| Golden State Providers, A Medical Corporation | |
|
865 Patriot Dr Ste 203 Moorpark CA 93021-3405 | |
| (805) 370-4684 | |
| (844) 748-4623 |
| Full Name | Golden State Providers, A Medical Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 865 Patriot Dr Ste 203, Moorpark, California |
| Authorized Official Name and Position | Saba Habis (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8058529100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden State Providers, A Medical Corporation 2000 Health Park Dr Brentwood TN 37027-4525 Ph: (615) 373-7600 | Golden State Providers, A Medical Corporation 865 Patriot Dr Ste 203 Moorpark CA 93021-3405 Ph: (805) 370-4684 |
| NPI Number | 1366859449 |
|---|---|
| Provider Enumeration Date | 07/21/2014 |
| Last Update Date | 10/30/2020 |
| Medicare PECOS PAC ID | 7012212475 |
|---|---|
| Medicare Enrollment ID | O20160223000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366859449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Andrea Natale |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1841382421 PECOS PAC ID: 6103727383 Enrollment ID: I20040120000456 |
| Provider Name | Hazem Zekry |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457304099 PECOS PAC ID: 7012801673 Enrollment ID: I20040212000865 |
| Provider Name | Jeffrey M Dembner |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1356423271 PECOS PAC ID: 2961396718 Enrollment ID: I20040212000907 |
| Provider Name | Andy Phuoc Quang Le |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659356368 PECOS PAC ID: 2466341706 Enrollment ID: I20040313000496 |
| Provider Name | Mukesh B Gupta |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255369542 PECOS PAC ID: 4183516404 Enrollment ID: I20040329001776 |
| Provider Name | Saibal Kar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1063449403 PECOS PAC ID: 0345235529 Enrollment ID: I20040416001381 |
| Provider Name | Long Xu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376686469 PECOS PAC ID: 6901884907 Enrollment ID: I20040707001222 |
| Provider Name | Michael H Do |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235102880 PECOS PAC ID: 9234101395 Enrollment ID: I20040809001422 |
| Provider Name | Wei Zhang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801970181 PECOS PAC ID: 8527034743 Enrollment ID: I20040908001124 |
| Provider Name | Gian P Nhan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982770657 PECOS PAC ID: 9335108380 Enrollment ID: I20041006000628 |
| Provider Name | Ronald P Enriquez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568406114 PECOS PAC ID: 0446144323 Enrollment ID: I20050228001077 |
| Provider Name | Tom Ts Yao |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659482909 PECOS PAC ID: 5496793366 Enrollment ID: I20050420001408 |
| Provider Name | Mohammad Asif Qadeer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346206299 PECOS PAC ID: 9739128158 Enrollment ID: I20050426000712 |
| Provider Name | Brian Yost |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528036837 PECOS PAC ID: 0840230785 Enrollment ID: I20050510000573 |
| Provider Name | Samy Louka |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700950136 PECOS PAC ID: 2961392980 Enrollment ID: I20070629000354 |
| Provider Name | Daren Filsinger |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386848802 PECOS PAC ID: 4183711278 Enrollment ID: I20071106000875 |
| Provider Name | Bruce R Holmblad |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790820876 PECOS PAC ID: 1456428903 Enrollment ID: I20080924000637 |
| Provider Name | Barbara P Brar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114060183 PECOS PAC ID: 9335200948 Enrollment ID: I20081201000584 |
| Provider Name | Anubhav Sinha |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770620817 PECOS PAC ID: 4284795675 Enrollment ID: I20081203000671 |
| Provider Name | David M Baloga |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801939871 PECOS PAC ID: 0143381301 Enrollment ID: I20081205000427 |
| Provider Name | Mahesh S Desilva |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114162682 PECOS PAC ID: 8820151772 Enrollment ID: I20090120000504 |
| Provider Name | Charles Eric Schroeder |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841265667 PECOS PAC ID: 3476507773 Enrollment ID: I20090126000520 |
| Provider Name | Philip A Faraci |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1851391593 PECOS PAC ID: 2365413648 Enrollment ID: I20090813000794 |
| Provider Name | Nathaniel C Law |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427073444 PECOS PAC ID: 7618014689 Enrollment ID: I20091023000096 |
| Provider Name | Gregory P Fontana |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1508840570 PECOS PAC ID: 6507905247 Enrollment ID: I20091209000358 |
| Provider Name | Fahmy Ibrahim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255424404 PECOS PAC ID: 0345206223 Enrollment ID: I20100708001080 |
| Provider Name | Ronghuan Liu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841333960 PECOS PAC ID: 1052509767 Enrollment ID: I20101222000517 |
| Provider Name | Jay P Roby |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144531773 PECOS PAC ID: 3971783457 Enrollment ID: I20110216000172 |
| Provider Name | Radhika Levaka |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881821080 PECOS PAC ID: 6901057876 Enrollment ID: I20121127000586 |
| Provider Name | Jordan L Newmark |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144489592 PECOS PAC ID: 6406029065 Enrollment ID: I20121128000396 |
| Provider Name | Ameeta Kharbanda |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1568616365 PECOS PAC ID: 1355596719 Enrollment ID: I20130311000084 |
| Provider Name | Christina Pantazopoulos |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073829685 PECOS PAC ID: 9133360647 Enrollment ID: I20130725000783 |
| Provider Name | Lawrence E Ong |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316254840 PECOS PAC ID: 8820239213 Enrollment ID: I20130727000099 |
| Provider Name | Joshua Siegel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043227903 PECOS PAC ID: 1759455405 Enrollment ID: I20131029000671 |
| Provider Name | Husam Alsamman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1932344058 PECOS PAC ID: 1355565839 Enrollment ID: I20140624002454 |
| Provider Name | Bo-lu Zhou |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275783110 PECOS PAC ID: 0345428421 Enrollment ID: I20140722001071 |
| Provider Name | Maninder Singh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568791614 PECOS PAC ID: 2163669474 Enrollment ID: I20140807001593 |
| Provider Name | Omar J Satter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871812941 PECOS PAC ID: 2466670518 Enrollment ID: I20140902001681 |
| Provider Name | Kevin Kleis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649566456 PECOS PAC ID: 5294052528 Enrollment ID: I20150326000905 |
| Provider Name | James Pugeda |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396908059 PECOS PAC ID: 1153599204 Enrollment ID: I20150914000666 |
| Provider Name | John Anthony Kuri |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275737280 PECOS PAC ID: 7719057447 Enrollment ID: I20160908000580 |
| Provider Name | Steven Andrew Brown |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285945998 PECOS PAC ID: 0143517011 Enrollment ID: I20160920001805 |
| Provider Name | Kelley C Mckenna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528410511 PECOS PAC ID: 1658669312 Enrollment ID: I20161012001276 |
| Provider Name | Winnie W Lee |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1023028776 PECOS PAC ID: 1951305556 Enrollment ID: I20161214001001 |
| Provider Name | Siddharth Singh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609134261 PECOS PAC ID: 2961771761 Enrollment ID: I20170711001767 |
| Provider Name | George E Ishak |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790190825 PECOS PAC ID: 4486925062 Enrollment ID: I20170731002336 |
| Provider Name | Patricia M Lowery |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831538305 PECOS PAC ID: 2466726955 Enrollment ID: I20170921003130 |
| Provider Name | Patricia Adrienne Whitney De Luna |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093154387 PECOS PAC ID: 8022382498 Enrollment ID: I20170922003040 |
| Provider Name | Rina Parmeshwar Balasubramanian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871935601 PECOS PAC ID: 6507132636 Enrollment ID: I20171018000162 |
| Provider Name | Yu Yu Lynn Yin Shu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174944706 PECOS PAC ID: 1658638515 Enrollment ID: I20171130002177 |
| Provider Name | Svetlana Helms |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225178007 PECOS PAC ID: 9234203043 Enrollment ID: I20180213002309 |
| Provider Name | Hank H Sun |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427493220 PECOS PAC ID: 3678880150 Enrollment ID: I20180523000231 |
| Provider Name | Steven Daniel Bonsall |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417375262 PECOS PAC ID: 3577818954 Enrollment ID: I20180626003442 |
| Provider Name | Leonard Kenneth Lee |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447690227 PECOS PAC ID: 2365798949 Enrollment ID: I20180712001046 |
| Provider Name | Kathleen M Hase |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992195663 PECOS PAC ID: 7416273727 Enrollment ID: I20180803001836 |
| Provider Name | Catrissa Laverne Lightfoot-siordia |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790103885 PECOS PAC ID: 2365707395 Enrollment ID: I20181009003379 |
| Provider Name | Amy Rieschick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063825552 PECOS PAC ID: 2668693730 Enrollment ID: I20190111003026 |
| Provider Name | Jeffrey E Murray |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962652172 PECOS PAC ID: 9638230196 Enrollment ID: I20190311002688 |
| Provider Name | Damon D Min |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588082549 PECOS PAC ID: 9436406501 Enrollment ID: I20190321002102 |
| Provider Name | Brian A Mcconnell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174533459 PECOS PAC ID: 2466527346 Enrollment ID: I20190416001627 |
| Provider Name | Sameer Sami Khan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316388606 PECOS PAC ID: 0042544116 Enrollment ID: I20190624000965 |
| Provider Name | Jessica Elizabeth Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487219291 PECOS PAC ID: 0840525044 Enrollment ID: I20190710002317 |
| Provider Name | Michael C R Andrews |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063791853 PECOS PAC ID: 5799062568 Enrollment ID: I20191106001768 |
| Provider Name | Nutan Winston |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1912993809 PECOS PAC ID: 1850454786 Enrollment ID: I20191126002408 |
| Provider Name | Kevin Saroo Chap |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770856288 PECOS PAC ID: 2769636968 Enrollment ID: I20191204000502 |
| Provider Name | Kimberly J Gerber |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801288550 PECOS PAC ID: 2466887575 Enrollment ID: I20200120000233 |
| Provider Name | Ergit Paparisto |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063867638 PECOS PAC ID: 7416387709 Enrollment ID: I20200429001627 |
| Provider Name | Jonathan Deeth |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376866335 PECOS PAC ID: 4789985243 Enrollment ID: I20200429001720 |
| Provider Name | Peter C Ning |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760639272 PECOS PAC ID: 3375709264 Enrollment ID: I20200429001871 |
| Provider Name | Alexandra M Bock |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336761519 PECOS PAC ID: 7911320379 Enrollment ID: I20200710002747 |
| Provider Name | Darion Michelle Pearson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093169237 PECOS PAC ID: 3274824503 Enrollment ID: I20200714003062 |
| Provider Name | Richard A Chiang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265895536 PECOS PAC ID: 5799055703 Enrollment ID: I20200715001253 |
| Provider Name | Gerard Joseph Hoatam |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407210008 PECOS PAC ID: 0547554065 Enrollment ID: I20200903000524 |
| Provider Name | Emely R Garcia |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124641444 PECOS PAC ID: 4284054529 Enrollment ID: I20201026002034 |
| Provider Name | Meilani S Chuquimia |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659994788 PECOS PAC ID: 4385054923 Enrollment ID: I20201110001365 |
| Provider Name | Jared S Lange |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578002689 PECOS PAC ID: 3072870625 Enrollment ID: I20201202001281 |
| Provider Name | Alex C Wilkie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164983029 PECOS PAC ID: 0941613491 Enrollment ID: I20201230002325 |
| Provider Name | Antonio Orellana |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790395721 PECOS PAC ID: 0547674384 Enrollment ID: I20210205001883 |
| Provider Name | Chanwang Park |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285954578 PECOS PAC ID: 8820234032 Enrollment ID: I20210210002315 |
| Provider Name | Joan S Chung |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205008273 PECOS PAC ID: 2365628518 Enrollment ID: I20210211002302 |
| Provider Name | Jasprit S Takher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235489709 PECOS PAC ID: 2163718115 Enrollment ID: I20210413002709 |
| Provider Name | Bahbak Adrangi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811972565 PECOS PAC ID: 5890880488 Enrollment ID: I20210416001550 |
| Provider Name | Jeffrey James Altizer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285208215 PECOS PAC ID: 9638560501 Enrollment ID: I20220104000201 |
| Provider Name | Fara J. Delaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831559756 PECOS PAC ID: 7810382207 Enrollment ID: I20220322001457 |
| Provider Name | Anthony M Nguyen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841947892 PECOS PAC ID: 3779970835 Enrollment ID: I20220420002071 |
| Provider Name | Anesha L Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871248799 PECOS PAC ID: 9638566797 Enrollment ID: I20220420002279 |
| Provider Name | Marwa Sidani |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851711618 PECOS PAC ID: 2466708672 Enrollment ID: I20220512001548 |
| Provider Name | Austin H Nguyen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083109797 PECOS PAC ID: 2163754755 Enrollment ID: I20220601000794 |
| Provider Name | Neal Christopher Petersen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023682127 PECOS PAC ID: 8628457892 Enrollment ID: I20220617000856 |
| Provider Name | Jerald Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679144562 PECOS PAC ID: 0547641326 Enrollment ID: I20220726001118 |
| Provider Name | Rodd Rezvani |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700314713 PECOS PAC ID: 3476823717 Enrollment ID: I20220928003592 |
| Provider Name | Kalyan Gupta Kuna |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316172935 PECOS PAC ID: 3375693070 Enrollment ID: I20221020001970 |
| Provider Name | Mark Anthony Dimaggio |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457001315 PECOS PAC ID: 0143691816 Enrollment ID: I20230118000303 |
| Provider Name | Hoa Q Nguyen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982324364 PECOS PAC ID: 5597130997 Enrollment ID: I20230418000907 |
| Provider Name | Jeffrey C Wood |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962499640 PECOS PAC ID: 8022072206 Enrollment ID: I20230502002926 |
| Provider Name | Oktay Mustafayev |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306554050 PECOS PAC ID: 7517324189 Enrollment ID: I20230613002614 |
| Provider Name | Patrick James Moran |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568178762 PECOS PAC ID: 6901265867 Enrollment ID: I20230710003514 |
| Provider Name | Russell L Shults |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083060073 PECOS PAC ID: 9638464183 Enrollment ID: I20230815003405 |
| Provider Name | Kanoo Priya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265151336 PECOS PAC ID: 0941671002 Enrollment ID: I20230920001540 |
| Provider Name | Vi M Ly |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346810793 PECOS PAC ID: 6103270426 Enrollment ID: I20230920002445 |
| Provider Name | Anjani D Golive |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023385283 PECOS PAC ID: 9830315621 Enrollment ID: I20230921002528 |
| Provider Name | Talitha Ruth Moton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295309342 PECOS PAC ID: 9436503372 Enrollment ID: I20230927000869 |
| Provider Name | Albert Scott |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285314765 PECOS PAC ID: 7416304654 Enrollment ID: I20231109003213 |
| Provider Name | Mengjie Wu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073003273 PECOS PAC ID: 0547649667 Enrollment ID: I20231220002100 |
| Provider Name | James Alan Berdahl |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770200529 PECOS PAC ID: 7911359872 Enrollment ID: I20240117001209 |
| Provider Name | Chris Oliver Soto |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164093092 PECOS PAC ID: 4880046119 Enrollment ID: I20240122004588 |
Patriot Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 885 Patriot Dr, Unit F, Moorpark, CA 93021 Phone: 805-334-1371 | |
Moorpark Family Medical Clinic Fqhc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 612 Spring Rd, Moorpark, CA 93021 Phone: 805-523-5400 | |
Moorpark Comprehensive Medical Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14711 Princeton Ave, Suite 2, Moorpark, CA 93021 Phone: 805-532-2032 Fax: 805-532-2844 | |
Moorpark Family Medicine Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 301 Science Dr, Suite #190, Moorpark, CA 93021 Phone: 805-531-9400 Fax: 805-531-9499 | |
Mark R Winkler Md Pa Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14366 Shawnee St, Moorpark, CA 93021 Phone: 818-882-5375 | |
Guardiant Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 887 Patriot Dr Ste B, Moorpark, CA 93021 Phone: 805-364-0889 Fax: 805-200-4434 |