| UCLA Entertainment Ind Medgrp | |
|
1000 Flower St Glendale CA 91201-3007 | |
| (818) 659-5000 | |
| Not Available |
| Full Name | UCLA Entertainment Ind Medgrp |
|---|---|
| Speciality | Internal Medicine |
| Location | 1000 Flower St, Glendale, California |
| Authorized Official Name and Position | Kathie Hale (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3103015311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| UCLA Entertainment Ind Medgrp 5767 W Century Blvd Suite 400 Los Angeles CA 90045-5631 Ph: (310) 301-8708 | UCLA Entertainment Ind Medgrp 1000 Flower St Glendale CA 91201-3007 Ph: (818) 659-5000 |
| NPI Number | 1891110888 |
|---|---|
| Provider Enumeration Date | 02/27/2014 |
| Last Update Date | 11/19/2020 |
| Certification Date | 09/10/2020 |
| Medicare PECOS PAC ID | 5294958815 |
|---|---|
| Medicare Enrollment ID | O20140528001538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891110888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Primary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (California) | Secondary |
| Provider Name | Silvia Darie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104827989 PECOS PAC ID: 9032007323 Enrollment ID: I20040308001454 |
| Provider Name | Shirley X Xu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790791945 PECOS PAC ID: 7416848239 Enrollment ID: I20040322001671 |
| Provider Name | Claudine L Armand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902909294 PECOS PAC ID: 5991794828 Enrollment ID: I20040506001812 |
| Provider Name | John Louie Go |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982643060 PECOS PAC ID: 1850375239 Enrollment ID: I20040614001669 |
| Provider Name | Suzanne Yoon Homer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194767582 PECOS PAC ID: 1759367162 Enrollment ID: I20040626000207 |
| Provider Name | Giovinetza Hasbun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255353496 PECOS PAC ID: 0749250447 Enrollment ID: I20040729000905 |
| Provider Name | Ronald Homer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316982614 PECOS PAC ID: 8022077429 Enrollment ID: I20041008001409 |
| Provider Name | Stefan G Ruehm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669416632 PECOS PAC ID: 6901850411 Enrollment ID: I20050308000846 |
| Provider Name | Timothy C Bullard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306801766 PECOS PAC ID: 2466491493 Enrollment ID: I20050428001239 |
| Provider Name | Anne C Hoyt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740230291 PECOS PAC ID: 7810960499 Enrollment ID: I20050526000501 |
| Provider Name | Keith Steven Garb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740381177 PECOS PAC ID: 5597709428 Enrollment ID: I20050613000468 |
| Provider Name | Richard T Kaplan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265462980 PECOS PAC ID: 9638105844 Enrollment ID: I20050711000393 |
| Provider Name | Keiko Tochikura |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417242389 PECOS PAC ID: 2466354998 Enrollment ID: I20050713000650 |
| Provider Name | Noriko Salamon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558397430 PECOS PAC ID: 9739113473 Enrollment ID: I20050922000578 |
| Provider Name | Thomas E Hascall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245315324 PECOS PAC ID: 3870511447 Enrollment ID: I20051102001176 |
| Provider Name | Denise R Aberle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053361501 PECOS PAC ID: 1153349899 Enrollment ID: I20051110000625 |
| Provider Name | David S Lu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073542668 PECOS PAC ID: 8426076100 Enrollment ID: I20051110000913 |
| Provider Name | Steven S Raman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114956745 PECOS PAC ID: 6204854987 Enrollment ID: I20051110000949 |
| Provider Name | Kambiz Motamedi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912956681 PECOS PAC ID: 4082632765 Enrollment ID: I20051110000968 |
| Provider Name | Jonathan G Goldin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477502144 PECOS PAC ID: 9436177110 Enrollment ID: I20051110000986 |
| Provider Name | Whitney B Pope |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295763761 PECOS PAC ID: 2062430754 Enrollment ID: I20051110001002 |
| Provider Name | John P Finn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619054533 PECOS PAC ID: 5698793388 Enrollment ID: I20051110001006 |
| Provider Name | Marjan Banooni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518983063 PECOS PAC ID: 5698794196 Enrollment ID: I20051114001087 |
| Provider Name | Juan P Villablanca |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073564407 PECOS PAC ID: 6406876226 Enrollment ID: I20051122000889 |
| Provider Name | Edward J Zaragoza |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518995141 PECOS PAC ID: 0244250546 Enrollment ID: I20051201000494 |
| Provider Name | Antoinette S Gomes |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1013953835 PECOS PAC ID: 2365463460 Enrollment ID: I20051216000531 |
| Provider Name | Justin P Mcwilliams |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1437292331 PECOS PAC ID: 2466466081 Enrollment ID: I20060202000413 |
| Provider Name | Satoshi Tateshima |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922042068 PECOS PAC ID: 1658389226 Enrollment ID: I20060323000833 |
| Provider Name | Michael L Douek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043253255 PECOS PAC ID: 6204844129 Enrollment ID: I20060403000803 |
| Provider Name | Daniel H Silverman |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1295761880 PECOS PAC ID: 7911910963 Enrollment ID: I20060717000357 |
| Provider Name | Michael Linetsky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568405389 PECOS PAC ID: 4880607753 Enrollment ID: I20060718000188 |
| Provider Name | Fereidoun G Abtin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447267547 PECOS PAC ID: 9436152873 Enrollment ID: I20060824000356 |
| Provider Name | Anna I Cheh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366471443 PECOS PAC ID: 9436153061 Enrollment ID: I20060912000667 |
| Provider Name | Cheryce P Fischer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487696134 PECOS PAC ID: 1850204223 Enrollment ID: I20070205000177 |
| Provider Name | Mary Marguerite Marfisee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700829934 PECOS PAC ID: 4789786914 Enrollment ID: I20070219000609 |
| Provider Name | Maitraya K Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932255189 PECOS PAC ID: 8426153388 Enrollment ID: I20070420000476 |
| Provider Name | Benjamin D Levine |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508985565 PECOS PAC ID: 5890894703 Enrollment ID: I20070618000479 |
| Provider Name | Mary Guevarra |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386776144 PECOS PAC ID: 4486754470 Enrollment ID: I20070703000767 |
| Provider Name | John P Livoni |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033200902 PECOS PAC ID: 9032200704 Enrollment ID: I20070809000497 |
| Provider Name | Michael E Fischer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740239060 PECOS PAC ID: 4981797073 Enrollment ID: I20070905000760 |
| Provider Name | Barbara Marion Kadell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891747564 PECOS PAC ID: 3274626932 Enrollment ID: I20070911000664 |
| Provider Name | Robert D Suh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285659748 PECOS PAC ID: 2264528223 Enrollment ID: I20071022000742 |
| Provider Name | Silvio Alan Del Castillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255405825 PECOS PAC ID: 5991777187 Enrollment ID: I20080324000162 |
| Provider Name | Antonio J Gutierrez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396917688 PECOS PAC ID: 6406935287 Enrollment ID: I20080505000717 |
| Provider Name | Jane M Dascalos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710159447 PECOS PAC ID: 1153492400 Enrollment ID: I20080614000058 |
| Provider Name | Bartlomiej Drewniak |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154594240 PECOS PAC ID: 1456428051 Enrollment ID: I20080924000149 |
| Provider Name | Omar S Sahagun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306812805 PECOS PAC ID: 0446351100 Enrollment ID: I20081104000190 |
| Provider Name | Diana Dermendjian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043415383 PECOS PAC ID: 2264591015 Enrollment ID: I20081107000382 |
| Provider Name | Ana Maria Maliglig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134277171 PECOS PAC ID: 4880756527 Enrollment ID: I20081215000467 |
| Provider Name | Patricia Mcdermott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447364872 PECOS PAC ID: 9133281397 Enrollment ID: I20081222000513 |
| Provider Name | Scott Genshaft |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1215189683 PECOS PAC ID: 6507922689 Enrollment ID: I20090226000208 |
| Provider Name | Melissa Joines |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043462369 PECOS PAC ID: 9234296161 Enrollment ID: I20090320000336 |
| Provider Name | Donald Lewis Roback |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467401240 PECOS PAC ID: 5395899140 Enrollment ID: I20090813000612 |
| Provider Name | Theodore Hall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538194840 PECOS PAC ID: 3870647571 Enrollment ID: I20090814000289 |
| Provider Name | Nazanin Yaghmai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629014329 PECOS PAC ID: 9133266398 Enrollment ID: I20091021000492 |
| Provider Name | Shahnaz G Ghahremani-koureh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205169075 PECOS PAC ID: 0446397301 Enrollment ID: I20091026000237 |
| Provider Name | John M Moriarty |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1609009125 PECOS PAC ID: 3375680259 Enrollment ID: I20091026000436 |
| Provider Name | Pauline Wu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457550246 PECOS PAC ID: 4385781913 Enrollment ID: I20091029000767 |
| Provider Name | Agatha H Postman Kuchta |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760638415 PECOS PAC ID: 5193886992 Enrollment ID: I20091113000465 |
| Provider Name | Reza Jahan |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1558304774 PECOS PAC ID: 5294875274 Enrollment ID: I20091223000247 |
| Provider Name | Richard Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366427510 PECOS PAC ID: 8729123419 Enrollment ID: I20100305000369 |
| Provider Name | Robert a Saed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235330119 PECOS PAC ID: 9032248208 Enrollment ID: I20100526000579 |
| Provider Name | Anokh Pahwa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689840944 PECOS PAC ID: 5597895755 Enrollment ID: I20100615000098 |
| Provider Name | Simin Bahrami |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881846582 PECOS PAC ID: 0749310910 Enrollment ID: I20100615000126 |
| Provider Name | Gregory D Saccone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427106384 PECOS PAC ID: 5294866844 Enrollment ID: I20100626000297 |
| Provider Name | Edward W Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215189550 PECOS PAC ID: 1557494226 Enrollment ID: I20100802000284 |
| Provider Name | Katrina R Beckett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356668701 PECOS PAC ID: 7911031679 Enrollment ID: I20100817000365 |
| Provider Name | Anh Trong Nguyen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467642926 PECOS PAC ID: 8729112230 Enrollment ID: I20100819000862 |
| Provider Name | Lori Taylor Serwatka |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891977468 PECOS PAC ID: 3870542871 Enrollment ID: I20100920001153 |
| Provider Name | Aneka J Braxton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558697375 PECOS PAC ID: 4082809884 Enrollment ID: I20101105000794 |
| Provider Name | Dora H So |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700807609 PECOS PAC ID: 3577594084 Enrollment ID: I20101115001157 |
| Provider Name | Sonia Devgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528002839 PECOS PAC ID: 2668494287 Enrollment ID: I20110307000260 |
| Provider Name | Kathleen L Ruchalski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235306077 PECOS PAC ID: 7113101031 Enrollment ID: I20110418000374 |
| Provider Name | Kathleen Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346275237 PECOS PAC ID: 0749466258 Enrollment ID: I20110518000404 |
| Provider Name | Rinat Masamed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518153246 PECOS PAC ID: 3173700044 Enrollment ID: I20110601000258 |
| Provider Name | Kyung-ah Cho Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750617247 PECOS PAC ID: 2668640145 Enrollment ID: I20110728000181 |
| Provider Name | Michael Shye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639469588 PECOS PAC ID: 8628247657 Enrollment ID: I20110809000581 |
| Provider Name | Gulpana M Mohammad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801196605 PECOS PAC ID: 3375712060 Enrollment ID: I20110815000615 |
| Provider Name | Leena J Uranwala |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003195579 PECOS PAC ID: 0547431868 Enrollment ID: I20110919000246 |
| Provider Name | Jonathan Helali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194977744 PECOS PAC ID: 9537331962 Enrollment ID: I20111007000312 |
| Provider Name | Tiffany Sheh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821158635 PECOS PAC ID: 3173790045 Enrollment ID: I20120117000468 |
| Provider Name | Irina Feldman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225305956 PECOS PAC ID: 2466619499 Enrollment ID: I20120202000841 |
| Provider Name | Norman H Solomon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356401178 PECOS PAC ID: 4284893231 Enrollment ID: I20120309000593 |
| Provider Name | Sandra Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720002512 PECOS PAC ID: 3971518192 Enrollment ID: I20120417000332 |
| Provider Name | Raymond Shing |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952668923 PECOS PAC ID: 6901069962 Enrollment ID: I20120531000602 |
| Provider Name | Paul J Iskander |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114183829 PECOS PAC ID: 8426212317 Enrollment ID: I20120605000335 |
| Provider Name | Adam Plotnik |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558621078 PECOS PAC ID: 8921263005 Enrollment ID: I20120625000226 |
| Provider Name | Bryan Y Yoo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356546899 PECOS PAC ID: 8820253800 Enrollment ID: I20120625000331 |
| Provider Name | Ameera F. F. Ismail |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124238761 PECOS PAC ID: 3173792900 Enrollment ID: I20120628000258 |
| Provider Name | Kevin George King |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225298565 PECOS PAC ID: 9739345026 Enrollment ID: I20120801000470 |
| Provider Name | Cameron Hassani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518261239 PECOS PAC ID: 6406024272 Enrollment ID: I20120803000580 |
| Provider Name | Benjamin E Plotkin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386844694 PECOS PAC ID: 1850569500 Enrollment ID: I20121217000289 |
| Provider Name | Sandra I Vizireanu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205060449 PECOS PAC ID: 1355593393 Enrollment ID: I20121220000208 |
| Provider Name | Ely R Felker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942528468 PECOS PAC ID: 5092968727 Enrollment ID: I20130109000257 |
| Provider Name | Sindy H Wei-mester |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053548115 PECOS PAC ID: 4486892718 Enrollment ID: I20130529000101 |
| Provider Name | Victor F Sai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255593604 PECOS PAC ID: 6103064878 Enrollment ID: I20130608000001 |
| Provider Name | Sumit Dua |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740437441 PECOS PAC ID: 0648418319 Enrollment ID: I20130608000010 |
| Provider Name | Justin a Dye |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1629212535 PECOS PAC ID: 9335387000 Enrollment ID: I20130608000064 |
| Provider Name | Jordan Anaokar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386893055 PECOS PAC ID: 2961641667 Enrollment ID: I20130610000211 |
| Provider Name | Nooshin Yashar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508109869 PECOS PAC ID: 0244464691 Enrollment ID: I20131018000134 |
| Provider Name | Mairead J Torsney-weir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669607511 PECOS PAC ID: 7719142868 Enrollment ID: I20131028000718 |
| Provider Name | Sharon Kim Macaluso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174964894 PECOS PAC ID: 4284869728 Enrollment ID: I20131108000915 |
| Provider Name | Manuel Mendoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952627184 PECOS PAC ID: 8820224942 Enrollment ID: I20131120001040 |
| Provider Name | Viktor Szeder |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1174609036 PECOS PAC ID: 6406922277 Enrollment ID: I20131125000051 |
| Provider Name | Rachelle D Padilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215210083 PECOS PAC ID: 1153559398 Enrollment ID: I20140114001168 |
| Provider Name | Mari Stephanie Machi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730407438 PECOS PAC ID: 3779711759 Enrollment ID: I20140121000950 |
| Provider Name | May Nour |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366679508 PECOS PAC ID: 8820227382 Enrollment ID: I20140203000147 |
| Provider Name | Robert Kozlowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013178102 PECOS PAC ID: 2668635335 Enrollment ID: I20140410001829 |
| Provider Name | Jennifer Heller-juarez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164640777 PECOS PAC ID: 4789808403 Enrollment ID: I20140618001843 |
| Provider Name | Walter Jong |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689092397 PECOS PAC ID: 2365666856 Enrollment ID: I20140625000105 |
| Provider Name | Banafsheh Salehi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629210653 PECOS PAC ID: 5991920845 Enrollment ID: I20140708002562 |
| Provider Name | Kirsten F Anthony |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457771966 PECOS PAC ID: 8224254339 Enrollment ID: I20140725001920 |
| Provider Name | Ashley Elizabeth Prosper |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932534492 PECOS PAC ID: 9931326931 Enrollment ID: I20140815000444 |
| Provider Name | Jordan Scott Gross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902032931 PECOS PAC ID: 1850519083 Enrollment ID: I20140828002536 |
| Provider Name | Melissa Louise Howard |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558772475 PECOS PAC ID: 3971722778 Enrollment ID: I20140909002269 |
| Provider Name | Betty Chen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063843969 PECOS PAC ID: 8022239870 Enrollment ID: I20141021001694 |
| Provider Name | Reuben Ram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275809691 PECOS PAC ID: 6406078252 Enrollment ID: I20141111000077 |
| Provider Name | Sharis Saketkhoo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013168400 PECOS PAC ID: 6002138070 Enrollment ID: I20141202000520 |
| Provider Name | Ashmeeta Praful Kapadia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538474093 PECOS PAC ID: 6204062185 Enrollment ID: I20150310002523 |
| Provider Name | Matthew T Quirk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528324522 PECOS PAC ID: 5597086009 Enrollment ID: I20150609003099 |
| Provider Name | Neema Jamshidi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275853434 PECOS PAC ID: 4688995921 Enrollment ID: I20150611001746 |
| Provider Name | Avetis Azizyan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336452184 PECOS PAC ID: 0840511192 Enrollment ID: I20150611001832 |
| Provider Name | Lila T Pourzand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942539853 PECOS PAC ID: 7810213899 Enrollment ID: I20150611002910 |
| Provider Name | Daniel Pourshalimi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215295662 PECOS PAC ID: 3375858996 Enrollment ID: I20150811005808 |
| Provider Name | Tejas Chandrakant Manchandia |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619242898 PECOS PAC ID: 4486960432 Enrollment ID: I20150904001793 |
| Provider Name | Truyen Dang Saxonberg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033350178 PECOS PAC ID: 8820305626 Enrollment ID: I20150910002071 |
| Provider Name | Patrick Yaffee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144587676 PECOS PAC ID: 0547577967 Enrollment ID: I20150917002096 |
| Provider Name | Sagir G Bera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033406574 PECOS PAC ID: 7911126735 Enrollment ID: I20151016000884 |
| Provider Name | Su Hutchinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972757219 PECOS PAC ID: 2264609494 Enrollment ID: I20151102001536 |
| Provider Name | Ashley R Mcleish |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881028595 PECOS PAC ID: 2062647068 Enrollment ID: I20151116001121 |
| Provider Name | Jason Fong Gi Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164786042 PECOS PAC ID: 4587960513 Enrollment ID: I20160316002653 |
| Provider Name | Johnathan Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669798443 PECOS PAC ID: 5597983916 Enrollment ID: I20160404000908 |
| Provider Name | Lucy Chow |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538402870 PECOS PAC ID: 4981993201 Enrollment ID: I20160510000781 |
| Provider Name | Arash Bedayat |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801182621 PECOS PAC ID: 0143528075 Enrollment ID: I20160511002652 |
| Provider Name | Jay Acharya |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871995498 PECOS PAC ID: 1951691831 Enrollment ID: I20160606001067 |
| Provider Name | Donald Y Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558651885 PECOS PAC ID: 2860782661 Enrollment ID: I20160607001969 |
| Provider Name | Milos M Cekic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609136258 PECOS PAC ID: 7911290960 Enrollment ID: I20160728000087 |
| Provider Name | Haatal Dave Macer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023309424 PECOS PAC ID: 7315230141 Enrollment ID: I20160801001311 |
| Provider Name | Roy Bryan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396021648 PECOS PAC ID: 7113171240 Enrollment ID: I20160826001633 |
| Provider Name | Richard R Cooke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740320670 PECOS PAC ID: 5294835781 Enrollment ID: I20160930001087 |
| Provider Name | Meri Antossyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457738460 PECOS PAC ID: 4082902192 Enrollment ID: I20161005001389 |
| Provider Name | Siddharth Ashok Padia |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1952578254 PECOS PAC ID: 7719031616 Enrollment ID: I20161206000863 |
| Provider Name | Roya Marzieh Nasseri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265695688 PECOS PAC ID: 9133272057 Enrollment ID: I20170207001619 |
| Provider Name | Tiane Marie Mendoza |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871032730 PECOS PAC ID: 9931483500 Enrollment ID: I20170227000718 |
| Provider Name | James Arthur Waters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205295243 PECOS PAC ID: 0042599755 Enrollment ID: I20170327001543 |
| Provider Name | Aarti Patil Luhar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477848471 PECOS PAC ID: 5698044964 Enrollment ID: I20170629000701 |
| Provider Name | Frank Hao |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1346508827 PECOS PAC ID: 5092084624 Enrollment ID: I20170712003923 |
| Provider Name | Reno Giovonni Terribilini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821402033 PECOS PAC ID: 1254558174 Enrollment ID: I20170720002059 |
| Provider Name | Amir Kasra Iranmahboob |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992063358 PECOS PAC ID: 2668742636 Enrollment ID: I20170724003709 |
| Provider Name | Navid Darouian |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487064564 PECOS PAC ID: 8729351218 Enrollment ID: I20170905002399 |
| Provider Name | Sarah Pacheco Beaty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609235423 PECOS PAC ID: 6800183484 Enrollment ID: I20171019001102 |
| Provider Name | Helen Chioma Okoh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396142956 PECOS PAC ID: 8820364144 Enrollment ID: I20171031002508 |
| Provider Name | Salim Feizal Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851772214 PECOS PAC ID: 9133488737 Enrollment ID: I20180104001086 |
| Provider Name | Moira Rashid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578900767 PECOS PAC ID: 7810284478 Enrollment ID: I20180214002800 |
| Provider Name | Mollie Ann Rashid |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588078968 PECOS PAC ID: 5991060451 Enrollment ID: I20180604001731 |
| Provider Name | Rohit Dewan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871859504 PECOS PAC ID: 9739450362 Enrollment ID: I20180605002640 |
| Provider Name | Nina M Capiro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770979239 PECOS PAC ID: 5597020826 Enrollment ID: I20180607000942 |
| Provider Name | Tiffany L Chan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457796518 PECOS PAC ID: 7517222854 Enrollment ID: I20180607001245 |
| Provider Name | Ravi N Srinivasa |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1134333768 PECOS PAC ID: 1456507664 Enrollment ID: I20180607002427 |
| Provider Name | Saurabh Gupta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952746802 PECOS PAC ID: 4486894110 Enrollment ID: I20180611002938 |
| Provider Name | Nathaniel David Moradzadeh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922341049 PECOS PAC ID: 6204182629 Enrollment ID: I20180627001889 |
| Provider Name | Varand Ghazikhanian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578759395 PECOS PAC ID: 1254519697 Enrollment ID: I20180628003583 |
| Provider Name | Michael J Kessler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831535061 PECOS PAC ID: 5193020360 Enrollment ID: I20180629001852 |
| Provider Name | Phillip Charles Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841687860 PECOS PAC ID: 2163778010 Enrollment ID: I20180706000879 |
| Provider Name | David Rigual |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1588907604 PECOS PAC ID: 2860719473 Enrollment ID: I20180730000894 |
| Provider Name | Mariya Nercessian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801282744 PECOS PAC ID: 0143574699 Enrollment ID: I20181119003232 |
| Provider Name | Hannah S Milch |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1043573140 PECOS PAC ID: 3173898087 Enrollment ID: I20181120001397 |
| Provider Name | Alanna Chig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821531948 PECOS PAC ID: 5991049843 Enrollment ID: I20181203002932 |
| Provider Name | Sean D Delshad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265894257 PECOS PAC ID: 6608120787 Enrollment ID: I20190411001696 |
| Provider Name | Bagrat Mkrtchyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013398916 PECOS PAC ID: 3870835846 Enrollment ID: I20190424000582 |
| Provider Name | Julie Urrunaga |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184764078 PECOS PAC ID: 1456693696 Enrollment ID: I20190508001950 |
| Provider Name | Daniel Sean Bradley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457700767 PECOS PAC ID: 0244522837 Enrollment ID: I20190603000985 |
| Provider Name | Alex Chung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982068284 PECOS PAC ID: 4385977578 Enrollment ID: I20190603001323 |
| Provider Name | Zachary Mark Haber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922461862 PECOS PAC ID: 6406189455 Enrollment ID: I20190606002727 |
| Provider Name | Holly Dieu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184155285 PECOS PAC ID: 5597090506 Enrollment ID: I20190712002650 |
| Provider Name | Daniel Demirchyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740639046 PECOS PAC ID: 6002142924 Enrollment ID: I20190730001544 |
| Provider Name | Bonny Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255750568 PECOS PAC ID: 6901134089 Enrollment ID: I20190828000189 |
| Provider Name | James S Chalfant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447679105 PECOS PAC ID: 6800136094 Enrollment ID: I20190925001895 |
| Provider Name | Eddy Ang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508158197 PECOS PAC ID: 5092947580 Enrollment ID: I20191008000716 |
| Provider Name | Isaac Sinai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669823860 PECOS PAC ID: 4789916792 Enrollment ID: I20191024000724 |
| Provider Name | Victoria Belle Yea Ri Shin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063837631 PECOS PAC ID: 1456683812 Enrollment ID: I20191105000037 |
| Provider Name | Ingrid Maria Payton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619526704 PECOS PAC ID: 7214369602 Enrollment ID: I20191125000951 |
| Provider Name | Fatemeh Abdollahi Mofakham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659652915 PECOS PAC ID: 4587963400 Enrollment ID: I20200213000840 |
| Provider Name | Ellen Leon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871132258 PECOS PAC ID: 2961833462 Enrollment ID: I20200518001730 |
| Provider Name | Jena Nicole Depetris |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962889063 PECOS PAC ID: 6305144452 Enrollment ID: I20200522001543 |
| Provider Name | Kim Mccray Carnazzola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629093083 PECOS PAC ID: 8426152638 Enrollment ID: I20200603001052 |
| Provider Name | Timothy William Iafe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508251422 PECOS PAC ID: 8921362856 Enrollment ID: I20200615002165 |
| Provider Name | Jasmin Awadeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346777646 PECOS PAC ID: 8022430933 Enrollment ID: I20200623001953 |
| Provider Name | Michael Chinazo Opene |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851827471 PECOS PAC ID: 8527480136 Enrollment ID: I20200626000240 |
| Provider Name | June Renee Santiano Lee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164038717 PECOS PAC ID: 6608296728 Enrollment ID: I20201012001277 |
| Provider Name | Meagan Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568818227 PECOS PAC ID: 3779858352 Enrollment ID: I20201023000863 |
| Provider Name | Feliks Avanesyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699295758 PECOS PAC ID: 0446520894 Enrollment ID: I20201029001808 |
| Provider Name | Abraham Yi |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932716909 PECOS PAC ID: 9234549619 Enrollment ID: I20201113002461 |
| Provider Name | Irene Riley Sung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720514185 PECOS PAC ID: 7810309143 Enrollment ID: I20201210001452 |
| Provider Name | Naoki Kaneko |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1306435805 PECOS PAC ID: 8426464231 Enrollment ID: I20210302002753 |
| Provider Name | Jessica Stewart |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1932487964 PECOS PAC ID: 0345514774 Enrollment ID: I20210303001017 |
| Provider Name | Olivia E Linden |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801250089 PECOS PAC ID: 5890086342 Enrollment ID: I20210325002684 |
| Provider Name | Chih-sheng Jason Chiang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295198638 PECOS PAC ID: 7618269572 Enrollment ID: I20210514000735 |
| Provider Name | Clara Rachel Lyashevsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962922690 PECOS PAC ID: 0840602777 Enrollment ID: I20210808000001 |
| Provider Name | Mandana Hodjati |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568763050 PECOS PAC ID: 4082897632 Enrollment ID: I20210811001710 |
| Provider Name | Isabel Bedoyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104306570 PECOS PAC ID: 6709281819 Enrollment ID: I20210826002246 |
| Provider Name | Shelly Prasad Chawla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447664636 PECOS PAC ID: 8628347523 Enrollment ID: I20211013002451 |
| Provider Name | Shirin Aghazadeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457842866 PECOS PAC ID: 4880093376 Enrollment ID: I20211104002222 |
| Provider Name | Peter Ming Zhang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821521972 PECOS PAC ID: 2961891312 Enrollment ID: I20211105001532 |
| Provider Name | Adrian V Go |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871264796 PECOS PAC ID: 4082003140 Enrollment ID: I20211110001734 |
| Provider Name | Ceylan Zeynep Cankurtaran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508064619 PECOS PAC ID: 7214105949 Enrollment ID: I20211201002372 |
| Provider Name | Ingrid Yinghong He |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760918155 PECOS PAC ID: 8022401975 Enrollment ID: I20220217000450 |
| Provider Name | Kylie Nicole Stoeppel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730844762 PECOS PAC ID: 5991191975 Enrollment ID: I20220330001798 |
| Provider Name | Andrea Sungjee Oh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740417765 PECOS PAC ID: 6305098484 Enrollment ID: I20220406001317 |
| Provider Name | Louie Humberto Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558823625 PECOS PAC ID: 2365839420 Enrollment ID: I20220420002286 |
| Provider Name | Stephen Shutian Cai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316471626 PECOS PAC ID: 7012264872 Enrollment ID: I20220523001090 |
| Provider Name | Jeremy Joseph Middleton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649771056 PECOS PAC ID: 9931587789 Enrollment ID: I20220607000971 |
| Provider Name | Nooshin Najmi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174985386 PECOS PAC ID: 5395123079 Enrollment ID: I20220608002482 |
| Provider Name | Tyler Joseph Sevco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790210961 PECOS PAC ID: 7416226204 Enrollment ID: I20220613001351 |
| Provider Name | Lucas R Cusumano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619408242 PECOS PAC ID: 4284037862 Enrollment ID: I20220613001373 |
| Provider Name | Joshua Kingsley Sweigert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295265239 PECOS PAC ID: 0547640195 Enrollment ID: I20220629001978 |
| Provider Name | Shenise Nicole Gilyard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922528108 PECOS PAC ID: 8527331644 Enrollment ID: I20220629003088 |
| Provider Name | Alex John-young Hu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104291632 PECOS PAC ID: 7719368117 Enrollment ID: I20220716000437 |
| Provider Name | Shahdee Zarini |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205399987 PECOS PAC ID: 2961737952 Enrollment ID: I20220729001744 |
| Provider Name | Alice Soojung Ha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699824771 PECOS PAC ID: 8224109137 Enrollment ID: I20220729002581 |
| Provider Name | Kevin Wesley Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770044174 PECOS PAC ID: 4486989522 Enrollment ID: I20220802000622 |
| Provider Name | Wade Kendrick Castro Licup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881157998 PECOS PAC ID: 2163805292 Enrollment ID: I20220822003202 |
| Provider Name | Wilmer Ernesto Garcia Ricardo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205496239 PECOS PAC ID: 8224419932 Enrollment ID: I20220825001632 |
| Provider Name | Soheil Kooraki |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124637087 PECOS PAC ID: 8426432006 Enrollment ID: I20220831000775 |
| Provider Name | Ardalan Tangestanipoor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427538057 PECOS PAC ID: 7719361054 Enrollment ID: I20220906000157 |
| Provider Name | David Shen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942781315 PECOS PAC ID: 8820472996 Enrollment ID: I20220908003349 |
| Provider Name | Kosha Doshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588124903 PECOS PAC ID: 3870979552 Enrollment ID: I20221004000825 |
| Provider Name | Young Soo Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407318587 PECOS PAC ID: 4880920966 Enrollment ID: I20230221001344 |
| Provider Name | Lea Azour |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790076941 PECOS PAC ID: 2365724994 Enrollment ID: I20230308000524 |
| Provider Name | James Daffin Senechal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780662106 PECOS PAC ID: 1153567219 Enrollment ID: I20230412002203 |
| Provider Name | Erika Denise Romero-gutierrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013572932 PECOS PAC ID: 1456726967 Enrollment ID: I20230417000267 |
| Provider Name | Tiffany Tse Yu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629573019 PECOS PAC ID: 3072979939 Enrollment ID: I20230518001550 |
| Provider Name | James Zhe Hui |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1023542099 PECOS PAC ID: 9638535495 Enrollment ID: I20230519002773 |
| Provider Name | Iris Ejune Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366946444 PECOS PAC ID: 4981061033 Enrollment ID: I20230605001077 |
| Provider Name | Ahmed Abbas Ashary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124641907 PECOS PAC ID: 6103285911 Enrollment ID: I20230711001799 |
| Provider Name | Layla Nina Farrahi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134742604 PECOS PAC ID: 7810353869 Enrollment ID: I20230801003830 |
| Provider Name | Sona Hurtz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831727759 PECOS PAC ID: 1456713528 Enrollment ID: I20230822001592 |
| Provider Name | Frederick Isaac Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245868298 PECOS PAC ID: 5890158596 Enrollment ID: I20230829001166 |
| Provider Name | Ryan Yavorsky |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720549850 PECOS PAC ID: 3870828155 Enrollment ID: I20231024001842 |
| Provider Name | Sarah Yang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548752033 PECOS PAC ID: 7315394350 Enrollment ID: I20231113001323 |
| Provider Name | Navpreet Singh Badesha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225698624 PECOS PAC ID: 8325373822 Enrollment ID: I20231117000757 |
| Provider Name | Niyati Vijay Vaidya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427430990 PECOS PAC ID: 8729478706 Enrollment ID: I20231219003849 |
| Provider Name | Meray Malena Ohanessian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114459807 PECOS PAC ID: 1850667643 Enrollment ID: I20240503000169 |
| Provider Name | Catherine Ann Mcnulty |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902367634 PECOS PAC ID: 8628419058 Enrollment ID: I20240515003639 |
| Provider Name | Lucien Anthony Rizzo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992366579 PECOS PAC ID: 3173958246 Enrollment ID: I20240517001409 |
| Provider Name | Sumana Dasari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114488210 PECOS PAC ID: 5395186530 Enrollment ID: I20240517003558 |
| Provider Name | Sara Mozayan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093277980 PECOS PAC ID: 1254669021 Enrollment ID: I20240520001055 |
| Provider Name | Nefize Turan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073008306 PECOS PAC ID: 5597107714 Enrollment ID: I20240520002735 |
| Provider Name | Chukwuemeka John Okafor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285197905 PECOS PAC ID: 4486096625 Enrollment ID: I20240520003342 |
| Provider Name | Rizwan Mohiuddin Zafer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346700382 PECOS PAC ID: 1951726165 Enrollment ID: I20240617003995 |
| Provider Name | Edward King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114505542 PECOS PAC ID: 3476096520 Enrollment ID: I20240618002357 |
| Provider Name | Anisha Sunil Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831772870 PECOS PAC ID: 6800149220 Enrollment ID: I20240718001525 |
| Provider Name | Haris Ali Rana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235719139 PECOS PAC ID: 7719423391 Enrollment ID: I20240718003604 |
| Provider Name | Dana Hong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982276341 PECOS PAC ID: 1557808482 Enrollment ID: I20240808003210 |
| Provider Name | Paula Celine Trepman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922561018 PECOS PAC ID: 2365773181 Enrollment ID: I20240808004480 |
| Provider Name | Kirin Brittany Escher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366028789 PECOS PAC ID: 5799224457 Enrollment ID: I20240826001976 |
| Provider Name | Arye Meir Lavin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730766239 PECOS PAC ID: 7911306352 Enrollment ID: I20250211000292 |
| Provider Name | Edmond Abdou |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386225316 PECOS PAC ID: 6406377407 Enrollment ID: I20250306002393 |
| Provider Name | Taylin Eun-hae Im |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588229710 PECOS PAC ID: 9234515701 Enrollment ID: I20250520004119 |
| Provider Name | Mckenna Borras |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003500711 PECOS PAC ID: 0244740868 Enrollment ID: I20250611002844 |
| Provider Name | Talin Nazarian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821730300 PECOS PAC ID: 0648646174 Enrollment ID: I20250616003298 |
| Provider Name | Linha Mazin Mohammed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528644556 PECOS PAC ID: 4981044492 Enrollment ID: I20250617001928 |
| Provider Name | Jack Szuwei Chen |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1922685924 PECOS PAC ID: 5395147763 Enrollment ID: I20250714002379 |
| Provider Name | Sasha Haddad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558010108 PECOS PAC ID: 0143736025 Enrollment ID: I20250718000480 |
| Provider Name | Yosef Yasmeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427794403 PECOS PAC ID: 8224490834 Enrollment ID: I20250721002486 |
| Provider Name | Taylor Amiel Attar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063049732 PECOS PAC ID: 1254753155 Enrollment ID: I20250724000908 |
| Provider Name | Jesse Kao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376121145 PECOS PAC ID: 1658871041 Enrollment ID: I20250820004781 |
| Provider Name | Katherine Hobbs Zeigler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740815729 PECOS PAC ID: 8921468695 Enrollment ID: I20251113002172 |
Silva Karchikian M D Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 Arden Ave, Suite 101, Glendale, CA 91203 Phone: 818-549-9305 Fax: 818-662-8812 |
Glendale Premier Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 W Eulalia St, #201, Glendale, CA 91204 Phone: 818-240-0601 Fax: 818-240-0687 |
Glenoaks Urgent Care Medical Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1100 W Glenoaks Blvd, Glendale, CA 91202 Phone: 818-242-3333 Fax: 818-546-1056 |
Rubin Manavi, MD, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 N Central Ave, Glendale, CA 91203 Phone: 818-241-0970 Fax: 818-638-0024 |
Armen Nercessian DO Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1139 N Brand Blvd Ste C, Glendale, CA 91202 Phone: 818-552-2011 Fax: 818-552-2012 |
Wound Care Solutions of California Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1800 S Brand Blvd Ste 119, Glendale, CA 91204 Phone: 818-206-5141 |