ripple |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346345493 PECOS PAC ID: 7911047113 Enrollment ID: I20091219000104 |
| Provider Name | Lerzan Tunali Madenci |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659504181 PECOS PAC ID: 6709926629 Enrollment ID: I20091226000014 |
| Provider Name | Anika Tene Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114119732 PECOS PAC ID: 1153464672 Enrollment ID: I20100205000591 |
| Provider Name | Sudha A Russell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528037892 PECOS PAC ID: 3779611306 Enrollment ID: I20100503000274 |
| Provider Name | Shauna M Lynch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356551220 PECOS PAC ID: 5395806327 Enrollment ID: I20100607000414 |
| Provider Name | Emilia Ambrosio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205865151 PECOS PAC ID: 2961535174 Enrollment ID: I20100809000185 |
| Provider Name | Deborah A Kronstad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972797637 PECOS PAC ID: 9537292701 Enrollment ID: I20100809000951 |
| Provider Name | Susan Bartolini |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538367982 PECOS PAC ID: 7113051848 Enrollment ID: I20100817001340 |
| Provider Name | Neil J Correia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316145303 PECOS PAC ID: 3072638857 Enrollment ID: I20100916000943 |
| Provider Name | Lilly I Kao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508830589 PECOS PAC ID: 3971795857 Enrollment ID: I20101011000611 |
| Provider Name | Ann Marie Rohan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871809590 PECOS PAC ID: 3577756568 Enrollment ID: I20101022000467 |
| Provider Name | Eric Chan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780773044 PECOS PAC ID: 0840483756 Enrollment ID: I20101025000290 |
| Provider Name | Maria E Flores-cooper |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649255480 PECOS PAC ID: 3173717782 Enrollment ID: I20101027001334 |
| Provider Name | Tara F Karp |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821287855 PECOS PAC ID: 9931393204 Enrollment ID: I20101101000123 |
| Provider Name | Linda W Fory |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073685814 PECOS PAC ID: 8022206622 Enrollment ID: I20101227000206 |
| Provider Name | Ann Lise Bollay |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487610333 PECOS PAC ID: 7012008188 Enrollment ID: I20110131000126 |
| Provider Name | Christina Anne Pinto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720309529 PECOS PAC ID: 7416125935 Enrollment ID: I20110727000300 |
| Provider Name | Aaron Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396904736 PECOS PAC ID: 1850560574 Enrollment ID: I20110812000503 |
| Provider Name | Patti Hamernik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043238454 PECOS PAC ID: 4981681038 Enrollment ID: I20110913000494 |
| Provider Name | Ethan Roy Etnyre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225021777 PECOS PAC ID: 1557559770 Enrollment ID: I20110916000270 |
| Provider Name | Karen Mikuni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497748958 PECOS PAC ID: 9638367857 Enrollment ID: I20110916000304 |
| Provider Name | Cesilia A Lomeli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891986675 PECOS PAC ID: 0345412342 Enrollment ID: I20111018000274 |
| Provider Name | Soquel L Goodin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821376146 PECOS PAC ID: 4587838941 Enrollment ID: I20111121000484 |
| Provider Name | Jaimee B Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871879635 PECOS PAC ID: 3072787191 Enrollment ID: I20111129000278 |
| Provider Name | Perla Park |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518973122 PECOS PAC ID: 9133388317 Enrollment ID: I20120307000446 |
| Provider Name | Maryam K. Tabrizi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932402476 PECOS PAC ID: 2163679036 Enrollment ID: I20120828000622 |
| Provider Name | Atipon Kangwanpornsiri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487854816 PECOS PAC ID: 8729239330 Enrollment ID: I20121107000688 |
| Provider Name | Shahrouz Eman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1861426702 PECOS PAC ID: 5597916973 Enrollment ID: I20121112000549 |
| Provider Name | Karolina Dembinski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952599078 PECOS PAC ID: 0345374286 Enrollment ID: I20121127000365 |
| Provider Name | Brandon L Todd |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1093075640 PECOS PAC ID: 0244477578 Enrollment ID: I20130506000262 |
| Provider Name | Catherine M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972881886 PECOS PAC ID: 1759528714 Enrollment ID: I20130510000243 |
| Provider Name | Frank V Giardina |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912062274 PECOS PAC ID: 1355589052 Enrollment ID: I20130606000795 |
| Provider Name | Agnela T Isaias |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790772572 PECOS PAC ID: 4789640186 Enrollment ID: I20130718000158 |
| Provider Name | Sharon C Sevilla-bodine |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366479859 PECOS PAC ID: 5991946386 Enrollment ID: I20130727000136 |
| Provider Name | Niranian Dass |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255650776 PECOS PAC ID: 4183866395 Enrollment ID: I20130816000453 |
| Provider Name | Jaspal S Dhaliwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093018269 PECOS PAC ID: 8325065741 Enrollment ID: I20131015001117 |
| Provider Name | Todd W Engstrom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538282587 PECOS PAC ID: 6608975669 Enrollment ID: I20131104001799 |
| Provider Name | Kathleen A Macmahon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518197995 PECOS PAC ID: 4981742285 Enrollment ID: I20131216001601 |
| Provider Name | Gregory L Jerkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699885137 PECOS PAC ID: 1951343300 Enrollment ID: I20140123000495 |
| Provider Name | Kristen D Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639410244 PECOS PAC ID: 7214166917 Enrollment ID: I20140129000324 |
| Provider Name | James M Mcghee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003910019 PECOS PAC ID: 1052408549 Enrollment ID: I20140305001534 |
| Provider Name | Juan Reinosa-salmeron |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1609120088 PECOS PAC ID: 8729210323 Enrollment ID: I20140414001769 |
| Provider Name | Michael Mcconnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356693683 PECOS PAC ID: 7214151687 Enrollment ID: I20140605001185 |
| Provider Name | Mellie Fay Keene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396865770 PECOS PAC ID: 7810112174 Enrollment ID: I20140701000939 |
| Provider Name | Lauren E Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003235904 PECOS PAC ID: 8729203484 Enrollment ID: I20140714001074 |
| Provider Name | Dena Tilley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871705251 PECOS PAC ID: 7517183957 Enrollment ID: I20140722000119 |
| Provider Name | Michelle D Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982738175 PECOS PAC ID: 6305906652 Enrollment ID: I20140724000128 |
| Provider Name | Jill Richert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710182993 PECOS PAC ID: 1850517038 Enrollment ID: I20140724000238 |
| Provider Name | Michelle Corbier |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013034412 PECOS PAC ID: 3476684655 Enrollment ID: I20140728000024 |
| Provider Name | Patrick Welch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710257357 PECOS PAC ID: 3476770173 Enrollment ID: I20140804000707 |
| Provider Name | Jinah Byram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578975751 PECOS PAC ID: 2062639701 Enrollment ID: I20140804001926 |
| Provider Name | Magdalena Serrano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609126655 PECOS PAC ID: 4789802521 Enrollment ID: I20140820001452 |
| Provider Name | Nubia Catarina Daguia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336459387 PECOS PAC ID: 6709006968 Enrollment ID: I20141010000483 |
| Provider Name | Heather Bosma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285037614 PECOS PAC ID: 8325269368 Enrollment ID: I20141016001582 |
| Provider Name | Ladan Modallel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669633376 PECOS PAC ID: 7416115878 Enrollment ID: I20141210001414 |
| Provider Name | Mark Princep Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780996371 PECOS PAC ID: 5799922894 Enrollment ID: I20150314000333 |
| Provider Name | Sari Winans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649677402 PECOS PAC ID: 3173840394 Enrollment ID: I20150327002158 |
| Provider Name | Pamela L Trottier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164667895 PECOS PAC ID: 8123287968 Enrollment ID: I20150731016954 |
| Provider Name | Bernardus G Kartono Winardi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700124161 PECOS PAC ID: 9638484462 Enrollment ID: I20150821014336 |
| Provider Name | Eric Chau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285970418 PECOS PAC ID: 8729394242 Enrollment ID: I20150828002052 |
| Provider Name | Michelina Timenovich |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902210586 PECOS PAC ID: 8527375765 Enrollment ID: I20150925001268 |
| Provider Name | Sara Elizabeth Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932447075 PECOS PAC ID: 8224332689 Enrollment ID: I20160204000840 |
| Provider Name | Franco J Castrejon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760840680 PECOS PAC ID: 3072819606 Enrollment ID: I20160308002720 |
| Provider Name | Heidi Lynn Harmon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851658348 PECOS PAC ID: 8325331630 Enrollment ID: I20160725001921 |
| Provider Name | Naomi Alessa Marr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790954865 PECOS PAC ID: 1951695253 Enrollment ID: I20160809002918 |
| Provider Name | Gizelle Mendoza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972696441 PECOS PAC ID: 1052607553 Enrollment ID: I20160909000970 |
| Provider Name | Ahmed Abdelaziz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790039733 PECOS PAC ID: 9739467903 Enrollment ID: I20161024001835 |
| Provider Name | Thomas Csanadi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487648796 PECOS PAC ID: 4688954969 Enrollment ID: I20161201002273 |
| Provider Name | Craig Joseph Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891038535 PECOS PAC ID: 2961791314 Enrollment ID: I20161213000596 |
| Provider Name | Meghan Mckiernan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104260454 PECOS PAC ID: 8123328531 Enrollment ID: I20161220001348 |
| Provider Name | Kalamani R Dharma |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023193646 PECOS PAC ID: 7214087857 Enrollment ID: I20170118001549 |
| Provider Name | Tarek Ahmed Nabil Abou El Kheir |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477521789 PECOS PAC ID: 7113989575 Enrollment ID: I20170123001498 |
| Provider Name | Monica Cecilia Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871705236 PECOS PAC ID: 3274816483 Enrollment ID: I20170214002142 |
| Provider Name | Gurjit S Marwah |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780776328 PECOS PAC ID: 3173806122 Enrollment ID: I20170216002606 |
| Provider Name | Erika Gabriela La Frano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326588450 PECOS PAC ID: 8123304227 Enrollment ID: I20170403002547 |
| Provider Name | Vellore Gundurao Kasturi |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1588862478 PECOS PAC ID: 6406925445 Enrollment ID: I20170511001972 |
| Provider Name | David Bentley |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750796660 PECOS PAC ID: 7911275698 Enrollment ID: I20170621002307 |
| Provider Name | Hanna Chariz V Roewer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164889184 PECOS PAC ID: 7618272535 Enrollment ID: I20170726003458 |
| Provider Name | Megan Leanne Burkett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629518725 PECOS PAC ID: 9739450107 Enrollment ID: I20170802003712 |
| Provider Name | Teeranun Jirajariyavej |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1730317751 PECOS PAC ID: 4486877933 Enrollment ID: I20170807003467 |
| Provider Name | Charla R Morgan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831153261 PECOS PAC ID: 7719132323 Enrollment ID: I20170809004032 |
| Provider Name | Estrella N Chavez Benzaquen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396187449 PECOS PAC ID: 2668745241 Enrollment ID: I20170901001033 |
| Provider Name | Rocio Lissette Rodriguez Valencia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679988182 PECOS PAC ID: 3173896305 Enrollment ID: I20170908002361 |
| Provider Name | Ana A Melendez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518211432 PECOS PAC ID: 1254605983 Enrollment ID: I20170920000007 |
| Provider Name | Muneerah Uqdah |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073778932 PECOS PAC ID: 7416213236 Enrollment ID: I20171110002924 |
| Provider Name | Cassandra J Heller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043570708 PECOS PAC ID: 4486893757 Enrollment ID: I20171114003070 |
| Provider Name | Rostislav Davydov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164751863 PECOS PAC ID: 2567604770 Enrollment ID: I20180124002571 |
| Provider Name | Erika L Fromhold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417476060 PECOS PAC ID: 4284994559 Enrollment ID: I20180205002908 |
| Provider Name | Minh Hue Truong Riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528300217 PECOS PAC ID: 7113287913 Enrollment ID: I20180215000813 |
| Provider Name | Arthur William Higgins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639513849 PECOS PAC ID: 7911226113 Enrollment ID: I20180404002802 |
| Provider Name | Amada J Adame |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760871123 PECOS PAC ID: 1153684493 Enrollment ID: I20180418002584 |
| Provider Name | Robert Francis Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427545698 PECOS PAC ID: 9931455110 Enrollment ID: I20180629002107 |
| Provider Name | Jonas Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801380605 PECOS PAC ID: 3577810761 Enrollment ID: I20180718004265 |
| Provider Name | Daniel Ernest Ayers |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871640060 PECOS PAC ID: 5395097877 Enrollment ID: I20181010003588 |
| Provider Name | Alaa Shaban |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902288749 PECOS PAC ID: 3274885769 Enrollment ID: I20181011000214 |
| Provider Name | Angela Misuraco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114901279 PECOS PAC ID: 4385669381 Enrollment ID: I20181112002294 |
| Provider Name | Lisa Cynthia Jimenez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790800381 PECOS PAC ID: 1951655422 Enrollment ID: I20181120000808 |
| Provider Name | Ada Eunice Gonzales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851867550 PECOS PAC ID: 4082958020 Enrollment ID: I20181203002347 |
| Provider Name | Jillian Davenport |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093133340 PECOS PAC ID: 9133419906 Enrollment ID: I20181205003069 |
| Provider Name | Christopher Blake Finnegan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1396941159 PECOS PAC ID: 6406195635 Enrollment ID: I20190305001787 |
| Provider Name | Teresann Nickle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831245786 PECOS PAC ID: 8426130774 Enrollment ID: I20190311002213 |
| Provider Name | Chelcia Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053702282 PECOS PAC ID: 6709105133 Enrollment ID: I20190502003157 |
| Provider Name | Kelli Maureen Compean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114488830 PECOS PAC ID: 0042553836 Enrollment ID: I20190517002213 |
| Provider Name | Annapurna Bobba |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134230386 PECOS PAC ID: 3476633124 Enrollment ID: I20190816001997 |
| Provider Name | Ben Cooke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528512803 PECOS PAC ID: 8729310875 Enrollment ID: I20191023001161 |
| Provider Name | Sarah Van Camp |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295148492 PECOS PAC ID: 9638391873 Enrollment ID: I20200206001902 |
| Provider Name | Antonio Serrano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225652498 PECOS PAC ID: 0547682148 Enrollment ID: I20200629001973 |
| Provider Name | Karen S Lapesarde |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376983023 PECOS PAC ID: 5698734556 Enrollment ID: I20200630001831 |
| Provider Name | Pablo Jose Yepez Bracamonte |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295265858 PECOS PAC ID: 6709201445 Enrollment ID: I20200729000909 |
| Provider Name | Alice Wong |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891331641 PECOS PAC ID: 2466881123 Enrollment ID: I20200915001591 |
| Provider Name | Starchild Weivoda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245506195 PECOS PAC ID: 1557670577 Enrollment ID: I20201019001251 |
| Provider Name | Billy Yu |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1578084653 PECOS PAC ID: 4486064615 Enrollment ID: I20201029001083 |
| Provider Name | David Kenneth Trefflich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861836942 PECOS PAC ID: 7810125325 Enrollment ID: I20201030000924 |
| Provider Name | Jane So-chun Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962450254 PECOS PAC ID: 5597953919 Enrollment ID: I20210126000971 |
| Provider Name | Alyssa Katherine Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083286249 PECOS PAC ID: 8628471125 Enrollment ID: I20210721002087 |
| Provider Name | Daniela Arbelaez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538651815 PECOS PAC ID: 3072917368 Enrollment ID: I20210809002826 |
| Provider Name | Camelia Soliman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245724061 PECOS PAC ID: 1355699265 Enrollment ID: I20210927002613 |
| Provider Name | Casey L Whipple |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720584253 PECOS PAC ID: 7416203567 Enrollment ID: I20210930001513 |
| Provider Name | Sheirill Maejan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124525514 PECOS PAC ID: 8325395007 Enrollment ID: I20211025000740 |
| Provider Name | Felipe Arce |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427243104 PECOS PAC ID: 1557441839 Enrollment ID: I20211122002249 |
| Provider Name | Sana Malik |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881356871 PECOS PAC ID: 2163812348 Enrollment ID: I20211201002876 |
| Provider Name | Sarah Elizabeth Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730798430 PECOS PAC ID: 4284026006 Enrollment ID: I20220127001782 |
| Provider Name | Michael Page |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1205989431 PECOS PAC ID: 6709804032 Enrollment ID: I20220225000944 |
| Provider Name | Rachel Iris Rios |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437632973 PECOS PAC ID: 2860888138 Enrollment ID: I20220413002337 |
| Provider Name | Alicia Dueck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144629890 PECOS PAC ID: 8820477292 Enrollment ID: I20220615003250 |
| Provider Name | Daniel Edward Gross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538340088 PECOS PAC ID: 3870972938 Enrollment ID: I20220620001582 |
| Provider Name | Janette Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972864296 PECOS PAC ID: 5496134504 Enrollment ID: I20220621001257 |
| Provider Name | Maxine S Bellamy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770562696 PECOS PAC ID: 7517987506 Enrollment ID: I20220705001018 |
| Provider Name | Danielle Connolly Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972240950 PECOS PAC ID: 6002298148 Enrollment ID: I20220805000311 |
| Provider Name | Rachel Haynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710280409 PECOS PAC ID: 8426489923 Enrollment ID: I20220829002690 |
| Provider Name | Verschoyle Hume Clarke Cronyn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609337831 PECOS PAC ID: 4981088432 Enrollment ID: I20220831003558 |
| Provider Name | Neha Sharma |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417442062 PECOS PAC ID: 0941684294 Enrollment ID: I20220906000763 |
| Provider Name | Samantha Guinevere Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457857419 PECOS PAC ID: 7618351990 Enrollment ID: I20220906001862 |
| Provider Name | Lizbeth Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033839907 PECOS PAC ID: 8022492206 Enrollment ID: I20220907003012 |
| Provider Name | Kaishawn D. Mcduffie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720604481 PECOS PAC ID: 8022492198 Enrollment ID: I20220908003258 |
| Provider Name | Nathaniel Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366904963 PECOS PAC ID: 1456767300 Enrollment ID: I20220909001882 |
| Provider Name | Matthew Potter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063971240 PECOS PAC ID: 4789009770 Enrollment ID: I20221003001175 |
| Provider Name | Libna Zurisadai Palma |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982277471 PECOS PAC ID: 9436535085 Enrollment ID: I20221005000179 |
| Provider Name | Alicia Guajardo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861862633 PECOS PAC ID: 6406232982 Enrollment ID: I20221006001960 |
| Provider Name | Leia Michelle Dumlao Ballesteros |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205557550 PECOS PAC ID: 4880060953 Enrollment ID: I20221013002669 |
| Provider Name | Larry James Sherfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437694221 PECOS PAC ID: 3870963143 Enrollment ID: I20221230002157 |
| Provider Name | Shirley Yue Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841879715 PECOS PAC ID: 6709240773 Enrollment ID: I20230908001515 |
| Provider Name | Austin Kevin Lillenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639810054 PECOS PAC ID: 8224492194 Enrollment ID: I20230911002462 |
| Provider Name | Boruch Goldstein |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164041265 PECOS PAC ID: 0042664195 Enrollment ID: I20230925000301 |
| Provider Name | Jakub Cekovsky |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235757790 PECOS PAC ID: 3971928987 Enrollment ID: I20231020002079 |
| Provider Name | Maria Guadalupe Martinez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1215056361 PECOS PAC ID: 2769828722 Enrollment ID: I20240312004221 |
Community Health Centers Oceano Del Mar Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2120 Cienaga, Oceano, CA 93445 Phone: 805-994-2100 Fax: 805-994-2197 |