| Gn Medical Associates, Inc. | |
|
3090 Bristol St Ste 200 Costa Mesa CA 92626-3061 | |
| (888) 789-9585 | |
| (562) 803-4500 |
| Full Name | Gn Medical Associates, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 3090 Bristol St Ste 200, Costa Mesa, California |
| Authorized Official Name and Position | Christine Mlot (PRESIDENT) |
| Authorized Official Contact | 8887989585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gn Medical Associates, Inc. 3090 Bristol St Ste 200 Costa Mesa CA 92626-3061 Ph: (888) 789-9585 | Gn Medical Associates, Inc. 3090 Bristol St Ste 200 Costa Mesa CA 92626-3061 Ph: (888) 789-9585 |
| NPI Number | 1275576522 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 01/18/2022 |
| Medicare PECOS PAC ID | 5092605816 |
|---|---|
| Medicare Enrollment ID | O20040316001465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275576522 | NPI | - | NPPES |
| GR0089880 | Medicaid | CA |
| Provider Name | Angela J Lamotte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538166764 PECOS PAC ID: 7416853619 Enrollment ID: I20031209000668 |
| Provider Name | Susan Keisner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417954793 PECOS PAC ID: 7113903345 Enrollment ID: I20040628000787 |
| Provider Name | Elaine Sofia Gertser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992719967 PECOS PAC ID: 6709866569 Enrollment ID: I20040722000345 |
| Provider Name | Christine M Mlot |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1538240239 PECOS PAC ID: 5193788685 Enrollment ID: I20041105000408 |
| Provider Name | Vakas A Sial |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659302305 PECOS PAC ID: 3870556087 Enrollment ID: I20041109000525 |
| Provider Name | Kerry Weiner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528062437 PECOS PAC ID: 7315848553 Enrollment ID: I20041109001258 |
| Provider Name | Blaine K Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518079565 PECOS PAC ID: 6406813369 Enrollment ID: I20041213000891 |
| Provider Name | Ujjwala S Dheeriya |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1770508582 PECOS PAC ID: 7911950936 Enrollment ID: I20050301000992 |
| Provider Name | Simon Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760594097 PECOS PAC ID: 9739133588 Enrollment ID: I20050307000457 |
| Provider Name | George E Fields |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457387482 PECOS PAC ID: 3173413994 Enrollment ID: I20050722000881 |
| Provider Name | Nghi D Vo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255410320 PECOS PAC ID: 1456380328 Enrollment ID: I20050810001145 |
| Provider Name | Shreeti Hasmukh Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154322691 PECOS PAC ID: 0244253003 Enrollment ID: I20060106000460 |
| Provider Name | Hyong Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396792677 PECOS PAC ID: 7719998251 Enrollment ID: I20060511000203 |
| Provider Name | Thuy Adrianne Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386688471 PECOS PAC ID: 8325044332 Enrollment ID: I20061016000226 |
| Provider Name | Lydia K Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093729824 PECOS PAC ID: 7012914039 Enrollment ID: I20061103000197 |
| Provider Name | Kien Tran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396831889 PECOS PAC ID: 5597669986 Enrollment ID: I20061204000120 |
| Provider Name | Melinda A Duarte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912933888 PECOS PAC ID: 8729088778 Enrollment ID: I20061222000161 |
| Provider Name | Xanthe Victoria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447270418 PECOS PAC ID: 0547362964 Enrollment ID: I20070302000262 |
| Provider Name | Virginia D Cruz Samonte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922176379 PECOS PAC ID: 8921103615 Enrollment ID: I20070425000534 |
| Provider Name | Ashish Malhotra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679583744 PECOS PAC ID: 4880655083 Enrollment ID: I20070726000253 |
| Provider Name | Claudio V Zawitkowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578558623 PECOS PAC ID: 7618046103 Enrollment ID: I20080523000558 |
| Provider Name | Flora Danque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013927425 PECOS PAC ID: 5890852776 Enrollment ID: I20090319000564 |
| Provider Name | Hamid Eskandari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063662682 PECOS PAC ID: 5890852313 Enrollment ID: I20090326000490 |
| Provider Name | Reginald Casilang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780784488 PECOS PAC ID: 6608923156 Enrollment ID: I20090420000659 |
| Provider Name | Michael A Pietila |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851315097 PECOS PAC ID: 7113076423 Enrollment ID: I20090515000348 |
| Provider Name | Joanna Yao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861680555 PECOS PAC ID: 5890849400 Enrollment ID: I20090817000611 |
| Provider Name | Orlando Acosta Collado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205964947 PECOS PAC ID: 8820143134 Enrollment ID: I20090909000538 |
| Provider Name | May P Goodly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164663753 PECOS PAC ID: 7416096458 Enrollment ID: I20091203000538 |
| Provider Name | James S Pratty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528049608 PECOS PAC ID: 4587695416 Enrollment ID: I20091222000364 |
| Provider Name | Rafaelito S Victoria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548363989 PECOS PAC ID: 1759405319 Enrollment ID: I20100902000983 |
| Provider Name | James P Sutton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114047628 PECOS PAC ID: 7113042722 Enrollment ID: I20100918000281 |
| Provider Name | Thuy Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891015871 PECOS PAC ID: 4082809835 Enrollment ID: I20101108000047 |
| Provider Name | Shiva Shabnam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679802037 PECOS PAC ID: 5092991992 Enrollment ID: I20110510000583 |
| Provider Name | Anna C Baston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649588005 PECOS PAC ID: 3577749076 Enrollment ID: I20110518000273 |
| Provider Name | Tam Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720153182 PECOS PAC ID: 6305917485 Enrollment ID: I20120328000989 |
| Provider Name | Marjorie Chan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174811624 PECOS PAC ID: 0648431932 Enrollment ID: I20120412000749 |
| Provider Name | Lei Guo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881836096 PECOS PAC ID: 0446407548 Enrollment ID: I20120824000262 |
| Provider Name | Rikki S Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053545442 PECOS PAC ID: 5395981310 Enrollment ID: I20130418000128 |
| Provider Name | Hebert Claude |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215213871 PECOS PAC ID: 6507003241 Enrollment ID: I20140102001441 |
| Provider Name | Katherine A Norris |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1356578769 PECOS PAC ID: 3375764467 Enrollment ID: I20141014001033 |
| Provider Name | Marcelle Sagerian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285780437 PECOS PAC ID: 6507189230 Enrollment ID: I20150102001180 |
| Provider Name | Patricia Shigley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265853774 PECOS PAC ID: 6800111725 Enrollment ID: I20150216002038 |
| Provider Name | Iyad Houshan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497773287 PECOS PAC ID: 3274538251 Enrollment ID: I20150513002209 |
| Provider Name | Subrato Ghosh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083607055 PECOS PAC ID: 5193997617 Enrollment ID: I20150526001962 |
| Provider Name | Ming-lung Lu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194116970 PECOS PAC ID: 2264745884 Enrollment ID: I20150724011030 |
| Provider Name | Christina Lynn Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134509177 PECOS PAC ID: 0749596500 Enrollment ID: I20150825004365 |
| Provider Name | Ronald Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417954306 PECOS PAC ID: 6103806278 Enrollment ID: I20151006002798 |
| Provider Name | Jessica Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003299033 PECOS PAC ID: 8527377431 Enrollment ID: I20151015001624 |
| Provider Name | Arceli Oliva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659422533 PECOS PAC ID: 8325205677 Enrollment ID: I20151123002903 |
| Provider Name | James Agatep |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578939153 PECOS PAC ID: 5799085627 Enrollment ID: I20151130000074 |
| Provider Name | Julie Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174977292 PECOS PAC ID: 8022317171 Enrollment ID: I20160425001468 |
| Provider Name | Janice Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962836833 PECOS PAC ID: 4082904958 Enrollment ID: I20160606000638 |
| Provider Name | Wesam Houshan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356467112 PECOS PAC ID: 0345472080 Enrollment ID: I20160926001447 |
| Provider Name | Andrew Imparato |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720400971 PECOS PAC ID: 1951680420 Enrollment ID: I20161128001933 |
| Provider Name | Negin Rajaipour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508286709 PECOS PAC ID: 1052692357 Enrollment ID: I20161228001543 |
| Provider Name | Andrea H Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861934838 PECOS PAC ID: 2062795222 Enrollment ID: I20170214000082 |
| Provider Name | Jay A Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891231700 PECOS PAC ID: 9931483757 Enrollment ID: I20170222002532 |
| Provider Name | Iman Guirgis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1154774933 PECOS PAC ID: 5092099812 Enrollment ID: I20170222002711 |
| Provider Name | James Conrad J Contreras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033586870 PECOS PAC ID: 9436437829 Enrollment ID: I20170303002043 |
| Provider Name | Kimberly Huynh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215475710 PECOS PAC ID: 3173809811 Enrollment ID: I20170413000466 |
| Provider Name | Marianne Plakas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942503701 PECOS PAC ID: 3375782733 Enrollment ID: I20170419003034 |
| Provider Name | John C Feng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346660081 PECOS PAC ID: 6709159775 Enrollment ID: I20170913003366 |
| Provider Name | Joni L Mcatee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689971814 PECOS PAC ID: 4183927999 Enrollment ID: I20170919003546 |
| Provider Name | Halie Holden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902320443 PECOS PAC ID: 9234404021 Enrollment ID: I20171004001613 |
| Provider Name | Mary Allison Redden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508381302 PECOS PAC ID: 9234495904 Enrollment ID: I20171113003027 |
| Provider Name | Lena M Rangel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679022628 PECOS PAC ID: 0244598209 Enrollment ID: I20171220001521 |
| Provider Name | Manuel Robert Brasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083127088 PECOS PAC ID: 3678833340 Enrollment ID: I20180129002245 |
| Provider Name | Tyler L Sprague |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881077428 PECOS PAC ID: 5092076133 Enrollment ID: I20180306000489 |
| Provider Name | Maricar M David |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467810309 PECOS PAC ID: 5597014571 Enrollment ID: I20180824000119 |
| Provider Name | Mary Ann M Tanglao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134632490 PECOS PAC ID: 7911258108 Enrollment ID: I20180927001382 |
| Provider Name | Kathleen Camia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306168752 PECOS PAC ID: 9830440106 Enrollment ID: I20190201002027 |
| Provider Name | Patrick Hachero Deligero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427412451 PECOS PAC ID: 2567725435 Enrollment ID: I20190208002025 |
| Provider Name | Ripal Chinubhai Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457720872 PECOS PAC ID: 1557678778 Enrollment ID: I20190312000424 |
| Provider Name | Brianne C Gober |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477713048 PECOS PAC ID: 7719125590 Enrollment ID: I20190402000317 |
| Provider Name | George Alburo Damasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104398890 PECOS PAC ID: 3375884653 Enrollment ID: I20190415001891 |
| Provider Name | Oluwaseun Boladale Ogunjimi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194243790 PECOS PAC ID: 4183965312 Enrollment ID: I20190416001189 |
| Provider Name | Tara C Bartlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124386347 PECOS PAC ID: 8325381296 Enrollment ID: I20190515003421 |
| Provider Name | Natalie Pung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679055586 PECOS PAC ID: 5890038608 Enrollment ID: I20190520000483 |
| Provider Name | Hilario C Noveno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124486865 PECOS PAC ID: 1951644608 Enrollment ID: I20190520002746 |
| Provider Name | Stacy Lynn Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891252318 PECOS PAC ID: 3476883927 Enrollment ID: I20190925002818 |
| Provider Name | Steven Howard Farber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245248574 PECOS PAC ID: 6800880873 Enrollment ID: I20191004002903 |
| Provider Name | Priya Jagasia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679641971 PECOS PAC ID: 4385749654 Enrollment ID: I20191015003333 |
| Provider Name | Richard Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588198352 PECOS PAC ID: 9436582541 Enrollment ID: I20191204000196 |
| Provider Name | Sara Jennifer Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982257390 PECOS PAC ID: 4183058126 Enrollment ID: I20191227000335 |
| Provider Name | Diana Yh Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740750785 PECOS PAC ID: 9931537396 Enrollment ID: I20200318000129 |
| Provider Name | Audrey Joan Realeza Cano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154987634 PECOS PAC ID: 2365871050 Enrollment ID: I20200331003633 |
| Provider Name | Magdiel R. De La Rosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669845186 PECOS PAC ID: 1254633399 Enrollment ID: I20200811002408 |
| Provider Name | Adam Solomon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871576041 PECOS PAC ID: 4082504162 Enrollment ID: I20201124001054 |
| Provider Name | Jose Mari Atangan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427611656 PECOS PAC ID: 4587098827 Enrollment ID: I20210225001523 |
| Provider Name | Liliane Idylle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114298957 PECOS PAC ID: 1355567223 Enrollment ID: I20210519001474 |
| Provider Name | Adenike Awolola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184263733 PECOS PAC ID: 7315343050 Enrollment ID: I20210907000205 |
| Provider Name | Elena Cristiana Marin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134897598 PECOS PAC ID: 4688052251 Enrollment ID: I20220609003077 |
| Provider Name | Roslyn Mazi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992449326 PECOS PAC ID: 8628459393 Enrollment ID: I20220713001901 |
| Provider Name | Rajdeep Sandhu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013473073 PECOS PAC ID: 0143604694 Enrollment ID: I20220831003612 |
| Provider Name | Vanessa Clara Seal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811352883 PECOS PAC ID: 3173909884 Enrollment ID: I20221004002102 |
| Provider Name | Mary Grace Matin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427779297 PECOS PAC ID: 5698151314 Enrollment ID: I20221004002325 |
| Provider Name | Mary Terese Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386367381 PECOS PAC ID: 4486025962 Enrollment ID: I20230119002511 |
| Provider Name | Elena Marie Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548966096 PECOS PAC ID: 1951774132 Enrollment ID: I20230309000761 |
| Provider Name | Nika Nakia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467622712 PECOS PAC ID: 0345394367 Enrollment ID: I20230816003091 |
| Provider Name | Ling Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396988416 PECOS PAC ID: 7214185826 Enrollment ID: I20231010000812 |
| Provider Name | Melissa Anne Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144898933 PECOS PAC ID: 1658728738 Enrollment ID: I20231110001586 |
| Provider Name | Joel Salinas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962798892 PECOS PAC ID: 3678735388 Enrollment ID: I20240214000166 |
| Provider Name | Kimberly Michelle Moreau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881431864 PECOS PAC ID: 5496291908 Enrollment ID: I20240720000433 |
| Provider Name | Jeffrey Alan Iverson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023850963 PECOS PAC ID: 0648718940 Enrollment ID: I20240819000608 |
Nazli Ahmed, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 275 Victoria St, # 2m, Costa Mesa, CA 92627 Phone: 949-642-5390 Fax: 949-642-1224 | |
Roberto N Valenton Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Victoria St, Costa Mesa, CA 92627 Phone: 949-642-2734 | |
Bristol Park Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 722 Baker St, Costa Mesa, CA 92626 Phone: 714-557-6300 Fax: 714-966-9567 | |
Shahrestani Chiropractic Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2328 Newport Blvd, Costa Mesa, CA 92627 Phone: 949-631-3139 Fax: 949-631-0747 | |
Md24 San Diego, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Anton Blvd Ste 1100, Costa Mesa, CA 92626 Phone: 623-374-7774 | |
Coastal Mesa Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 777 W 19th St Ste J, Costa Mesa, CA 92627 Phone: 657-203-2133 | |
Newport Mesa Medical Group, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 275 Victoria St, Ste 1e, Costa Mesa, CA 92627 Phone: 949-574-3615 |