| Queenscare Health Centers - Bresee | |
|
184 Bimini Pl Los Angeles CA 90004-5903 | |
| (213) 201-6878 | |
| (213) 201-6872 |
| Full Name | Queenscare Health Centers - Bresee |
|---|---|
| Speciality | Clinic/Center |
| Location | 184 Bimini Pl, Los Angeles, California |
| Authorized Official Name and Position | Barbara B Hines (PRESIDENT & CEO) |
| Authorized Official Contact | 3236694305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Queenscare Health Centers - Bresee 950 S Grand Ave 2nd Floor South Los Angeles CA 90015-4202 Ph: (323) 669-4302 | Queenscare Health Centers - Bresee 184 Bimini Pl Los Angeles CA 90004-5903 Ph: (213) 201-6878 |
| NPI Number | 1093886251 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 12/08/2014 |
| Medicare PECOS PAC ID | 3072619618 |
|---|---|
| Medicare Enrollment ID | O20170425001131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093886251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550000045 (California) | Primary |
| Provider Name | Ana C Chang-smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639242019 PECOS PAC ID: 1951294297 Enrollment ID: I20040203001127 |
| Provider Name | Jo Ann M Woodward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114993730 PECOS PAC ID: 7315936358 Enrollment ID: I20040506001106 |
| Provider Name | Quynh Tu Duong |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740378967 PECOS PAC ID: 2769459858 Enrollment ID: I20040916001140 |
| Provider Name | Goretti Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487740619 PECOS PAC ID: 8426008616 Enrollment ID: I20050125001149 |
| Provider Name | Stephen N Pine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356352108 PECOS PAC ID: 8022055672 Enrollment ID: I20050414000739 |
| Provider Name | Edward Regan Liao |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942358916 PECOS PAC ID: 5799723524 Enrollment ID: I20050421000496 |
| Provider Name | Lucille A Ridgill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306862701 PECOS PAC ID: 1557398435 Enrollment ID: I20050721001027 |
| Provider Name | Lalitha M Vakkalanka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194755959 PECOS PAC ID: 9436177284 Enrollment ID: I20051109001200 |
| Provider Name | Ryan K Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982799953 PECOS PAC ID: 0345261764 Enrollment ID: I20051213000940 |
| Provider Name | Silverio P Arano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447229851 PECOS PAC ID: 2163430398 Enrollment ID: I20060330000251 |
| Provider Name | Michelle Faraday Demitri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710925623 PECOS PAC ID: 8123124542 Enrollment ID: I20070501000697 |
| Provider Name | Maria Teresa E Lim Heya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952348849 PECOS PAC ID: 7012013436 Enrollment ID: I20070501000709 |
| Provider Name | Albert A Nassir |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821161860 PECOS PAC ID: 7315020146 Enrollment ID: I20080215000680 |
| Provider Name | Kourosh Daneshgar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275619736 PECOS PAC ID: 8224111059 Enrollment ID: I20080313000165 |
| Provider Name | Claudia Ramos-smulevich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811980634 PECOS PAC ID: 1052479243 Enrollment ID: I20081016000147 |
| Provider Name | Amanda Weiler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881781375 PECOS PAC ID: 5799825386 Enrollment ID: I20091211000349 |
| Provider Name | Kraig L Golden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689713380 PECOS PAC ID: 7911023973 Enrollment ID: I20100927001335 |
| Provider Name | Jamie C Lin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588960538 PECOS PAC ID: 8022286780 Enrollment ID: I20110725000035 |
| Provider Name | Ben Ha |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043305774 PECOS PAC ID: 6800066523 Enrollment ID: I20120125000840 |
| Provider Name | Alfred S Hong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689901746 PECOS PAC ID: 6608033873 Enrollment ID: I20120131000802 |
| Provider Name | Cornelia R Dangla Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710320536 PECOS PAC ID: 2961633128 Enrollment ID: I20140401001601 |
| Provider Name | Margarita Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285912741 PECOS PAC ID: 5890927487 Enrollment ID: I20140414001460 |
| Provider Name | Thaung M Aung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598196255 PECOS PAC ID: 8729303060 Enrollment ID: I20150209002120 |
| Provider Name | Myla Pineda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134533318 PECOS PAC ID: 0840515698 Enrollment ID: I20150219000364 |
| Provider Name | Damian Robledo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376831289 PECOS PAC ID: 3577879873 Enrollment ID: I20150901002596 |
| Provider Name | Samantha L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033535406 PECOS PAC ID: 3173826914 Enrollment ID: I20160128000341 |
| Provider Name | Larry Lee Alenbaugh |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881631885 PECOS PAC ID: 5294897922 Enrollment ID: I20170106000413 |
| Provider Name | Luis J Espinoza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053640789 PECOS PAC ID: 8527340009 Enrollment ID: I20170117002366 |
| Provider Name | Moe Moe Kyi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487932612 PECOS PAC ID: 9335315282 Enrollment ID: I20170530001728 |
| Provider Name | Cecilia Mitchell |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1053483339 PECOS PAC ID: 9931476546 Enrollment ID: I20170602001744 |
| Provider Name | Karla Turner |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1003975566 PECOS PAC ID: 1456628064 Enrollment ID: I20170602001911 |
| Provider Name | Moe Aung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427370618 PECOS PAC ID: 3678768330 Enrollment ID: I20170831001913 |
| Provider Name | Jessica Khankhanian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699162842 PECOS PAC ID: 9537400775 Enrollment ID: I20190416001592 |
| Provider Name | Saurabh B Gandhi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790129641 PECOS PAC ID: 8527363076 Enrollment ID: I20190416002171 |
| Provider Name | Cory Clement |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1154736684 PECOS PAC ID: 7810220597 Enrollment ID: I20190612000883 |
| Provider Name | Ronald Redoblado |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1336204866 PECOS PAC ID: 3971886466 Enrollment ID: I20190620002419 |
| Provider Name | Robert Hagbom |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609255850 PECOS PAC ID: 2466786728 Enrollment ID: I20190620002668 |
| Provider Name | Dienan Nhu Tran |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1841465721 PECOS PAC ID: 8426382797 Enrollment ID: I20190620002840 |
| Provider Name | Annie Ledoux |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1689933178 PECOS PAC ID: 0345574513 Enrollment ID: I20190620003225 |
| Provider Name | Eric De Leon Celo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275576845 PECOS PAC ID: 1355447681 Enrollment ID: I20190621002405 |
| Provider Name | Connie Millare Pasco |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700051968 PECOS PAC ID: 0345574448 Enrollment ID: I20190624002090 |
| Provider Name | Ming Jacqueline Luong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831146174 PECOS PAC ID: 6800018581 Enrollment ID: I20190626003404 |
| Provider Name | Anselm P Hall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679642243 PECOS PAC ID: 8325321730 Enrollment ID: I20190716003711 |
| Provider Name | Susan Del Rosario |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1679514798 PECOS PAC ID: 4385740703 Enrollment ID: I20190729003492 |
| Provider Name | Jennifer Min |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144766841 PECOS PAC ID: 9931438249 Enrollment ID: I20190912000376 |
| Provider Name | Lance Michael Schaina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194165431 PECOS PAC ID: 7810227378 Enrollment ID: I20190925002915 |
| Provider Name | Jedd Lyn Layo Ticar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760844310 PECOS PAC ID: 4587994744 Enrollment ID: I20191001002397 |
| Provider Name | Hla Moe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811316151 PECOS PAC ID: 5799016366 Enrollment ID: I20191011002094 |
| Provider Name | Liza Lynne Rimular |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992130827 PECOS PAC ID: 0345565719 Enrollment ID: I20191014000094 |
| Provider Name | Nhan Nguyen Trong Pham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588018741 PECOS PAC ID: 2769713171 Enrollment ID: I20191016003128 |
| Provider Name | Douglas P. Ahern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538578109 PECOS PAC ID: 6103258975 Enrollment ID: I20191115001721 |
| Provider Name | Houry Koushakjian |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1972541654 PECOS PAC ID: 1658477070 Enrollment ID: I20191121001267 |
| Provider Name | Gena Catherine Craemer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356892343 PECOS PAC ID: 7810270220 Enrollment ID: I20191126000813 |
| Provider Name | David Angel Cortez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437701208 PECOS PAC ID: 2668808502 Enrollment ID: I20200212001864 |
| Provider Name | Yun Ah Hwang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942759261 PECOS PAC ID: 4183908882 Enrollment ID: I20200313001902 |
| Provider Name | Cristina Lucia Sandoval |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194004861 PECOS PAC ID: 7315377215 Enrollment ID: I20200416002117 |
| Provider Name | Kiarash Bakhaj |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1235662255 PECOS PAC ID: 5890055420 Enrollment ID: I20200727000225 |
| Provider Name | Genice L Schumann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679031595 PECOS PAC ID: 8022442045 Enrollment ID: I20200928002472 |
| Provider Name | Mikhail Lyubarev |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205105038 PECOS PAC ID: 9739509951 Enrollment ID: I20201008002717 |
| Provider Name | Lizeth Lopez Zamora |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023563848 PECOS PAC ID: 9537564661 Enrollment ID: I20210826003103 |
| Provider Name | Shapan Debnath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730614652 PECOS PAC ID: 8325312168 Enrollment ID: I20220411002658 |
| Provider Name | Arianna Lanier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669137089 PECOS PAC ID: 2668859661 Enrollment ID: I20220512001781 |
| Provider Name | Umangi P Popat |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114125085 PECOS PAC ID: 2769567577 Enrollment ID: I20220715002513 |
| Provider Name | Ahoo Sharif Sahba |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295924611 PECOS PAC ID: 9234500976 Enrollment ID: I20230515001441 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
Clinica Virgen De Guadalupe Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 985 W Vernon Ave, Los Angeles, CA 90037 Phone: 323-234-6300 | |
Ssg San Pedro Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5811 S San Pedro St, Los Angeles, CA 90011 Phone: 213-553-1800 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Medical Group Eapc Prop 99 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Citadel Dr, Ste 490, Los Angeles, CA 90040 Phone: 323-725-8751 Fax: 323-889-7399 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |
Apla Health & Wellness - David Geffen Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 S Kingsley Dr, Los Angeles, CA 90005 Phone: 213-201-1623 Fax: 213-201-1595 |