| Honorhealth Medical Group, Llc | |
|
10230 W Happy Valley Pkwy Ste 200 Peoria AZ 85383-4255 | |
| (623) 561-3030 | |
| (623) 825-5630 |
| Full Name | Honorhealth Medical Group, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10230 W Happy Valley Pkwy Ste 200, Peoria, Arizona |
| Authorized Official Name and Position | Savas Petrides (SVP/CEO) |
| Authorized Official Contact | 4806964020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Honorhealth Medical Group, Llc 2500 W Utopia Rd Ste 100 Phoenix AZ 85027-4172 Ph: (480) 587-5314 | Honorhealth Medical Group, Llc 10230 W Happy Valley Pkwy Ste 200 Peoria AZ 85383-4255 Ph: (623) 561-3030 |
| NPI Number | 1043851793 |
|---|---|
| Provider Enumeration Date | 10/03/2019 |
| Last Update Date | 09/17/2020 |
| Medicare PECOS PAC ID | 1557274057 |
|---|---|
| Medicare Enrollment ID | O20031119000717 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043851793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Priya Radhakrishnan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932290327 PECOS PAC ID: 6800700501 Enrollment ID: I20031117000836 |
| Provider Name | Jerry M Fioramonti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669465530 PECOS PAC ID: 5294639746 Enrollment ID: I20031125000696 |
| Provider Name | Christopher N Bressler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659303360 PECOS PAC ID: 5597650671 Enrollment ID: I20040218000112 |
| Provider Name | Jessica T Ellsworth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649235185 PECOS PAC ID: 7315832961 Enrollment ID: I20040220000976 |
| Provider Name | James B Vogt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740332352 PECOS PAC ID: 8921991142 Enrollment ID: I20040224000307 |
| Provider Name | Alan W Hamilton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447226675 PECOS PAC ID: 1850291691 Enrollment ID: I20040224000328 |
| Provider Name | Luis M Irizarry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487658175 PECOS PAC ID: 1456247741 Enrollment ID: I20040224000817 |
| Provider Name | John B Lees |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639239908 PECOS PAC ID: 6608764857 Enrollment ID: I20040309000419 |
| Provider Name | Michael S Roberts |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1932159357 PECOS PAC ID: 2264324227 Enrollment ID: I20040325001517 |
| Provider Name | David D Minor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356441356 PECOS PAC ID: 6406848217 Enrollment ID: I20040401000436 |
| Provider Name | Maria E Avilez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730126756 PECOS PAC ID: 7416949169 Enrollment ID: I20040401000800 |
| Provider Name | Michael G Sills |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689664658 PECOS PAC ID: 2062405558 Enrollment ID: I20040408000683 |
| Provider Name | Celeste M. Correa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114909926 PECOS PAC ID: 7810980117 Enrollment ID: I20040423001375 |
| Provider Name | Steven C Boles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114031507 PECOS PAC ID: 6002802469 Enrollment ID: I20040427000012 |
| Provider Name | Daryl P Beabeau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689663643 PECOS PAC ID: 6103816152 Enrollment ID: I20040513000373 |
| Provider Name | Howard B Fleishon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407845464 PECOS PAC ID: 2062401615 Enrollment ID: I20040513001290 |
| Provider Name | Phillip M Moeser |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013906072 PECOS PAC ID: 7012907801 Enrollment ID: I20040513001398 |
| Provider Name | Phillip V Pileggi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023046430 PECOS PAC ID: 5597756494 Enrollment ID: I20040520000011 |
| Provider Name | Lee M Ugol |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861498578 PECOS PAC ID: 6406830801 Enrollment ID: I20040615000101 |
| Provider Name | Jennifer Burke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902833601 PECOS PAC ID: 8527044163 Enrollment ID: I20040625000130 |
| Provider Name | Marla E Sample-ormes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972707255 PECOS PAC ID: 9234112921 Enrollment ID: I20040709000805 |
| Provider Name | John V Woellner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043202013 PECOS PAC ID: 0345229233 Enrollment ID: I20040715000012 |
| Provider Name | Brent W Walters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891855425 PECOS PAC ID: 2769468743 Enrollment ID: I20040803000558 |
| Provider Name | Madonna C Mallari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164402285 PECOS PAC ID: 8022084086 Enrollment ID: I20040909001284 |
| Provider Name | Meggan Bauer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003873639 PECOS PAC ID: 6608842661 Enrollment ID: I20040909001331 |
| Provider Name | Peter Fred Levins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407876303 PECOS PAC ID: 4385603380 Enrollment ID: I20041006000220 |
| Provider Name | Alan H Mallace |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1659341667 PECOS PAC ID: 4284694084 Enrollment ID: I20041015000632 |
| Provider Name | Anette G Gawelko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922048198 PECOS PAC ID: 0749240372 Enrollment ID: I20041018000567 |
| Provider Name | Steven B Wolpert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932165032 PECOS PAC ID: 0345201414 Enrollment ID: I20041021000866 |
| Provider Name | Gregory A Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730168204 PECOS PAC ID: 6204897259 Enrollment ID: I20041022000448 |
| Provider Name | Ira H Ungar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992765606 PECOS PAC ID: 0042275695 Enrollment ID: I20041123000811 |
| Provider Name | Melanie Patton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063405090 PECOS PAC ID: 0244295525 Enrollment ID: I20041129000469 |
| Provider Name | Claire Bowey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730143983 PECOS PAC ID: 8224094057 Enrollment ID: I20041203000413 |
| Provider Name | Shilpa Gujrathi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528056967 PECOS PAC ID: 1153388566 Enrollment ID: I20041217000158 |
| Provider Name | Alberto M Guerrero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427066570 PECOS PAC ID: 2163470568 Enrollment ID: I20050113000230 |
| Provider Name | Constantia A Abarikwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497832620 PECOS PAC ID: 0446209647 Enrollment ID: I20050114000157 |
| Provider Name | Mufid Khoury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396893335 PECOS PAC ID: 6901855055 Enrollment ID: I20050117000153 |
| Provider Name | Shannan M Murphy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083688253 PECOS PAC ID: 0648267955 Enrollment ID: I20050117000273 |
| Provider Name | Vicky H Chen-yang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033159207 PECOS PAC ID: 7113976192 Enrollment ID: I20050117000485 |
| Provider Name | Shital K Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609850676 PECOS PAC ID: 7618928235 Enrollment ID: I20050201000574 |
| Provider Name | Cary C Bucko |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881783603 PECOS PAC ID: 0749271666 Enrollment ID: I20050302000603 |
| Provider Name | Thomas E Sutton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225031982 PECOS PAC ID: 3375598386 Enrollment ID: I20050312000056 |
| Provider Name | Jack N Poles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962484949 PECOS PAC ID: 4385685825 Enrollment ID: I20050516000437 |
| Provider Name | Gerald F Schwartzberg |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104914472 PECOS PAC ID: 6406898725 Enrollment ID: I20050526000642 |
| Provider Name | Kim R Olson Gibbs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225010986 PECOS PAC ID: 6901849793 Enrollment ID: I20050602000681 |
| Provider Name | Kristin J Shealey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932191897 PECOS PAC ID: 4981631322 Enrollment ID: I20050718000863 |
| Provider Name | Denise A Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578549408 PECOS PAC ID: 3870524002 Enrollment ID: I20050826000420 |
| Provider Name | Diane M Shuck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861477697 PECOS PAC ID: 9537191283 Enrollment ID: I20050902000302 |
| Provider Name | Hedieh Saghari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134312044 PECOS PAC ID: 6800820358 Enrollment ID: I20050923000201 |
| Provider Name | Haihong H Zhao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447227657 PECOS PAC ID: 1951327808 Enrollment ID: I20051019001091 |
| Provider Name | Mark D Whitaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578572384 PECOS PAC ID: 8527085190 Enrollment ID: I20051102000353 |
| Provider Name | William L Redenius |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154396455 PECOS PAC ID: 5092733212 Enrollment ID: I20051107000484 |
| Provider Name | Robert C Milam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699734160 PECOS PAC ID: 1850319930 Enrollment ID: I20051107001132 |
| Provider Name | Robert Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821049800 PECOS PAC ID: 0446278451 Enrollment ID: I20051108001058 |
| Provider Name | Gary A Rada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992793335 PECOS PAC ID: 0648298463 Enrollment ID: I20051109001027 |
| Provider Name | Michael S Gordon |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1114929114 PECOS PAC ID: 2264451244 Enrollment ID: I20051118000510 |
| Provider Name | Vimala M Kukunoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063477495 PECOS PAC ID: 9638082795 Enrollment ID: I20051121000474 |
| Provider Name | Tiffany C Pankow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164468633 PECOS PAC ID: 2860411733 Enrollment ID: I20051121000504 |
| Provider Name | Nimisha D Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215928254 PECOS PAC ID: 8426077397 Enrollment ID: I20051121000560 |
| Provider Name | Steven Lugo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356451934 PECOS PAC ID: 7911927538 Enrollment ID: I20051129000041 |
| Provider Name | Alvin I Bogart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891726444 PECOS PAC ID: 2567482128 Enrollment ID: I20051129000424 |
| Provider Name | Gregory A Bode |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831138239 PECOS PAC ID: 7113940685 Enrollment ID: I20060111000008 |
| Provider Name | Eileen M Gebhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306820642 PECOS PAC ID: 0244289494 Enrollment ID: I20060206000132 |
| Provider Name | Kim L Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609813922 PECOS PAC ID: 8325053309 Enrollment ID: I20060310000496 |
| Provider Name | Ethiopia Gebeyehu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609845908 PECOS PAC ID: 7012928195 Enrollment ID: I20060606000277 |
| Provider Name | Emily A Winett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063444552 PECOS PAC ID: 4486658390 Enrollment ID: I20060907000498 |
| Provider Name | Adam J Balzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386611507 PECOS PAC ID: 9436156569 Enrollment ID: I20061101000523 |
| Provider Name | Heather Kay Otoole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992797880 PECOS PAC ID: 1456359058 Enrollment ID: I20061114000591 |
| Provider Name | Linda N Greer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346297991 PECOS PAC ID: 3577665744 Enrollment ID: I20070220000141 |
| Provider Name | Craig M Peters |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023167384 PECOS PAC ID: 0446357206 Enrollment ID: I20070514000317 |
| Provider Name | Joshua A Millstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376749721 PECOS PAC ID: 5092816652 Enrollment ID: I20070726000170 |
| Provider Name | Tammie S Naranjo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871549519 PECOS PAC ID: 4082706510 Enrollment ID: I20070828000775 |
| Provider Name | Bradley T Lawrence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184694663 PECOS PAC ID: 4981796455 Enrollment ID: I20070829000035 |
| Provider Name | Smita Kapoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477749687 PECOS PAC ID: 3173611134 Enrollment ID: I20071109000035 |
| Provider Name | Barbara A Backer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134171374 PECOS PAC ID: 8224060728 Enrollment ID: I20071218000143 |
| Provider Name | Daniel B Schlosser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518953611 PECOS PAC ID: 7517057896 Enrollment ID: I20071227000087 |
| Provider Name | Harry S Tamm |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295714079 PECOS PAC ID: 8527098326 Enrollment ID: I20080306000024 |
| Provider Name | Lori H Travis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093794885 PECOS PAC ID: 7012092778 Enrollment ID: I20080306000033 |
| Provider Name | Justin W Wight |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467641811 PECOS PAC ID: 4880763796 Enrollment ID: I20080519000519 |
| Provider Name | Therese J Sargent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851393433 PECOS PAC ID: 0547330409 Enrollment ID: I20080606000284 |
| Provider Name | Matthew R Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336119973 PECOS PAC ID: 7315019155 Enrollment ID: I20080710000494 |
| Provider Name | Paul W Sieckmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841280856 PECOS PAC ID: 5395818991 Enrollment ID: I20080715000574 |
| Provider Name | Amber R Hennenhoefer |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1831274828 PECOS PAC ID: 9537232103 Enrollment ID: I20080716000286 |
| Provider Name | Ritu Sadhu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679604524 PECOS PAC ID: 6103910609 Enrollment ID: I20080724000427 |
| Provider Name | Stacy E Gustin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265618136 PECOS PAC ID: 8426125857 Enrollment ID: I20080925000707 |
| Provider Name | Tracey C Hedberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376790360 PECOS PAC ID: 6406924612 Enrollment ID: I20081001000181 |
| Provider Name | Sarah J Snell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831189315 PECOS PAC ID: 8820166069 Enrollment ID: I20081001000451 |
| Provider Name | Steven D Salas |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235135278 PECOS PAC ID: 7618045691 Enrollment ID: I20081003000291 |
| Provider Name | Elizabeth R Shapiro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528232378 PECOS PAC ID: 8628136538 Enrollment ID: I20081022000140 |
| Provider Name | Darlene E Moyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912181751 PECOS PAC ID: 3173682101 Enrollment ID: I20081106000119 |
| Provider Name | Ian H Rothwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316040611 PECOS PAC ID: 0446313811 Enrollment ID: I20090112000115 |
| Provider Name | Richard C Silver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811999121 PECOS PAC ID: 1153234661 Enrollment ID: I20090313000057 |
| Provider Name | Michele A Sazama |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316100696 PECOS PAC ID: 9234286014 Enrollment ID: I20090414000247 |
| Provider Name | Daniel J Deusterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447437942 PECOS PAC ID: 2769539402 Enrollment ID: I20090415000092 |
| Provider Name | Rajesh N Soni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235147380 PECOS PAC ID: 9133298029 Enrollment ID: I20090611000474 |
| Provider Name | Andrea L Darby-stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750364980 PECOS PAC ID: 0446301261 Enrollment ID: I20090707000510 |
| Provider Name | Jared J Berkowitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386865780 PECOS PAC ID: 0042362410 Enrollment ID: I20090715000590 |
| Provider Name | Christopher W Park |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700863198 PECOS PAC ID: 3971670993 Enrollment ID: I20090724000229 |
| Provider Name | Richard H Rutkowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588667042 PECOS PAC ID: 1658424171 Enrollment ID: I20090731000266 |
| Provider Name | Jose R Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437127313 PECOS PAC ID: 5294889283 Enrollment ID: I20090810000428 |
| Provider Name | Stanley E Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043250756 PECOS PAC ID: 3971657917 Enrollment ID: I20090811000186 |
| Provider Name | Michael C Nussdorfer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740250323 PECOS PAC ID: 0446205074 Enrollment ID: I20090813000079 |
| Provider Name | Elizabeth M Oconnor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164601274 PECOS PAC ID: 1254485477 Enrollment ID: I20090821000247 |
| Provider Name | Purna Chettri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487815221 PECOS PAC ID: 4688729692 Enrollment ID: I20090827000069 |
| Provider Name | Patrick J Roscetti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295911030 PECOS PAC ID: 4688710783 Enrollment ID: I20091002000461 |
| Provider Name | Ruth J Bland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073743936 PECOS PAC ID: 3072650472 Enrollment ID: I20091016000075 |
| Provider Name | Trupti K Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598784274 PECOS PAC ID: 1456356773 Enrollment ID: I20091103000221 |
| Provider Name | Jose Ivan A Rago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477714137 PECOS PAC ID: 0244379774 Enrollment ID: I20091123000418 |
| Provider Name | Patrick M Knowles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053313452 PECOS PAC ID: 3476650193 Enrollment ID: I20091123000720 |
| Provider Name | Alvin G Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033105143 PECOS PAC ID: 8426042276 Enrollment ID: I20091208000711 |
| Provider Name | Michael B Alpern |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124071584 PECOS PAC ID: 9032174925 Enrollment ID: I20091210000212 |
| Provider Name | Susan S Eller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558699595 PECOS PAC ID: 4587705165 Enrollment ID: I20100105000010 |
| Provider Name | Richard A Wall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811971393 PECOS PAC ID: 9638211329 Enrollment ID: I20100119000165 |
| Provider Name | Wendell B Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598757114 PECOS PAC ID: 4486798287 Enrollment ID: I20100217000398 |
| Provider Name | Alfredo L Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225002371 PECOS PAC ID: 6709920465 Enrollment ID: I20100218000236 |
| Provider Name | Jacqueline I Doris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922090992 PECOS PAC ID: 5496899155 Enrollment ID: I20100218000277 |
| Provider Name | Dana M Paull |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114909751 PECOS PAC ID: 3375520034 Enrollment ID: I20100223000208 |
| Provider Name | Therese G Argyros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033210653 PECOS PAC ID: 8325183213 Enrollment ID: I20100303000481 |
| Provider Name | Jerome E Rubbelke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164415113 PECOS PAC ID: 4587709472 Enrollment ID: I20100303000496 |
| Provider Name | Veronica J Lindo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366469280 PECOS PAC ID: 2365587045 Enrollment ID: I20100305000262 |
| Provider Name | Paul Kelley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548210602 PECOS PAC ID: 2163559238 Enrollment ID: I20100421000410 |
| Provider Name | Bradley Monk |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487734646 PECOS PAC ID: 9537203393 Enrollment ID: I20100617000888 |
| Provider Name | Karl H. Espinosa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689650707 PECOS PAC ID: 8123158128 Enrollment ID: I20100618000268 |
| Provider Name | Prineet K Tung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285849372 PECOS PAC ID: 6507998358 Enrollment ID: I20100714001017 |
| Provider Name | James J Dearing |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528065422 PECOS PAC ID: 1052445004 Enrollment ID: I20100812001166 |
| Provider Name | John A Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487851358 PECOS PAC ID: 9436273679 Enrollment ID: I20100825000582 |
| Provider Name | Dee A Allred |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902082746 PECOS PAC ID: 5597889741 Enrollment ID: I20100825000624 |
| Provider Name | Anuneet K Haas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215960653 PECOS PAC ID: 1557367612 Enrollment ID: I20100910001003 |
| Provider Name | Javier A Zayas-bazan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568647162 PECOS PAC ID: 5193892727 Enrollment ID: I20101005000269 |
| Provider Name | Abby C Roberts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104008275 PECOS PAC ID: 6800088717 Enrollment ID: I20101011001007 |
| Provider Name | Narendra A Godbole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396745956 PECOS PAC ID: 7416147368 Enrollment ID: I20101011001154 |
| Provider Name | Jonathon Y Markovitz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811977242 PECOS PAC ID: 5890988455 Enrollment ID: I20101015000466 |
| Provider Name | Edward P Aranas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285831156 PECOS PAC ID: 5890989453 Enrollment ID: I20101028000421 |
| Provider Name | Kent M Hatfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811938152 PECOS PAC ID: 2860473790 Enrollment ID: I20101029000403 |
| Provider Name | Cynthia L Kegowicz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063415529 PECOS PAC ID: 9032304860 Enrollment ID: I20101105001263 |
| Provider Name | Linda M Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558543678 PECOS PAC ID: 7517153422 Enrollment ID: I20101117001570 |
| Provider Name | Kenneth I Klein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154304327 PECOS PAC ID: 3779770730 Enrollment ID: I20101203000378 |
| Provider Name | Jeffrey Dale Leitner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740466549 PECOS PAC ID: 0749477636 Enrollment ID: I20101203000943 |
| Provider Name | Dawn V Bigham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154488336 PECOS PAC ID: 9537357363 Enrollment ID: I20101221000766 |
| Provider Name | Debora A Villa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801850623 PECOS PAC ID: 5991697286 Enrollment ID: I20110106001224 |
| Provider Name | Richard A Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700863701 PECOS PAC ID: 2961691324 Enrollment ID: I20110117000051 |
| Provider Name | Sheetal Gosalia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528244365 PECOS PAC ID: 0648459727 Enrollment ID: I20110120001191 |
| Provider Name | Frank Edward Cibulka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760472351 PECOS PAC ID: 1456245513 Enrollment ID: I20110209000993 |
| Provider Name | Claire Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184927998 PECOS PAC ID: 8628250073 Enrollment ID: I20110307001004 |
| Provider Name | Andres M Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083667810 PECOS PAC ID: 8921108564 Enrollment ID: I20110322001025 |
| Provider Name | Cathryn Echeverria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386967453 PECOS PAC ID: 8224213640 Enrollment ID: I20110429000171 |
| Provider Name | Patrick L Pine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922184712 PECOS PAC ID: 4082890280 Enrollment ID: I20110524000838 |
| Provider Name | Annette L Caruso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356632285 PECOS PAC ID: 5496769119 Enrollment ID: I20110525000416 |
| Provider Name | Romina Lo Montano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306165485 PECOS PAC ID: 9032396932 Enrollment ID: I20110601000700 |
| Provider Name | Christopher L Finlay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538176912 PECOS PAC ID: 2961497748 Enrollment ID: I20110608000040 |
| Provider Name | Dana Meredith Chase |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1396888947 PECOS PAC ID: 1557429867 Enrollment ID: I20110707000535 |
| Provider Name | Paras Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720252844 PECOS PAC ID: 1355519000 Enrollment ID: I20110722000564 |
| Provider Name | Paramvir S Sidhu |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1124220116 PECOS PAC ID: 1658431374 Enrollment ID: I20110726000656 |
| Provider Name | Rhianna M Meadows |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194988311 PECOS PAC ID: 4486840097 Enrollment ID: I20110805000227 |
| Provider Name | Valerie I Bustos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659598258 PECOS PAC ID: 3476619842 Enrollment ID: I20111101000788 |
| Provider Name | Harvinder S Deogun |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1558568501 PECOS PAC ID: 6305019548 Enrollment ID: I20111102000934 |
| Provider Name | Tamara Djurisic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740213503 PECOS PAC ID: 3072598234 Enrollment ID: I20111116000331 |
| Provider Name | Dana Wasserman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013093582 PECOS PAC ID: 4082888060 Enrollment ID: I20111201000515 |
| Provider Name | Jody L Pelusi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053352450 PECOS PAC ID: 8527235993 Enrollment ID: I20120125000961 |
| Provider Name | Simrat Kaur |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1568452357 PECOS PAC ID: 1759348576 Enrollment ID: I20120203000701 |
| Provider Name | Patrick A Tafoya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265696702 PECOS PAC ID: 7012175011 Enrollment ID: I20120222000480 |
| Provider Name | Christopher Bonati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407016884 PECOS PAC ID: 2860652252 Enrollment ID: I20120321000826 |
| Provider Name | Hetal Trivedi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467725945 PECOS PAC ID: 0547420580 Enrollment ID: I20120328000521 |
| Provider Name | Todd V Lincoln |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487742268 PECOS PAC ID: 5890771315 Enrollment ID: I20120514000716 |
| Provider Name | Francisco Pena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992855381 PECOS PAC ID: 7517854334 Enrollment ID: I20120622000360 |
| Provider Name | James Murphy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790801355 PECOS PAC ID: 0345406864 Enrollment ID: I20120726000565 |
| Provider Name | Nevedita S Saraswat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336233899 PECOS PAC ID: 0648277624 Enrollment ID: I20120917000080 |
| Provider Name | Alethea Y Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891929733 PECOS PAC ID: 0143470534 Enrollment ID: I20121019000535 |
| Provider Name | Lori Ann Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255397220 PECOS PAC ID: 3678501681 Enrollment ID: I20121108000677 |
| Provider Name | Jennifer A Lembas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073862132 PECOS PAC ID: 5193976058 Enrollment ID: I20121127000448 |
| Provider Name | Andrea W Patton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831326990 PECOS PAC ID: 7113179409 Enrollment ID: I20121213000168 |
| Provider Name | Louis H Hagler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740509181 PECOS PAC ID: 1153573100 Enrollment ID: I20121220000356 |
| Provider Name | Sarah Z Sonchik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306190459 PECOS PAC ID: 1759534043 Enrollment ID: I20130117000435 |
| Provider Name | Heather M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891044202 PECOS PAC ID: 0446403547 Enrollment ID: I20130122000553 |
| Provider Name | Corina J Veatch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255592697 PECOS PAC ID: 7810140902 Enrollment ID: I20130124000272 |
| Provider Name | Hong Li |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548537608 PECOS PAC ID: 7810141983 Enrollment ID: I20130128000131 |
| Provider Name | Carrie M Mattie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134465008 PECOS PAC ID: 0749435840 Enrollment ID: I20130221000017 |
| Provider Name | Nancy Brewer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275885030 PECOS PAC ID: 8628213634 Enrollment ID: I20130322000149 |
| Provider Name | Jaclyn N Bacon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265716344 PECOS PAC ID: 0840436986 Enrollment ID: I20130416000701 |
| Provider Name | Stephanie Piercy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841555802 PECOS PAC ID: 0446498737 Enrollment ID: I20130528000400 |
| Provider Name | Harpreet K Sandhu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215135462 PECOS PAC ID: 3173772449 Enrollment ID: I20130529000693 |
| Provider Name | Nicole M Thrift |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518194521 PECOS PAC ID: 5395984819 Enrollment ID: I20130613000307 |
| Provider Name | Jimmy Youssef Saade |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407065667 PECOS PAC ID: 9335210517 Enrollment ID: I20130617000613 |
| Provider Name | Nancy Youssef |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487833752 PECOS PAC ID: 2264672286 Enrollment ID: I20130715000521 |
| Provider Name | Kimberly Brandstetter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205134350 PECOS PAC ID: 6002057932 Enrollment ID: I20130718000590 |
| Provider Name | Nathan W Matthews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720307176 PECOS PAC ID: 2365683760 Enrollment ID: I20130727000271 |
| Provider Name | Jamie L Beckman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831418268 PECOS PAC ID: 6901047307 Enrollment ID: I20130727000276 |
| Provider Name | Jeannine L Hinds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699091694 PECOS PAC ID: 3678711868 Enrollment ID: I20130806000847 |
| Provider Name | Pedro R Choca |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154499853 PECOS PAC ID: 5698919819 Enrollment ID: I20130910000171 |
| Provider Name | Frank Y Tsai |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1518134691 PECOS PAC ID: 7214001395 Enrollment ID: I20130910000220 |
| Provider Name | Arthur Rothstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477803393 PECOS PAC ID: 2062656101 Enrollment ID: I20130911000760 |
| Provider Name | Carla M Scalmato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598107658 PECOS PAC ID: 0042454647 Enrollment ID: I20130923000092 |
| Provider Name | Mila Easapour Cheshani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871861617 PECOS PAC ID: 0547404022 Enrollment ID: I20130924000263 |
| Provider Name | Rachel C Deatherage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295055580 PECOS PAC ID: 8628202082 Enrollment ID: I20131018000373 |
| Provider Name | Shalini Singh-karnik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598994717 PECOS PAC ID: 2062647399 Enrollment ID: I20131022002360 |
| Provider Name | Debra J Motrych |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679911028 PECOS PAC ID: 0446486526 Enrollment ID: I20131119001782 |
| Provider Name | Shaun E Dekutoski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871548719 PECOS PAC ID: 1456489681 Enrollment ID: I20131209000602 |
| Provider Name | Kristen L Thomsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841216884 PECOS PAC ID: 0446224836 Enrollment ID: I20131226000126 |
| Provider Name | Heidi E Symons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083035430 PECOS PAC ID: 8224268313 Enrollment ID: I20140312000815 |
| Provider Name | Farshad Fani Marvasti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073846762 PECOS PAC ID: 5890989867 Enrollment ID: I20140312001129 |
| Provider Name | Kellie Ann Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619314523 PECOS PAC ID: 0345471033 Enrollment ID: I20140321001055 |
| Provider Name | Donna J Callicutt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356753008 PECOS PAC ID: 2264656875 Enrollment ID: I20140620000553 |
| Provider Name | Sara S Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225458425 PECOS PAC ID: 8325264443 Enrollment ID: I20140725002348 |
| Provider Name | Lisa K Dela Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326471640 PECOS PAC ID: 2466688163 Enrollment ID: I20140806001270 |
| Provider Name | Amanda R Mihalik |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1639499767 PECOS PAC ID: 1557580321 Enrollment ID: I20140910001879 |
| Provider Name | Lokeswari Bucchireddigari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538575253 PECOS PAC ID: 1355561291 Enrollment ID: I20140929000203 |
| Provider Name | John P Deuel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164461729 PECOS PAC ID: 9830195650 Enrollment ID: I20141007000034 |
| Provider Name | Robert M Taxin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033145271 PECOS PAC ID: 8527197219 Enrollment ID: I20141008000915 |
| Provider Name | Theodore John Prier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780889261 PECOS PAC ID: 3971658071 Enrollment ID: I20141106002234 |
| Provider Name | Nicholas Kucinski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477817450 PECOS PAC ID: 6305068099 Enrollment ID: I20141113000505 |
| Provider Name | Stephanie Ressler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285041509 PECOS PAC ID: 8224350632 Enrollment ID: I20141212001759 |
| Provider Name | Kylie A Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386071611 PECOS PAC ID: 4385967207 Enrollment ID: I20141230001216 |
| Provider Name | Elizabeth E Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952694036 PECOS PAC ID: 1153645965 Enrollment ID: I20150128000006 |
| Provider Name | Larisa Lopatko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710377148 PECOS PAC ID: 6103142567 Enrollment ID: I20150302000625 |
| Provider Name | David E Nagata |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750371324 PECOS PAC ID: 3476549585 Enrollment ID: I20150730012870 |
| Provider Name | Harold A Couch |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1356723068 PECOS PAC ID: 0840504833 Enrollment ID: I20150804005920 |
| Provider Name | Robert Winter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255691226 PECOS PAC ID: 0042525776 Enrollment ID: I20150810002967 |
| Provider Name | Harry H Yu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437160389 PECOS PAC ID: 5799723367 Enrollment ID: I20150826000641 |
| Provider Name | Lisa N Burgin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679949846 PECOS PAC ID: 8820304017 Enrollment ID: I20150902002570 |
| Provider Name | Tia Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841675576 PECOS PAC ID: 9436465382 Enrollment ID: I20150908003135 |
| Provider Name | Christina Celestino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518347285 PECOS PAC ID: 9739496167 Enrollment ID: I20150917002348 |
| Provider Name | Kylee A Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669854147 PECOS PAC ID: 4688981913 Enrollment ID: I20150917002605 |
| Provider Name | Jacqueline Kasnot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871975482 PECOS PAC ID: 9032427000 Enrollment ID: I20150924003346 |
| Provider Name | Jenny Ho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427315506 PECOS PAC ID: 8022327121 Enrollment ID: I20151012000590 |
| Provider Name | Preet Mangat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417211632 PECOS PAC ID: 0042529885 Enrollment ID: I20151019001715 |
| Provider Name | Elise R Donnelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568757847 PECOS PAC ID: 4981913720 Enrollment ID: I20151019002012 |
| Provider Name | Kelly Isbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326485335 PECOS PAC ID: 6709195209 Enrollment ID: I20151023001633 |
| Provider Name | Sarahjeet Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518221506 PECOS PAC ID: 3678882875 Enrollment ID: I20151028001715 |
| Provider Name | Joby S Mathews |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174715726 PECOS PAC ID: 3476607912 Enrollment ID: I20151028002839 |
| Provider Name | Ruth Ayala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790155745 PECOS PAC ID: 9335449578 Enrollment ID: I20151119002900 |
| Provider Name | Jacqueline L Stockton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760860571 PECOS PAC ID: 6305146390 Enrollment ID: I20151123002948 |
| Provider Name | Erin Elizabeth Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447622782 PECOS PAC ID: 7810297306 Enrollment ID: I20151207001130 |
| Provider Name | Christopher Braley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053370601 PECOS PAC ID: 1052344785 Enrollment ID: I20151221000528 |
| Provider Name | Amelia R Adames-zamora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306210364 PECOS PAC ID: 1951603695 Enrollment ID: I20160112001750 |
| Provider Name | Jennifer Vanyo-novak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962665497 PECOS PAC ID: 8729252747 Enrollment ID: I20160118000483 |
| Provider Name | Raj P Terkonda |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1639176803 PECOS PAC ID: 5991829210 Enrollment ID: I20160229000813 |
| Provider Name | Stephanie L Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861462509 PECOS PAC ID: 8729068184 Enrollment ID: I20160317001606 |
| Provider Name | Jessica M Berdeja |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1215190749 PECOS PAC ID: 6901077031 Enrollment ID: I20160414000781 |
| Provider Name | Kassondra Suzanne Grzankowski |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1316109648 PECOS PAC ID: 7810287208 Enrollment ID: I20160525002943 |
| Provider Name | Irma G Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992181820 PECOS PAC ID: 1153377213 Enrollment ID: I20160609000355 |
| Provider Name | Jean L Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740542711 PECOS PAC ID: 0941591853 Enrollment ID: I20160624000035 |
| Provider Name | Christa Mcenerney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831536788 PECOS PAC ID: 9931322039 Enrollment ID: I20160627002605 |
| Provider Name | David H Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316172356 PECOS PAC ID: 2062638851 Enrollment ID: I20160719001462 |
| Provider Name | Nicole A Konkowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104263292 PECOS PAC ID: 6709179039 Enrollment ID: I20160725002595 |
| Provider Name | Andrea Horning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821478942 PECOS PAC ID: 4688989361 Enrollment ID: I20160726002187 |
| Provider Name | Rustan H Sharer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275979064 PECOS PAC ID: 3678866415 Enrollment ID: I20160801001749 |
| Provider Name | Shailesh Chandramohan Garg |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962630269 PECOS PAC ID: 9335432129 Enrollment ID: I20160802000302 |
| Provider Name | Sarah Wong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164873907 PECOS PAC ID: 5395039416 Enrollment ID: I20160811001304 |
| Provider Name | Mckenzie L Siemion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720438682 PECOS PAC ID: 7810282308 Enrollment ID: I20160823001572 |
| Provider Name | Daren Barker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194957902 PECOS PAC ID: 1658527643 Enrollment ID: I20160826002486 |
| Provider Name | Veronica K Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366736761 PECOS PAC ID: 2264728054 Enrollment ID: I20160902000728 |
| Provider Name | Yarden Tahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669819819 PECOS PAC ID: 0840586632 Enrollment ID: I20160902000901 |
| Provider Name | Simi K Dhillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023459583 PECOS PAC ID: 5395961924 Enrollment ID: I20160920001982 |
| Provider Name | Dmitry Bisk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083059323 PECOS PAC ID: 4284951864 Enrollment ID: I20160928001569 |
| Provider Name | Adam C Draper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346685682 PECOS PAC ID: 3072839174 Enrollment ID: I20161014000751 |
| Provider Name | Jamael T Delgado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467615971 PECOS PAC ID: 0244401545 Enrollment ID: I20161019001595 |
| Provider Name | Jacqueline Bohanske |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922151992 PECOS PAC ID: 3375831647 Enrollment ID: I20161019002611 |
| Provider Name | Melissa I Sheridan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659310530 PECOS PAC ID: 0345528485 Enrollment ID: I20161025001840 |
| Provider Name | Michael Talkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790723997 PECOS PAC ID: 5193781599 Enrollment ID: I20161109000868 |
| Provider Name | Francesca M Baile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770034597 PECOS PAC ID: 1658650460 Enrollment ID: I20161118001783 |
| Provider Name | Pamela J Haire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366993685 PECOS PAC ID: 5799064382 Enrollment ID: I20161123000629 |
| Provider Name | Jacqueline M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922400811 PECOS PAC ID: 3577885573 Enrollment ID: I20161128001227 |
| Provider Name | Donna M Simon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1962954610 PECOS PAC ID: 0345520664 Enrollment ID: I20161202001337 |
| Provider Name | Jessica R Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639513047 PECOS PAC ID: 4183904881 Enrollment ID: I20161215002324 |
| Provider Name | Eric R Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730591249 PECOS PAC ID: 4688990450 Enrollment ID: I20161216001454 |
| Provider Name | Victoria Cupic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669421038 PECOS PAC ID: 0941212765 Enrollment ID: I20170411000590 |
| Provider Name | Nicolette R Hawthorne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902341431 PECOS PAC ID: 7618245010 Enrollment ID: I20170607001256 |
| Provider Name | Foluso N Ogunleye |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1972766772 PECOS PAC ID: 0446325559 Enrollment ID: I20170810001201 |
| Provider Name | Michael N Luong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124439856 PECOS PAC ID: 4789960956 Enrollment ID: I20170926001891 |
| Provider Name | Lindsay J Baltzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932588944 PECOS PAC ID: 3870863475 Enrollment ID: I20170929001161 |
| Provider Name | Bridgette S Harp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881138840 PECOS PAC ID: 0547535577 Enrollment ID: I20171002001304 |
| Provider Name | Elena Y Kaitschuck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326589466 PECOS PAC ID: 2769757269 Enrollment ID: I20171010001158 |
| Provider Name | Chelsea Joy Thomsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003227927 PECOS PAC ID: 7810116662 Enrollment ID: I20171024000250 |
| Provider Name | Amanda M Marvin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215342852 PECOS PAC ID: 3678795499 Enrollment ID: I20171110001468 |
| Provider Name | Aneri S Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053677674 PECOS PAC ID: 6406162890 Enrollment ID: I20171208002752 |
| Provider Name | Lauren A Bisswurm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043720766 PECOS PAC ID: 7618236431 Enrollment ID: I20180123002947 |
| Provider Name | Erica L Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558898650 PECOS PAC ID: 4688936313 Enrollment ID: I20180316001801 |
| Provider Name | Ashley R Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356707509 PECOS PAC ID: 3678837796 Enrollment ID: I20180425002597 |
| Provider Name | Jai S Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407892268 PECOS PAC ID: 2163495953 Enrollment ID: I20180515001767 |
| Provider Name | Aaron C Barrett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558748921 PECOS PAC ID: 2668720780 Enrollment ID: I20180807001274 |
| Provider Name | Janelle E Donaldson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679955058 PECOS PAC ID: 6204185226 Enrollment ID: I20180823001669 |
| Provider Name | Melissa D Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801380662 PECOS PAC ID: 0143570879 Enrollment ID: I20180830001034 |
| Provider Name | Matthew S Zweig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003298480 PECOS PAC ID: 9931459559 Enrollment ID: I20180831001521 |
| Provider Name | Brett W Warden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962883827 PECOS PAC ID: 3173831815 Enrollment ID: I20180928001573 |
| Provider Name | Christopher Samuel Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235519562 PECOS PAC ID: 4284904889 Enrollment ID: I20180928002156 |
| Provider Name | Heather I Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538656715 PECOS PAC ID: 4880946425 Enrollment ID: I20181010001413 |
| Provider Name | George P Roy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295122943 PECOS PAC ID: 7810290244 Enrollment ID: I20181012001995 |
| Provider Name | Grishma R Sheth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255728390 PECOS PAC ID: 4486907094 Enrollment ID: I20181029003235 |
| Provider Name | John A Bigler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437544236 PECOS PAC ID: 3779898986 Enrollment ID: I20181105001814 |
| Provider Name | Jamillah L Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881067932 PECOS PAC ID: 9032418504 Enrollment ID: I20181119000987 |
| Provider Name | Brent E Smoots |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003202144 PECOS PAC ID: 5092002154 Enrollment ID: I20181120002454 |
| Provider Name | Mila Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225471527 PECOS PAC ID: 3375821960 Enrollment ID: I20181127001428 |
| Provider Name | Kathryn E Bond |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619355336 PECOS PAC ID: 6608171590 Enrollment ID: I20181203002187 |
| Provider Name | Christa L O'mara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003975012 PECOS PAC ID: 5092050450 Enrollment ID: I20181213001458 |
| Provider Name | Nichole M Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558841411 PECOS PAC ID: 2466797279 Enrollment ID: I20181226001661 |
| Provider Name | Amela Hozic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225417090 PECOS PAC ID: 4082950316 Enrollment ID: I20190108001935 |
| Provider Name | Kara Combs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265827885 PECOS PAC ID: 3375832769 Enrollment ID: I20190219002676 |
| Provider Name | Nikkeya Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831662469 PECOS PAC ID: 7618216375 Enrollment ID: I20190225003036 |
| Provider Name | Jacob Tuttle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023370053 PECOS PAC ID: 1759529704 Enrollment ID: I20190327001275 |
| Provider Name | Jordana R Zanger-jaffee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861489387 PECOS PAC ID: 5597739961 Enrollment ID: I20190507002114 |
| Provider Name | Ijeoma Udaku Uche |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851686638 PECOS PAC ID: 7315172137 Enrollment ID: I20190605002972 |
| Provider Name | Anthony J Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013471309 PECOS PAC ID: 5092048629 Enrollment ID: I20190612003625 |
| Provider Name | Kenneth F Horowitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467568642 PECOS PAC ID: 5294742193 Enrollment ID: I20190620000311 |
| Provider Name | Fatima Elia Covino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609933753 PECOS PAC ID: 5092935361 Enrollment ID: I20190805001677 |
| Provider Name | Danielle J Mackelprang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437712791 PECOS PAC ID: 0446589303 Enrollment ID: I20190903001637 |
| Provider Name | Samuel Oluwaseun Tytler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225423130 PECOS PAC ID: 8123331931 Enrollment ID: I20190928000005 |
| Provider Name | Shawnee R Fudurich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861057507 PECOS PAC ID: 0446580674 Enrollment ID: I20191001001138 |
| Provider Name | Caitlin Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164885588 PECOS PAC ID: 1850685959 Enrollment ID: I20191004002364 |
| Provider Name | Jennifer H Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902118086 PECOS PAC ID: 7810138286 Enrollment ID: I20191014001829 |
| Provider Name | Rasha Yacoub |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932512183 PECOS PAC ID: 4284932997 Enrollment ID: I20191022001295 |
| Provider Name | Kristen Lynn Stout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053876722 PECOS PAC ID: 8325370489 Enrollment ID: I20191023001404 |
| Provider Name | Burgess Levenda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336702679 PECOS PAC ID: 6002148087 Enrollment ID: I20191023003471 |
| Provider Name | Laura Lynn Lefever |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952630311 PECOS PAC ID: 5193858108 Enrollment ID: I20191025001452 |
| Provider Name | Alisha Lipsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033645718 PECOS PAC ID: 2668704974 Enrollment ID: I20191105002347 |
| Provider Name | Dianna H Soweidan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265894760 PECOS PAC ID: 7416242045 Enrollment ID: I20191106001703 |
| Provider Name | Pallavi Suvarna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770931578 PECOS PAC ID: 4284929274 Enrollment ID: I20191112003330 |
| Provider Name | Nicole Lynn Kranc |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790149995 PECOS PAC ID: 1557656642 Enrollment ID: I20191220000627 |
| Provider Name | Suneet Wander Dullet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346509734 PECOS PAC ID: 9537476577 Enrollment ID: I20191223001857 |
| Provider Name | James T Whitfill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326280405 PECOS PAC ID: 7517393853 Enrollment ID: I20200205002417 |
| Provider Name | Allison Steele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548624919 PECOS PAC ID: 2365711132 Enrollment ID: I20200416000404 |
| Provider Name | Anne Burriss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154951028 PECOS PAC ID: 0648601559 Enrollment ID: I20200508002537 |
| Provider Name | Dana Sall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992095020 PECOS PAC ID: 6204061468 Enrollment ID: I20200615001280 |
| Provider Name | Andrew M Pace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568826196 PECOS PAC ID: 5092094649 Enrollment ID: I20200615002219 |
| Provider Name | Heather Harrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720440019 PECOS PAC ID: 3072889484 Enrollment ID: I20200702002572 |
| Provider Name | Tereza Molfino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144676636 PECOS PAC ID: 0941623680 Enrollment ID: I20200714000558 |
| Provider Name | David M Medunick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861488736 PECOS PAC ID: 5890751531 Enrollment ID: I20200721002021 |
| Provider Name | Raul I Medina Sicre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649685652 PECOS PAC ID: 0446525968 Enrollment ID: I20200728000253 |
| Provider Name | Ana Rosa Gonzales |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689103509 PECOS PAC ID: 6901161884 Enrollment ID: I20200729002305 |
| Provider Name | Shavith G Samson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578097374 PECOS PAC ID: 9133490212 Enrollment ID: I20200803003394 |
| Provider Name | Kellen Joseph Hayes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881076974 PECOS PAC ID: 8022366491 Enrollment ID: I20200805000925 |
| Provider Name | Matthew John Herrmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508251091 PECOS PAC ID: 6709188279 Enrollment ID: I20200810002576 |
| Provider Name | Jaclyn Therese Cronin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992237184 PECOS PAC ID: 8123398708 Enrollment ID: I20200812001091 |
| Provider Name | Halley Christine Sullivan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770945180 PECOS PAC ID: 9234426560 Enrollment ID: I20200813001815 |
| Provider Name | Matthew Braig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356705610 PECOS PAC ID: 0244525491 Enrollment ID: I20200817000672 |
| Provider Name | Brittany A Miranda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821614587 PECOS PAC ID: 1850718701 Enrollment ID: I20200824003248 |
| Provider Name | Akua B Ekunwe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104350123 PECOS PAC ID: 5890068795 Enrollment ID: I20201013002300 |
| Provider Name | Anna M Grijalva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922612084 PECOS PAC ID: 3779903638 Enrollment ID: I20201014001043 |
| Provider Name | Danielle M Duchini |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1356562094 PECOS PAC ID: 2466543814 Enrollment ID: I20210104000595 |
| Provider Name | Lamia Boric |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1689881898 PECOS PAC ID: 6204006372 Enrollment ID: I20210127002592 |
| Provider Name | Maribeth Kitma Odango |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417562844 PECOS PAC ID: 1951716778 Enrollment ID: I20210209000351 |
| Provider Name | Elena Eloriaga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528667615 PECOS PAC ID: 1052727674 Enrollment ID: I20210305002059 |
| Provider Name | Leslie A Saeugling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669070454 PECOS PAC ID: 7315354248 Enrollment ID: I20210322000684 |
| Provider Name | Sari Yehuda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033370820 PECOS PAC ID: 9739339284 Enrollment ID: I20210324002854 |
| Provider Name | Kimberly N Ariza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639604945 PECOS PAC ID: 2466785522 Enrollment ID: I20210419002387 |
| Provider Name | Scott Waters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245209741 PECOS PAC ID: 5092742957 Enrollment ID: I20210621003072 |
| Provider Name | Darna Khav Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841866860 PECOS PAC ID: 7113322058 Enrollment ID: I20210816002914 |
| Provider Name | Ashkan Alkhamisi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669850509 PECOS PAC ID: 7911280342 Enrollment ID: I20210819003018 |
| Provider Name | Hayley Golek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245735190 PECOS PAC ID: 3678806635 Enrollment ID: I20210820002141 |
| Provider Name | Sarah Frederike Otter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386149623 PECOS PAC ID: 6406190354 Enrollment ID: I20210827001373 |
| Provider Name | Katayoun N Paydar |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1447401211 PECOS PAC ID: 6709945298 Enrollment ID: I20210907003584 |
| Provider Name | Jason Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073947115 PECOS PAC ID: 5890192421 Enrollment ID: I20210924001581 |
| Provider Name | Ashley B Dyer-giaquinto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427552413 PECOS PAC ID: 9739412842 Enrollment ID: I20210927002129 |
| Provider Name | Peter Gills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376039560 PECOS PAC ID: 5092140202 Enrollment ID: I20210929002429 |
| Provider Name | Jocelyn Bowker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477059723 PECOS PAC ID: 1456604347 Enrollment ID: I20211015001498 |
| Provider Name | Sanah Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356844120 PECOS PAC ID: 9032449632 Enrollment ID: I20211112001416 |
| Provider Name | Lindsay Porter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891140760 PECOS PAC ID: 2567797566 Enrollment ID: I20211206002642 |
| Provider Name | Ivorie Chantala Coleman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376040444 PECOS PAC ID: 9931599511 Enrollment ID: I20211214002686 |
| Provider Name | Arrol Alan Wissel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770254633 PECOS PAC ID: 4981095213 Enrollment ID: I20211222000159 |
| Provider Name | Ghazal Mostajabian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447668439 PECOS PAC ID: 7517238686 Enrollment ID: I20211228000804 |
| Provider Name | Kadi E Stapleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750057022 PECOS PAC ID: 9436541927 Enrollment ID: I20220112002389 |
| Provider Name | Alyssa Danielle Gunawan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710426879 PECOS PAC ID: 5395137400 Enrollment ID: I20220124001166 |
| Provider Name | Cynthia S Disanto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528724200 PECOS PAC ID: 0345634895 Enrollment ID: I20220225000814 |
| Provider Name | Kimberly Marie Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487228557 PECOS PAC ID: 3173917184 Enrollment ID: I20220308000330 |
| Provider Name | Krystal Campanaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013670439 PECOS PAC ID: 0547648719 Enrollment ID: I20220531000529 |
| Provider Name | Rajil Karnani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063517142 PECOS PAC ID: 0547268609 Enrollment ID: I20220605000008 |
| Provider Name | Ashley Nicolette Squier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912659251 PECOS PAC ID: 0042690950 Enrollment ID: I20220709000791 |
| Provider Name | Denise Coventry |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1184240756 PECOS PAC ID: 4284014085 Enrollment ID: I20220711003408 |
| Provider Name | Courtney James Clawson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780147553 PECOS PAC ID: 7911231147 Enrollment ID: I20220718000643 |
| Provider Name | Monica Chaung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437654795 PECOS PAC ID: 8123351160 Enrollment ID: I20220719002997 |
| Provider Name | Seema Jain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013442151 PECOS PAC ID: 0244508570 Enrollment ID: I20220825001515 |
| Provider Name | Benjamin Grant Gifford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518427343 PECOS PAC ID: 7719214352 Enrollment ID: I20220830001897 |
| Provider Name | Luis Sabatini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386632776 PECOS PAC ID: 2567560469 Enrollment ID: I20220830002090 |
| Provider Name | Amie Cocoros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316502339 PECOS PAC ID: 8921483504 Enrollment ID: I20220918000042 |
| Provider Name | Huiqing Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629704200 PECOS PAC ID: 1951786102 Enrollment ID: I20220923002175 |
| Provider Name | Jessica Heintz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477013274 PECOS PAC ID: 8729314257 Enrollment ID: I20220926001699 |
| Provider Name | Casey Myers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831650019 PECOS PAC ID: 5799161436 Enrollment ID: I20221003002109 |
| Provider Name | Jessica C Wintonli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215203682 PECOS PAC ID: 2668782814 Enrollment ID: I20221004001897 |
| Provider Name | Linda Joyce Stanek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619462173 PECOS PAC ID: 3779830419 Enrollment ID: I20221114002653 |
| Provider Name | Ashlee Tucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508530007 PECOS PAC ID: 4284002270 Enrollment ID: I20221123000158 |
| Provider Name | Freyda Velazquez Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447789359 PECOS PAC ID: 7416226444 Enrollment ID: I20221219001142 |
| Provider Name | Andrew Joseph Ochoa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144782400 PECOS PAC ID: 9133455538 Enrollment ID: I20221222002821 |
| Provider Name | Mollie Gaeddert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881288322 PECOS PAC ID: 5799194569 Enrollment ID: I20230126001407 |
| Provider Name | Chee Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144946856 PECOS PAC ID: 2668844366 Enrollment ID: I20230206002776 |
| Provider Name | Lisa Ashworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578287876 PECOS PAC ID: 8123490216 Enrollment ID: I20230227002411 |
| Provider Name | Elizabeth Eileen Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679296222 PECOS PAC ID: 7214300714 Enrollment ID: I20230303000796 |
| Provider Name | Alyssa Vecchio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316650294 PECOS PAC ID: 1254706302 Enrollment ID: I20230404000812 |
| Provider Name | Jennifer Gayle Ries-clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619435310 PECOS PAC ID: 0042677445 Enrollment ID: I20230530002618 |
| Provider Name | Ajoy Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831238872 PECOS PAC ID: 1557409091 Enrollment ID: I20230710001583 |
| Provider Name | Elizabeth Ann Gaddi Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629607924 PECOS PAC ID: 8729449996 Enrollment ID: I20230803003320 |
| Provider Name | Melissa Reed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669661864 PECOS PAC ID: 2163845512 Enrollment ID: I20230816001936 |
| Provider Name | Jonathan Michael Dill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023646973 PECOS PAC ID: 9739503814 Enrollment ID: I20230824003680 |
| Provider Name | Bryant Kao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881221257 PECOS PAC ID: 3577926393 Enrollment ID: I20230828001004 |
| Provider Name | Laura L Loesel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295827566 PECOS PAC ID: 7618974148 Enrollment ID: I20230828002573 |
| Provider Name | Marwan Al-ani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871116905 PECOS PAC ID: 3274996780 Enrollment ID: I20230831001872 |
| Provider Name | Alex Beck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144849381 PECOS PAC ID: 5496174419 Enrollment ID: I20230901000620 |
| Provider Name | Taylor Patterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316576093 PECOS PAC ID: 4284024670 Enrollment ID: I20231004002024 |
| Provider Name | Collin Pitts |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1346643483 PECOS PAC ID: 0941603039 Enrollment ID: I20231016001739 |
| Provider Name | Siobhan Emily Faenza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013477900 PECOS PAC ID: 1850770876 Enrollment ID: I20231031000272 |
| Provider Name | Sugandha Nagarajan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447878921 PECOS PAC ID: 7113340753 Enrollment ID: I20231116002718 |
| Provider Name | Nicolas Batterton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659661908 PECOS PAC ID: 7416175435 Enrollment ID: I20231117001705 |
| Provider Name | Jason Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811485287 PECOS PAC ID: 1355746231 Enrollment ID: I20231130001873 |
| Provider Name | Cindy Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164879144 PECOS PAC ID: 7618234915 Enrollment ID: I20240109002158 |
| Provider Name | Kristen Kathleen Ash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891476495 PECOS PAC ID: 9739532938 Enrollment ID: I20240124001253 |
Centerwell Senior Primary Care-peoria Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10280 N 91st Ave, Peoria, AZ 85345 Phone: 602-842-9880 Fax: 877-891-4091 | |
Elite Infusions Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10252 W Villa Chula, Peoria, AZ 85383 Phone: 623-210-5041 | |
Banner Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8510 W Deer Valley Rd Ste 100, Peoria, AZ 85382 Phone: 623-561-4532 | |
Arizona Doctors, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6739 W Cactus Rd, Peoria, AZ 85381 Phone: 623-240-1110 Fax: 623-889-0814 | |
Az Cosmetic & Family Dentistry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13695 N 75th Ave, Peoria, AZ 85381 Phone: 602-439-1101 Fax: 602-789-1653 | |
Honorhealth Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10230 W Happy Valley Pkwy Ste 100, Peoria, AZ 85383 Phone: 623-266-4699 | |
Anesthesia Services For Gi Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14155 N 83rd Ave Ste 122, Peoria, AZ 85381 Phone: 623-694-1445 |