| Ea Health Physicians Medical Group Texas Pa | |
|
12396 World Trade Dr Ste 303 San Diego CA 92128-3792 | |
| (858) 759-4765 | |
| (858) 201-4987 |
| Full Name | Ea Health Physicians Medical Group Texas Pa |
|---|---|
| Speciality | General Practice |
| Location | 12396 World Trade Dr Ste 303, San Diego, California |
| Authorized Official Name and Position | Arthur L Gruen (MD/OWNER) |
| Authorized Official Contact | 8587594765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ea Health Physicians Medical Group Texas Pa Po Box 227257 Dallas TX 75222-7257 Ph: (858) 759-4765 | Ea Health Physicians Medical Group Texas Pa 12396 World Trade Dr Ste 303 San Diego CA 92128-3792 Ph: (858) 759-4765 |
| NPI Number | 1063786523 |
|---|---|
| Provider Enumeration Date | 03/01/2012 |
| Last Update Date | 01/09/2024 |
| Medicare PECOS PAC ID | 2769645563 |
|---|---|
| Medicare Enrollment ID | O20120515000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063786523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Stuart Alan Stein |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093797037 PECOS PAC ID: 0749179406 Enrollment ID: I20040311001278 |
| Provider Name | Marie D Percy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013966837 PECOS PAC ID: 9931194255 Enrollment ID: I20040416000837 |
| Provider Name | Krzysztof K Brozynski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598759805 PECOS PAC ID: 2769477652 Enrollment ID: I20040419001595 |
| Provider Name | Huned M Husain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679535645 PECOS PAC ID: 5698758811 Enrollment ID: I20040609001087 |
| Provider Name | Stephen A Rowe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518991876 PECOS PAC ID: 7618929654 Enrollment ID: I20050217000499 |
| Provider Name | Michael J Landgarten |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1588665780 PECOS PAC ID: 6901855014 Enrollment ID: I20050421000529 |
| Provider Name | Donghong Zhang |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1477577435 PECOS PAC ID: 0143292052 Enrollment ID: I20060112000699 |
| Provider Name | George Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578588752 PECOS PAC ID: 9638172034 Enrollment ID: I20060823000674 |
| Provider Name | Caroline G Ferris |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1376576652 PECOS PAC ID: 6103821848 Enrollment ID: I20061002000180 |
| Provider Name | Justice U Odu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245330745 PECOS PAC ID: 0345342226 Enrollment ID: I20070223000151 |
| Provider Name | Gustavo N Del Toro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437288305 PECOS PAC ID: 0941307532 Enrollment ID: I20070516000032 |
| Provider Name | Mohamed S Mohamed-aly |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891721700 PECOS PAC ID: 4385741982 Enrollment ID: I20070516000053 |
| Provider Name | Jessie D Hicks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811994023 PECOS PAC ID: 5698843548 Enrollment ID: I20081006000549 |
| Provider Name | Farzad Fakouri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043408495 PECOS PAC ID: 7517026859 Enrollment ID: I20081031000509 |
| Provider Name | Eli Azzi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1770548786 PECOS PAC ID: 9032107602 Enrollment ID: I20081121000023 |
| Provider Name | Craig L Mcdonald |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356393854 PECOS PAC ID: 2668474131 Enrollment ID: I20091008000217 |
| Provider Name | Chelliah Pandian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467419010 PECOS PAC ID: 9133171762 Enrollment ID: I20091102000174 |
| Provider Name | John W Durst |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013932540 PECOS PAC ID: 8224177399 Enrollment ID: I20091202000607 |
| Provider Name | Mohammad K Khedr |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1427051705 PECOS PAC ID: 5496731341 Enrollment ID: I20100113000206 |
| Provider Name | Sanober Kable |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295876399 PECOS PAC ID: 0749371128 Enrollment ID: I20100603000044 |
| Provider Name | Muhammad S Mustafa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154511871 PECOS PAC ID: 3274540315 Enrollment ID: I20100812000658 |
| Provider Name | Angelena M Ho |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255408308 PECOS PAC ID: 6406971027 Enrollment ID: I20100920000077 |
| Provider Name | Michael Bendele Blackmon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1043202849 PECOS PAC ID: 5698960102 Enrollment ID: I20101110000615 |
| Provider Name | Ekene Ifeanyi Okolo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528372729 PECOS PAC ID: 5395933212 Enrollment ID: I20101220000503 |
| Provider Name | Saud Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821126525 PECOS PAC ID: 3577662808 Enrollment ID: I20101230000419 |
| Provider Name | Naveed A Klair |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053503870 PECOS PAC ID: 4789878661 Enrollment ID: I20110112000981 |
| Provider Name | Tanveer Ahmed |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1265491724 PECOS PAC ID: 1759304009 Enrollment ID: I20110719000453 |
| Provider Name | James Wade Wilson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841400520 PECOS PAC ID: 4284802000 Enrollment ID: I20110722000125 |
| Provider Name | Swati F D Souza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902087091 PECOS PAC ID: 0446335566 Enrollment ID: I20111011000085 |
| Provider Name | Anna Varghese |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194986372 PECOS PAC ID: 1456526094 Enrollment ID: I20111212000049 |
| Provider Name | Michael Joseph Sebesta |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447218409 PECOS PAC ID: 9032268222 Enrollment ID: I20120620000371 |
| Provider Name | Aisha C Noble |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982831764 PECOS PAC ID: 0547416919 Enrollment ID: I20120820000268 |
| Provider Name | Elizabeth Race |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568424596 PECOS PAC ID: 1557510989 Enrollment ID: I20120928000614 |
| Provider Name | Joseph Jeanette |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881738649 PECOS PAC ID: 3577712876 Enrollment ID: I20121002000194 |
| Provider Name | Praneetha Puskuri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851581656 PECOS PAC ID: 4082894373 Enrollment ID: I20121004000606 |
| Provider Name | Syed M Ali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144434010 PECOS PAC ID: 2062593643 Enrollment ID: I20121108000631 |
| Provider Name | James J Mc Farland |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760510978 PECOS PAC ID: 2062314453 Enrollment ID: I20121128000165 |
| Provider Name | Kenneth Michael Kingdon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114067196 PECOS PAC ID: 6406014653 Enrollment ID: I20121213000319 |
| Provider Name | Victor M Nwiloh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851338032 PECOS PAC ID: 1658354832 Enrollment ID: I20130618000583 |
| Provider Name | Satish Agadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275724585 PECOS PAC ID: 9436386877 Enrollment ID: I20131211000346 |
| Provider Name | Saima Ubaid Khawaja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891768172 PECOS PAC ID: 3375507932 Enrollment ID: I20131227001665 |
| Provider Name | Amanda Parker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457472425 PECOS PAC ID: 5193989523 Enrollment ID: I20140225002082 |
| Provider Name | Nishi Gupta |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336373133 PECOS PAC ID: 4688823040 Enrollment ID: I20140311001674 |
| Provider Name | Richard T Pruiksma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053357491 PECOS PAC ID: 6901840099 Enrollment ID: I20140324001272 |
| Provider Name | Sofia Gul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346573086 PECOS PAC ID: 3779749171 Enrollment ID: I20140407000883 |
| Provider Name | Benjamin James Blow |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477798676 PECOS PAC ID: 0345474920 Enrollment ID: I20140414000575 |
| Provider Name | Arshad A Quddoos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093714628 PECOS PAC ID: 6002804028 Enrollment ID: I20140424001020 |
| Provider Name | Monicah W Gichinga Mugwe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376581470 PECOS PAC ID: 0648253385 Enrollment ID: I20140430001222 |
| Provider Name | Atif Fazal Rahman Shahnawaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902056971 PECOS PAC ID: 3072784149 Enrollment ID: I20140620000962 |
| Provider Name | Babar Zuberi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275532640 PECOS PAC ID: 9335165893 Enrollment ID: I20140626002564 |
| Provider Name | Brandon J Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528316460 PECOS PAC ID: 0042437337 Enrollment ID: I20140811000718 |
| Provider Name | Randolph Torres Ramos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619125515 PECOS PAC ID: 0840471652 Enrollment ID: I20140813002280 |
| Provider Name | Abrar A Mohammed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124227608 PECOS PAC ID: 7214028943 Enrollment ID: I20140904001779 |
| Provider Name | Kristoffer A Seelbach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336432012 PECOS PAC ID: 8820217094 Enrollment ID: I20140920000184 |
| Provider Name | Neal R Vassa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457607830 PECOS PAC ID: 3971723891 Enrollment ID: I20140927000192 |
| Provider Name | Snigdha Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932363116 PECOS PAC ID: 3779650973 Enrollment ID: I20141001000611 |
| Provider Name | Shalin Parikh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902105240 PECOS PAC ID: 6608098413 Enrollment ID: I20150203002193 |
| Provider Name | Abdier Delgado Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619384427 PECOS PAC ID: 9931328069 Enrollment ID: I20150224000400 |
| Provider Name | Caxton A Opere |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073614723 PECOS PAC ID: 9931163722 Enrollment ID: I20150506002143 |
| Provider Name | Rupali J Prabhukhot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669630265 PECOS PAC ID: 5597931873 Enrollment ID: I20150728003376 |
| Provider Name | Neil N Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992016919 PECOS PAC ID: 7618193996 Enrollment ID: I20151005000547 |
| Provider Name | Sujay Inampudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710181490 PECOS PAC ID: 5890887020 Enrollment ID: I20151012000734 |
| Provider Name | Ezmina K Lalani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831407964 PECOS PAC ID: 5496907750 Enrollment ID: I20151012001589 |
| Provider Name | Mohammad H Kabir |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1285859389 PECOS PAC ID: 6800940404 Enrollment ID: I20151201001512 |
| Provider Name | Manuel A Fernandez Palmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407136310 PECOS PAC ID: 5496055014 Enrollment ID: I20151203000082 |
| Provider Name | Shamsuddin B Lalani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578853594 PECOS PAC ID: 7214252683 Enrollment ID: I20160503000717 |
| Provider Name | Kaneza W Bgoya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922398940 PECOS PAC ID: 1153612783 Enrollment ID: I20160629000071 |
| Provider Name | Kinjal Desai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679860290 PECOS PAC ID: 5294050951 Enrollment ID: I20171212000041 |
| Provider Name | Esayas G Abebe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427436880 PECOS PAC ID: 2163779927 Enrollment ID: I20180725000614 |
| Provider Name | Ameet V Thatishetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053506949 PECOS PAC ID: 5496823312 Enrollment ID: I20191003002786 |
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