| Pacific Redwood Medical Group Inc | |
|
275 Hospital Dr Ukiah CA 95482 | |
| (707) 462-7900 | |
| (707) 462-7947 |
| Full Name | Pacific Redwood Medical Group Inc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 275 Hospital Dr, Ukiah, California |
| Authorized Official Name and Position | Gary W Fausone (PRESIDENT) |
| Authorized Official Contact | 7074627900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Redwood Medical Group Inc Po Box 2800 Ukiah CA 95482-2800 Ph: (707) 462-7900 | Pacific Redwood Medical Group Inc 275 Hospital Dr Ukiah CA 95482 Ph: (707) 462-7900 |
| NPI Number | 1033103676 |
|---|---|
| Provider Enumeration Date | 09/09/2005 |
| Last Update Date | 07/31/2018 |
| Medicare PECOS PAC ID | 5496652703 |
|---|---|
| Medicare Enrollment ID | O20031215000997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033103676 | NPI | - | NPPES |
| 17165692005 | Other | CA | STATE COMPENSATION INS |
| GR0093400 | Medicaid | CA | |
| 352149100 | Other | DOL (DEPT OF LABOR) | |
| ZZZ06060Z | Other | CA | BLUE SHIELD |
| Provider Name | Robin David Serrahn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295726503 PECOS PAC ID: 3971498809 Enrollment ID: I20040218000984 |
| Provider Name | Laura L Wedderburn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912981788 PECOS PAC ID: 6507754322 Enrollment ID: I20040304000935 |
| Provider Name | Gerry V Lazzareschi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780768762 PECOS PAC ID: 4385627058 Enrollment ID: I20040611001394 |
| Provider Name | Michaela A Shepphard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154356509 PECOS PAC ID: 0840265534 Enrollment ID: I20040826001141 |
| Provider Name | David G Streeter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952342057 PECOS PAC ID: 2264490606 Enrollment ID: I20041230000651 |
| Provider Name | Mary K Newkirk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124088323 PECOS PAC ID: 3375580962 Enrollment ID: I20050414001001 |
| Provider Name | Rodney B Look |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831120781 PECOS PAC ID: 9830132588 Enrollment ID: I20050603000857 |
| Provider Name | Azade Izadi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801051321 PECOS PAC ID: 2567478340 Enrollment ID: I20060302000723 |
| Provider Name | Barry R Sheppard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700836764 PECOS PAC ID: 8921003815 Enrollment ID: I20060927000580 |
| Provider Name | Debbie Louise Marks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447231220 PECOS PAC ID: 8527067891 Enrollment ID: I20061214000149 |
| Provider Name | Jorge A Allende |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619970068 PECOS PAC ID: 2567560899 Enrollment ID: I20070608000578 |
| Provider Name | Walter M Bortz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225012016 PECOS PAC ID: 8729976519 Enrollment ID: I20070711000636 |
| Provider Name | Kellie M Olson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346281946 PECOS PAC ID: 1153318308 Enrollment ID: I20070920000509 |
| Provider Name | Joseph G Mallon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407041197 PECOS PAC ID: 5890882500 Enrollment ID: I20071027000054 |
| Provider Name | Roger A Cheitlin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881643732 PECOS PAC ID: 9830279595 Enrollment ID: I20080107000861 |
| Provider Name | James F Dolan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043338106 PECOS PAC ID: 5597847954 Enrollment ID: I20080124000516 |
| Provider Name | Lillian F Basner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750321972 PECOS PAC ID: 9032016340 Enrollment ID: I20080408000501 |
| Provider Name | Marvin G Trotter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720027436 PECOS PAC ID: 8123105608 Enrollment ID: I20080408000613 |
| Provider Name | Tuan A Luu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326001660 PECOS PAC ID: 3577642370 Enrollment ID: I20080505000856 |
| Provider Name | Gary W Fausone |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316997737 PECOS PAC ID: 3577632371 Enrollment ID: I20080520000434 |
| Provider Name | Barbara J Kilian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306869342 PECOS PAC ID: 0749285815 Enrollment ID: I20090611000433 |
| Provider Name | Leslee H Devies |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164613634 PECOS PAC ID: 0446302384 Enrollment ID: I20090723000397 |
| Provider Name | Evan M Chisum |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811037716 PECOS PAC ID: 5395898019 Enrollment ID: I20090728000778 |
| Provider Name | Gregory S Larsen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104073709 PECOS PAC ID: 2163568759 Enrollment ID: I20091013000382 |
| Provider Name | Anjuli Basu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679583579 PECOS PAC ID: 9830236421 Enrollment ID: I20091030000527 |
| Provider Name | Evan D Bloom |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285894931 PECOS PAC ID: 5395818140 Enrollment ID: I20091217000663 |
| Provider Name | Benjamin E Stone |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932359254 PECOS PAC ID: 0143412965 Enrollment ID: I20101012000892 |
| Provider Name | Nhat H Hoang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215196480 PECOS PAC ID: 4284827114 Enrollment ID: I20101022001110 |
| Provider Name | Kathie R. Calloway |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235166034 PECOS PAC ID: 5991603219 Enrollment ID: I20101102000247 |
| Provider Name | Brandon C Begley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568624708 PECOS PAC ID: 1355521964 Enrollment ID: I20110726000439 |
| Provider Name | Carla A Toms |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730258336 PECOS PAC ID: 3678744661 Enrollment ID: I20110923000129 |
| Provider Name | Mark H Luoto |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932158854 PECOS PAC ID: 2769389071 Enrollment ID: I20111129000646 |
| Provider Name | Ethan Ross |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780848507 PECOS PAC ID: 0547419681 Enrollment ID: I20121004000278 |
| Provider Name | Christiane A Eisele |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679791305 PECOS PAC ID: 9931138286 Enrollment ID: I20121207000155 |
| Provider Name | Samuel Martisius |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043440308 PECOS PAC ID: 1052559762 Enrollment ID: I20130607000091 |
| Provider Name | Marika Catherine Ennis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215249214 PECOS PAC ID: 4486897444 Enrollment ID: I20130823000896 |
| Provider Name | Jennifer L Graff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053757922 PECOS PAC ID: 3678700135 Enrollment ID: I20131209001384 |
| Provider Name | Bonnie L Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710031158 PECOS PAC ID: 4789812454 Enrollment ID: I20140102001519 |
| Provider Name | Georgina L Calderon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013159359 PECOS PAC ID: 1355579731 Enrollment ID: I20140109001043 |
| Provider Name | Daniel Matthew Fentress |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649583071 PECOS PAC ID: 5294950218 Enrollment ID: I20140708001415 |
| Provider Name | Cristina M Martinez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477825784 PECOS PAC ID: 9830314749 Enrollment ID: I20140709002540 |
| Provider Name | Candice M Dolbier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629333893 PECOS PAC ID: 8325271661 Enrollment ID: I20141017000764 |
| Provider Name | John D Colfax |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770630667 PECOS PAC ID: 3375634777 Enrollment ID: I20150417000050 |
| Provider Name | Jillian E Cipa-tatum |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629410584 PECOS PAC ID: 7618295924 Enrollment ID: I20150417000637 |
| Provider Name | Viola W Chu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053752113 PECOS PAC ID: 8426360629 Enrollment ID: I20150630002946 |
| Provider Name | Anand J Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114273729 PECOS PAC ID: 1355655143 Enrollment ID: I20151026002726 |
| Provider Name | Deron Theodore Warren |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962491670 PECOS PAC ID: 1355658741 Enrollment ID: I20151112001812 |
| Provider Name | Julie Oliva |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902242548 PECOS PAC ID: 6103117197 Enrollment ID: I20160622001420 |
| Provider Name | Duncan M Johnston |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669770574 PECOS PAC ID: 4082907290 Enrollment ID: I20160726002056 |
| Provider Name | Amarinder Singh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023435468 PECOS PAC ID: 0840572228 Enrollment ID: I20170119001211 |
| Provider Name | Brian L Chang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164840013 PECOS PAC ID: 9830481480 Enrollment ID: I20170201001567 |
| Provider Name | Julie D Gesch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467899187 PECOS PAC ID: 6800179920 Enrollment ID: I20170214002739 |
| Provider Name | Claudette Rhoades |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194975003 PECOS PAC ID: 4587818984 Enrollment ID: I20170613001332 |
| Provider Name | Austin T Tidwell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366862690 PECOS PAC ID: 4789800053 Enrollment ID: I20170710001438 |
| Provider Name | Christopher Deuel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932545035 PECOS PAC ID: 7719204197 Enrollment ID: I20170823000850 |
| Provider Name | Erin L Bainbridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104368729 PECOS PAC ID: 3072886043 Enrollment ID: I20170913003353 |
| Provider Name | Tod B Imperato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942726252 PECOS PAC ID: 5890061030 Enrollment ID: I20171016003219 |
| Provider Name | Shannon Cross Todd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659870186 PECOS PAC ID: 0446513949 Enrollment ID: I20180416001865 |
| Provider Name | Amar Tomar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871956060 PECOS PAC ID: 0547524449 Enrollment ID: I20180430002789 |
| Provider Name | Kevin A Padrez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396130159 PECOS PAC ID: 8921371154 Enrollment ID: I20180606002079 |
| Provider Name | Erica Valdovinos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548655087 PECOS PAC ID: 5799035051 Enrollment ID: I20180906002526 |
| Provider Name | Michael C Butterfield |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871835389 PECOS PAC ID: 7810247889 Enrollment ID: I20180912002913 |
| Provider Name | Michael David Hausberger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306253422 PECOS PAC ID: 6406150911 Enrollment ID: I20181010003233 |
| Provider Name | Jennifer Lillian Zernec |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285981027 PECOS PAC ID: 6204137375 Enrollment ID: I20181010003499 |
| Provider Name | Jodi L Parungao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932528965 PECOS PAC ID: 1355560954 Enrollment ID: I20181016003217 |
| Provider Name | Martha E Montgomery |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477948586 PECOS PAC ID: 3577817626 Enrollment ID: I20181108002136 |
| Provider Name | Timothy E Burger |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972889236 PECOS PAC ID: 1759508070 Enrollment ID: I20190222000392 |
| Provider Name | Mammen Maliakkal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497730816 PECOS PAC ID: 5092743104 Enrollment ID: I20190228000800 |
| Provider Name | Wilbert Perez Velez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275989964 PECOS PAC ID: 5496020711 Enrollment ID: I20191106000548 |
| Provider Name | Alexander D W Schmalz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912405267 PECOS PAC ID: 2860826831 Enrollment ID: I20191227001618 |
| Provider Name | Shah Z Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356704779 PECOS PAC ID: 5092008854 Enrollment ID: I20200407003238 |
| Provider Name | Sara Alice Martin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992237531 PECOS PAC ID: 9638409923 Enrollment ID: I20200504000351 |
| Provider Name | Ali Pandamouz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548600224 PECOS PAC ID: 3870924954 Enrollment ID: I20200505000401 |
| Provider Name | Mark Guevorkian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053765727 PECOS PAC ID: 3476893181 Enrollment ID: I20200619001300 |
| Provider Name | Amber H Gilmore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407210768 PECOS PAC ID: 2264726041 Enrollment ID: I20200901002688 |
| Provider Name | Christopher D Roden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316108947 PECOS PAC ID: 2466870050 Enrollment ID: I20200914002336 |
| Provider Name | Vanessa R Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417560194 PECOS PAC ID: 7911327036 Enrollment ID: I20201012001072 |
| Provider Name | Laurent Palmatier |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386175230 PECOS PAC ID: 7214201417 Enrollment ID: I20201030002504 |
| Provider Name | Katie L Hatch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417310897 PECOS PAC ID: 8729498449 Enrollment ID: I20201109003307 |
| Provider Name | Rowen O Jin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063943967 PECOS PAC ID: 1951738996 Enrollment ID: I20201124002688 |
| Provider Name | Brian J Kwan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124569322 PECOS PAC ID: 5597174284 Enrollment ID: I20210510002373 |
| Provider Name | David Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538734793 PECOS PAC ID: 8628475985 Enrollment ID: I20210929001445 |
| Provider Name | Nimeka Nitrice Dupree Phillip |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114388014 PECOS PAC ID: 6204168040 Enrollment ID: I20220104000916 |
| Provider Name | Suman J Gupta |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417480500 PECOS PAC ID: 9537404470 Enrollment ID: I20220218001002 |
| Provider Name | Jamal Jefferson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790244523 PECOS PAC ID: 8921489675 Enrollment ID: I20220713001146 |
| Provider Name | Esteban Cubillos Torres |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285138735 PECOS PAC ID: 5597146662 Enrollment ID: I20220720002937 |
| Provider Name | Alexandra C Lambeck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235698002 PECOS PAC ID: 8729468517 Enrollment ID: I20220727000930 |
| Provider Name | Nadir S Zaidi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245790849 PECOS PAC ID: 9739564543 Enrollment ID: I20220914003882 |
| Provider Name | John A Muraski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083242358 PECOS PAC ID: 2062898190 Enrollment ID: I20220927003290 |
| Provider Name | Linnea Lantz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841759974 PECOS PAC ID: 4486030475 Enrollment ID: I20220928001964 |
| Provider Name | Codee Alexandra Champney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316501588 PECOS PAC ID: 0840667606 Enrollment ID: I20221108000670 |
| Provider Name | Katrina J Stime |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154882934 PECOS PAC ID: 4587068622 Enrollment ID: I20221230001854 |
| Provider Name | Claire Hirschmann |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437618287 PECOS PAC ID: 4385014109 Enrollment ID: I20230111002981 |
| Provider Name | Urvi B Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902169873 PECOS PAC ID: 5395058358 Enrollment ID: I20230202003225 |
| Provider Name | Alexandra Friedman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548898091 PECOS PAC ID: 5991154957 Enrollment ID: I20231215001688 |
| Provider Name | Avery Newcomb |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780212886 PECOS PAC ID: 2860896859 Enrollment ID: I20231226000661 |
| Provider Name | Erik Kramer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427687706 PECOS PAC ID: 9830549013 Enrollment ID: I20240112001004 |
| Provider Name | Azad Molla Hosseini |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396373486 PECOS PAC ID: 3274986187 Enrollment ID: I20240126003195 |
| Provider Name | Elaine Maria Dellinger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225667850 PECOS PAC ID: 1052755758 Enrollment ID: I20240221002894 |
| Provider Name | John T Higgins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013492867 PECOS PAC ID: 3678911831 Enrollment ID: I20240406000004 |
| Provider Name | Andrew Mark Wilke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124086947 PECOS PAC ID: 6305733585 Enrollment ID: I20240408001501 |
| Provider Name | Alexis A Loudon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700666138 PECOS PAC ID: 0244670123 Enrollment ID: I20240425000747 |
| Provider Name | Aravind Addepalli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871170142 PECOS PAC ID: 0648713594 Enrollment ID: I20240619002005 |
| Provider Name | Max Olesevich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073706677 PECOS PAC ID: 6800958851 Enrollment ID: I20240730002256 |
| Provider Name | Alexander E Ayala |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396262549 PECOS PAC ID: 8628515277 Enrollment ID: I20240801000847 |
| Provider Name | Tianyu Tang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295317949 PECOS PAC ID: 7810342771 Enrollment ID: I20250307002717 |
| Provider Name | Keerthi Gondy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255918769 PECOS PAC ID: 4587019666 Enrollment ID: I20250310000128 |
| Provider Name | Yonathan Ararso |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558941427 PECOS PAC ID: 1850812629 Enrollment ID: I20250310001413 |
| Provider Name | Kelsey Coolahan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669054334 PECOS PAC ID: 8123540648 Enrollment ID: I20250313002525 |
| Provider Name | Rachel Elizabeth Tsolinas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174100838 PECOS PAC ID: 7113375643 Enrollment ID: I20250313003058 |
| Provider Name | Claire Beata Kaufman Raines |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447830567 PECOS PAC ID: 7810419207 Enrollment ID: I20250314000778 |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 232 Hospital Dr Ste B, Ukiah, CA 95482 Phone: 707-463-7356 Fax: 707-462-1051 | |
Medical Offices Of Robert Rushton, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 844 S Dora St, Ukiah, CA 95482 Phone: 707-462-8603 Fax: 707-462-8605 | |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 234 Hospital Dr, Ukiah, CA 95482 Phone: 707-463-7425 | |
Motionhealth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 557 E Perkins St, Ukiah, CA 95482 Phone: 707-467-9664 | |
Galen Inpatient Physician Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 275 Hospital Dr, Ukiah, CA 95482 Phone: 707-462-3111 | |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1050 N State St, Ukiah, CA 95482 Phone: 707-463-7495 Fax: 707-462-7846 |