| Greenley Primary Care | |
|
19747 Greenley Rd Suite S-2 Sonora CA 95370-5998 | |
| (209) 536-2665 | |
| (209) 533-7696 |
| Full Name | Greenley Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 19747 Greenley Rd, Sonora, California |
| Authorized Official Name and Position | Gregory D. Mcculloch (PRESIDENT) |
| Authorized Official Contact | 2095365019 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenley Primary Care 1000 Greenley Rd Sonora CA 95370-5200 | Greenley Primary Care 19747 Greenley Rd Suite S-2 Sonora CA 95370-5998 Ph: (209) 536-2665 |
| NPI Number | 1033100854 |
|---|---|
| Provider Enumeration Date | 11/01/2005 |
| Last Update Date | 11/26/2025 |
| Certification Date | 11/26/2025 |
| Medicare PECOS PAC ID | 4284538505 |
|---|---|
| Medicare Enrollment ID | O20040316000829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033100854 | NPI | - | NPPES |
| ZZZ52953Z | Other | CA | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 030000094 (California) | Primary |
| Provider Name | Felix Anthony Conte |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285712760 PECOS PAC ID: 7719872365 Enrollment ID: I20040220000965 |
| Provider Name | Donald K Westbie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912984436 PECOS PAC ID: 7416940135 Enrollment ID: I20040407000516 |
| Provider Name | Tiffany L Waters |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184652695 PECOS PAC ID: 1456345222 Enrollment ID: I20040413001793 |
| Provider Name | Robert N Keenan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558325654 PECOS PAC ID: 8426045162 Enrollment ID: I20040426001923 |
| Provider Name | Darienne M Marcetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174614010 PECOS PAC ID: 2567459035 Enrollment ID: I20040427001108 |
| Provider Name | Jon Sherman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366443053 PECOS PAC ID: 2365423290 Enrollment ID: I20040526001622 |
| Provider Name | Mark P Miller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073575353 PECOS PAC ID: 7214916295 Enrollment ID: I20040715001396 |
| Provider Name | Chung Yam |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295856250 PECOS PAC ID: 1658351838 Enrollment ID: I20040720001537 |
| Provider Name | Devanie S Teel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861584823 PECOS PAC ID: 5092785949 Enrollment ID: I20040728000693 |
| Provider Name | Miroslav Djokic |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1023048865 PECOS PAC ID: 1850362849 Enrollment ID: I20040803001554 |
| Provider Name | Christopher J Krpan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811059918 PECOS PAC ID: 1951374396 Enrollment ID: I20040823001068 |
| Provider Name | Harry Balian |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427150952 PECOS PAC ID: 7315912896 Enrollment ID: I20040827001208 |
| Provider Name | Stephen J Hopkins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265498539 PECOS PAC ID: 5294797569 Enrollment ID: I20041028001148 |
| Provider Name | Christine Ann Elder |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235164047 PECOS PAC ID: 1850357609 Enrollment ID: I20041203000579 |
| Provider Name | Douglas W Ankrom |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558390393 PECOS PAC ID: 5597721795 Enrollment ID: I20041209000244 |
| Provider Name | Liliana Gelvez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205972957 PECOS PAC ID: 6204892318 Enrollment ID: I20041209000394 |
| Provider Name | James L Reese |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1538173059 PECOS PAC ID: 9436116357 Enrollment ID: I20041213000646 |
| Provider Name | Siamak Karimian |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225091812 PECOS PAC ID: 7719933258 Enrollment ID: I20050328000568 |
| Provider Name | Julia a Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174509103 PECOS PAC ID: 1254388804 Enrollment ID: I20050405001299 |
| Provider Name | Deborah Leanne Kagay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700098597 PECOS PAC ID: 5395786495 Enrollment ID: I20050519000114 |
| Provider Name | Jennifer L Neufeld Trujillo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861482671 PECOS PAC ID: 0244266641 Enrollment ID: I20050715000831 |
| Provider Name | Matthew a Williamson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831173111 PECOS PAC ID: 9032137096 Enrollment ID: I20051108000643 |
| Provider Name | Claudia D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780734632 PECOS PAC ID: 1052325875 Enrollment ID: I20060201000275 |
| Provider Name | Angelica Buenrostro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720052418 PECOS PAC ID: 4183633670 Enrollment ID: I20060411000523 |
| Provider Name | Sean Anderson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144287061 PECOS PAC ID: 0547263295 Enrollment ID: I20060817000564 |
| Provider Name | Ser W Vang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699784470 PECOS PAC ID: 2961307087 Enrollment ID: I20061004000370 |
| Provider Name | Gilbert Simoni |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316922958 PECOS PAC ID: 7315970787 Enrollment ID: I20061120000297 |
| Provider Name | Kenneth M Royle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891873378 PECOS PAC ID: 6406845395 Enrollment ID: I20070626000799 |
| Provider Name | Serap Sobnosky |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447302823 PECOS PAC ID: 7911091566 Enrollment ID: I20070913000551 |
| Provider Name | Keith C Myers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770622862 PECOS PAC ID: 1254412885 Enrollment ID: I20080121000271 |
| Provider Name | Peter Bippart |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700844248 PECOS PAC ID: 6709850860 Enrollment ID: I20080124000385 |
| Provider Name | Sanjeev K Goswami |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720148612 PECOS PAC ID: 9638278922 Enrollment ID: I20080410000206 |
| Provider Name | Matthew L Personius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528022712 PECOS PAC ID: 9931195328 Enrollment ID: I20080425000402 |
| Provider Name | Ayman a Hosny |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265414155 PECOS PAC ID: 3870675671 Enrollment ID: I20080521000408 |
| Provider Name | Ralph Retherford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801043799 PECOS PAC ID: 5496820862 Enrollment ID: I20080819000856 |
| Provider Name | Gunnar E Rohde-moe |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215912019 PECOS PAC ID: 7911065917 Enrollment ID: I20081020000580 |
| Provider Name | Kishore K Kalluri |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073517751 PECOS PAC ID: 3476574732 Enrollment ID: I20081216000355 |
| Provider Name | Steven Shield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619954237 PECOS PAC ID: 1153484837 Enrollment ID: I20090106000675 |
| Provider Name | Alberto a Bolanos |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467548008 PECOS PAC ID: 6406919745 Enrollment ID: I20090113000075 |
| Provider Name | Matthew T Maynard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861617417 PECOS PAC ID: 0941391056 Enrollment ID: I20091211000329 |
| Provider Name | Harry Matossian |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316945702 PECOS PAC ID: 3375430564 Enrollment ID: I20100827000676 |
| Provider Name | Stephen a Desantis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366442584 PECOS PAC ID: 9234254020 Enrollment ID: I20100916001122 |
| Provider Name | Gabriel Herscu |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1528230679 PECOS PAC ID: 4284829920 Enrollment ID: I20101108001309 |
| Provider Name | Sundararajan Srikanth |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1104934082 PECOS PAC ID: 0042497414 Enrollment ID: I20110613000239 |
| Provider Name | Jacey Jean Rodriguez-serva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215255062 PECOS PAC ID: 6608046149 Enrollment ID: I20110819000230 |
| Provider Name | Sapoora Manshaii |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922041185 PECOS PAC ID: 4587564174 Enrollment ID: I20111221000399 |
| Provider Name | Randolph B Roxas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174560072 PECOS PAC ID: 9234305145 Enrollment ID: I20111227000322 |
| Provider Name | Wais Tarrar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801047998 PECOS PAC ID: 2264619709 Enrollment ID: I20120604000080 |
| Provider Name | Airell L Nygaard |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417920760 PECOS PAC ID: 3870499304 Enrollment ID: I20120703000593 |
| Provider Name | Muhammad Chaudhry |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609001262 PECOS PAC ID: 5597920801 Enrollment ID: I20120711000126 |
| Provider Name | John P Nelligan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952491151 PECOS PAC ID: 1759310279 Enrollment ID: I20120827000636 |
| Provider Name | Theodore N Powers |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740417187 PECOS PAC ID: 5597914523 Enrollment ID: I20121005000385 |
| Provider Name | Sekhar Ujwala U Eadula |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427313345 PECOS PAC ID: 7719131416 Enrollment ID: I20130205000341 |
| Provider Name | Anahita Rezaie |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821294000 PECOS PAC ID: 7517051782 Enrollment ID: I20130719000425 |
| Provider Name | Paul B Kubin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770833352 PECOS PAC ID: 2860628351 Enrollment ID: I20131111000432 |
| Provider Name | Rhunjay J. Yu |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1255527024 PECOS PAC ID: 7719113745 Enrollment ID: I20131122000781 |
| Provider Name | John S Chorba |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538364138 PECOS PAC ID: 6204065881 Enrollment ID: I20140130000887 |
| Provider Name | Mathea J Salas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184781932 PECOS PAC ID: 7810953759 Enrollment ID: I20140821000801 |
| Provider Name | Christopher Jones |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649594417 PECOS PAC ID: 8123249703 Enrollment ID: I20141023001998 |
| Provider Name | Krysta L Wolken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073914347 PECOS PAC ID: 1153644133 Enrollment ID: I20141223001945 |
| Provider Name | Janet J Briggs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225323165 PECOS PAC ID: 2062735871 Enrollment ID: I20150101000017 |
| Provider Name | Laura Harper |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760805444 PECOS PAC ID: 4183942386 Enrollment ID: I20150420002115 |
| Provider Name | Josebelo D Chong |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1891815791 PECOS PAC ID: 4284735499 Enrollment ID: I20150717002788 |
| Provider Name | Chrystal Bradley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366886392 PECOS PAC ID: 2961718176 Enrollment ID: I20150902003131 |
| Provider Name | Anita Kumari |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1518128222 PECOS PAC ID: 0345475794 Enrollment ID: I20151103002916 |
| Provider Name | Paramvir Singh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346213444 PECOS PAC ID: 8022081652 Enrollment ID: I20151207002499 |
| Provider Name | Annie Michele Fagundes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891178182 PECOS PAC ID: 5496057044 Enrollment ID: I20160113002077 |
| Provider Name | Nathaniel Methot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225422140 PECOS PAC ID: 6103121983 Enrollment ID: I20160217000772 |
| Provider Name | Abdullah M Khalid |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811239981 PECOS PAC ID: 7113225624 Enrollment ID: I20160909002454 |
| Provider Name | Giovanni M Salerno |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942242698 PECOS PAC ID: 8325947237 Enrollment ID: I20160921001052 |
| Provider Name | Diana E Monsalve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962770958 PECOS PAC ID: 9133395403 Enrollment ID: I20161109000982 |
| Provider Name | Daniel Su |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235442534 PECOS PAC ID: 1052548013 Enrollment ID: I20161219002099 |
| Provider Name | Guiqing Huang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710364856 PECOS PAC ID: 3971884040 Enrollment ID: I20170103001761 |
| Provider Name | Cynthia N Carbin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376609008 PECOS PAC ID: 8527159110 Enrollment ID: I20170327002433 |
| Provider Name | Anna Khananian |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1982137287 PECOS PAC ID: 6800167388 Enrollment ID: I20170801003139 |
| Provider Name | Neal K Kaushal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447542238 PECOS PAC ID: 0547534679 Enrollment ID: I20170927003861 |
| Provider Name | Michael Richard Portillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306235957 PECOS PAC ID: 4981961265 Enrollment ID: I20171121001297 |
| Provider Name | Megan Mary Greenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740623420 PECOS PAC ID: 6800167990 Enrollment ID: I20171130000816 |
| Provider Name | Andy T Suess |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699110429 PECOS PAC ID: 2062652241 Enrollment ID: I20171222000677 |
| Provider Name | Jennifer B Hamblin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629457403 PECOS PAC ID: 2365748639 Enrollment ID: I20180710002176 |
| Provider Name | Carlos Alvarez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982679239 PECOS PAC ID: 5193799161 Enrollment ID: I20180808002455 |
| Provider Name | Erica M Vega |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316367469 PECOS PAC ID: 1153672126 Enrollment ID: I20181002000757 |
| Provider Name | Jacob L Wester |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1447693973 PECOS PAC ID: 2062764962 Enrollment ID: I20181003003042 |
| Provider Name | Cicely Chen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043625916 PECOS PAC ID: 3375897077 Enrollment ID: I20181115002381 |
| Provider Name | Robert Baker Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437145380 PECOS PAC ID: 4688827868 Enrollment ID: I20181128000693 |
| Provider Name | Jeffrey John Henefeld |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972768489 PECOS PAC ID: 9335424068 Enrollment ID: I20190206001506 |
| Provider Name | Sheila K Ponzio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992742381 PECOS PAC ID: 7719145473 Enrollment ID: I20190227001774 |
| Provider Name | David F Bohannon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881072643 PECOS PAC ID: 7012248693 Enrollment ID: I20191011002334 |
| Provider Name | Anne L Palumbo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396731709 PECOS PAC ID: 3870536600 Enrollment ID: I20191219002052 |
| Provider Name | Jocelyn Moll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285090902 PECOS PAC ID: 8729382742 Enrollment ID: I20200108000289 |
| Provider Name | Nick H Gabriel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952351777 PECOS PAC ID: 0648248658 Enrollment ID: I20200109001910 |
| Provider Name | Sanya M Wadhwa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003234501 PECOS PAC ID: 5092088369 Enrollment ID: I20200630002375 |
| Provider Name | Yewande Adeshina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346334596 PECOS PAC ID: 4880696582 Enrollment ID: I20200805001425 |
| Provider Name | Alexa L Calfee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508108978 PECOS PAC ID: 4284052887 Enrollment ID: I20200914002779 |
| Provider Name | Joette L Lucco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780785923 PECOS PAC ID: 6406122472 Enrollment ID: I20210122001499 |
| Provider Name | Matthew Narron |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881831659 PECOS PAC ID: 6507271921 Enrollment ID: I20210217002042 |
| Provider Name | Tamara Ann Chambless |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952346785 PECOS PAC ID: 6204832983 Enrollment ID: I20210225001181 |
| Provider Name | Hannah Cho Hyuna Row |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1427258243 PECOS PAC ID: 9931241783 Enrollment ID: I20210225002765 |
| Provider Name | Donna Newman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841825007 PECOS PAC ID: 9335556760 Enrollment ID: I20210330002619 |
| Provider Name | Loui Abdelghani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912161787 PECOS PAC ID: 9931252616 Enrollment ID: I20210716002007 |
| Provider Name | Mandeep Singh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285949537 PECOS PAC ID: 4880837947 Enrollment ID: I20210928000243 |
| Provider Name | Ariana Abid |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1285154807 PECOS PAC ID: 9931468584 Enrollment ID: I20210929001508 |
| Provider Name | Alexander Heard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316916471 PECOS PAC ID: 1658641261 Enrollment ID: I20211027002553 |
| Provider Name | Emanuel a Shapera |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407268790 PECOS PAC ID: 2466769864 Enrollment ID: I20220224000198 |
| Provider Name | David Row |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1871797118 PECOS PAC ID: 9537212378 Enrollment ID: I20220224002207 |
| Provider Name | Barbara B Feldhaus |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326704651 PECOS PAC ID: 3375937766 Enrollment ID: I20220301001097 |
| Provider Name | Manan a Jhaveri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306285739 PECOS PAC ID: 0941590152 Enrollment ID: I20220404002528 |
| Provider Name | Rajesh Kunadharaju |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659712420 PECOS PAC ID: 7810280286 Enrollment ID: I20220622003012 |
| Provider Name | Ayush P Motwani |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1629496153 PECOS PAC ID: 0446475412 Enrollment ID: I20220708003187 |
| Provider Name | Gary Collins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245286905 PECOS PAC ID: 4789610338 Enrollment ID: I20220712001183 |
| Provider Name | Kellye Singletary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063433324 PECOS PAC ID: 5698918480 Enrollment ID: I20220812002460 |
| Provider Name | Charles Laurence Long |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1780035220 PECOS PAC ID: 6901280387 Enrollment ID: I20220902001443 |
| Provider Name | Kumar Sanam |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1295049575 PECOS PAC ID: 7214208347 Enrollment ID: I20221123001248 |
| Provider Name | Tamara Huff |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932336997 PECOS PAC ID: 9739309543 Enrollment ID: I20230424001968 |
| Provider Name | Julia M Dean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932812138 PECOS PAC ID: 4880052463 Enrollment ID: I20230614003086 |
| Provider Name | Arnaldo Vivanco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376034009 PECOS PAC ID: 2365804440 Enrollment ID: I20230822002012 |
| Provider Name | Vijaya Mukthinuthalapati |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164874855 PECOS PAC ID: 4284927559 Enrollment ID: I20230830000988 |
| Provider Name | Lindsay M Burton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679008650 PECOS PAC ID: 0648666065 Enrollment ID: I20230831002676 |
| Provider Name | Seneca Ann Storm |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1285731588 PECOS PAC ID: 2961430160 Enrollment ID: I20230913002098 |
| Provider Name | Mohammad Naeemullah Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295778215 PECOS PAC ID: 3476538760 Enrollment ID: I20230925001562 |
| Provider Name | Paula Sharon Newman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174734610 PECOS PAC ID: 7719045087 Enrollment ID: I20231018003222 |
| Provider Name | John S Golden |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780744268 PECOS PAC ID: 2567512973 Enrollment ID: I20240131000078 |
| Provider Name | Kristin B Toney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952853624 PECOS PAC ID: 4789964784 Enrollment ID: I20240229003242 |
| Provider Name | Edsel Antonio |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265790752 PECOS PAC ID: 5092022418 Enrollment ID: I20240607000249 |
| Provider Name | Eric T Hansen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154396570 PECOS PAC ID: 9133116007 Enrollment ID: I20240624003186 |
| Provider Name | Ayaz a Khan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1619438603 PECOS PAC ID: 1850625112 Enrollment ID: I20240820000355 |
| Provider Name | Donn Hohengarten |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1710024591 PECOS PAC ID: 9234661455 Enrollment ID: I20241014001183 |
| Provider Name | Carl J Hauser |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831116425 PECOS PAC ID: 8022011246 Enrollment ID: I20241014001597 |
| Provider Name | Zachary S Barlow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013584127 PECOS PAC ID: 4587065420 Enrollment ID: I20241028002599 |
| Provider Name | Geoffrey Kraemer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1922448935 PECOS PAC ID: 6406147685 Enrollment ID: I20241205001895 |
| Provider Name | Mehmet Cilingiroglu |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1710922125 PECOS PAC ID: 8022036110 Enrollment ID: I20241205003626 |
| Provider Name | Alejandro Vasquez |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164493367 PECOS PAC ID: 5092785394 Enrollment ID: I20241206002055 |
| Provider Name | Saiprasad Narsingam |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1760822175 PECOS PAC ID: 4082917844 Enrollment ID: I20241218002304 |
| Provider Name | Keren Akakpo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639627938 PECOS PAC ID: 1850748492 Enrollment ID: I20250106000517 |
| Provider Name | Brandon J Painter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417516253 PECOS PAC ID: 7113448200 Enrollment ID: I20250305002353 |
| Provider Name | Mark R Gordon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982652939 PECOS PAC ID: 1153330808 Enrollment ID: I20250716000862 |
| Provider Name | Charles Henry Black |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790988087 PECOS PAC ID: 0042497554 Enrollment ID: I20251106002947 |
| Provider Name | Charles N Boadu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861056699 PECOS PAC ID: 6800258773 Enrollment ID: I20251119001639 |
| Provider Name | Jessica R Nash |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437670544 PECOS PAC ID: 2264760842 Enrollment ID: I20260128002737 |
| Provider Name | Siddique M Chaudhary |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912382870 PECOS PAC ID: 5597067579 Enrollment ID: I20260310003738 |
M a C T Health Board, Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 940 Sylva Ln Ste A, Sonora, CA 95370 Phone: 209-588-4664 Fax: 209-674-6218 |
Sonora Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13951 Mono Way, Suite A, Sonora, CA 95370 Phone: 209-532-3370 Fax: 209-532-3340 |
Foothill Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 650 Pauline Ct, Sonora, CA 95370 Phone: 209-532-5154 Fax: 209-533-7696 |
Kathy Bosch Chiropractic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19515 Village Dr, Ste B, Sonora, CA 95370 Phone: 209-533-4330 Fax: 509-532-5374 |
Sierra Elder Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 109 E Jackson St, Sonora, CA 95370 Phone: 669-900-5721 Fax: 209-288-2461 |
William E. Zachow, D.O. Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19747 Greenley Rd, Suite S-2, Sonora, CA 95370 Phone: 602-790-4221 |