| Venice Family Clinic | |
|
604 Rose Ave Venice CA 90291-2767 | |
| (310) 392-8636 | |
| Not Available |
| Full Name | Venice Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 604 Rose Ave, Venice, California |
| Authorized Official Name and Position | Mitesh G Popat (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3106647901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Venice Family Clinic 604 Rose Ave Venice CA 90291-2767 Ph: (310) 392-8636 | Venice Family Clinic 604 Rose Ave Venice CA 90291-2767 Ph: (310) 392-8636 |
| NPI Number | 1669418513 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 09/11/2023 |
| Medicare PECOS PAC ID | 2264339126 |
|---|---|
| Medicare Enrollment ID | O20031217001082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669418513 | NPI | - | NPPES |
| Provider Name | Charles C Huynh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841225885 PECOS PAC ID: 5395647671 Enrollment ID: I20040126000861 |
| Provider Name | Margarita Loeza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407967763 PECOS PAC ID: 2567357270 Enrollment ID: I20040219001033 |
| Provider Name | Blanca Andres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477664852 PECOS PAC ID: 5193610889 Enrollment ID: I20040220000544 |
| Provider Name | Coley M King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215038856 PECOS PAC ID: 7315936507 Enrollment ID: I20040511001804 |
| Provider Name | Benjamin M Shapiro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356447460 PECOS PAC ID: 3971584418 Enrollment ID: I20040528001014 |
| Provider Name | Carol R Schwartz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477665248 PECOS PAC ID: 1557345949 Enrollment ID: I20040614001716 |
| Provider Name | Karen C Lamp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548371172 PECOS PAC ID: 6507840840 Enrollment ID: I20040615001060 |
| Provider Name | Myles Spar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013028307 PECOS PAC ID: 3072597327 Enrollment ID: I20040615001149 |
| Provider Name | William Jay Resnick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134133879 PECOS PAC ID: 8426023151 Enrollment ID: I20040826001463 |
| Provider Name | Edgard S Artiga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942312970 PECOS PAC ID: 4587628953 Enrollment ID: I20041116000202 |
| Provider Name | Mary H Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649373200 PECOS PAC ID: 1850341249 Enrollment ID: I20050124000754 |
| Provider Name | Despina G Kayichian |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972614493 PECOS PAC ID: 7618996638 Enrollment ID: I20051117001066 |
| Provider Name | John A Roohan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245274125 PECOS PAC ID: 3971502089 Enrollment ID: I20061218000315 |
| Provider Name | Karen W Jenne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760588412 PECOS PAC ID: 1850392754 Enrollment ID: I20070119000270 |
| Provider Name | Beverly A Karpman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033278841 PECOS PAC ID: 4981707882 Enrollment ID: I20070314000320 |
| Provider Name | Goli Mirzaie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114116647 PECOS PAC ID: 7214001643 Enrollment ID: I20080804000354 |
| Provider Name | Elisabeth Cederblom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144301177 PECOS PAC ID: 6103986567 Enrollment ID: I20081115000198 |
| Provider Name | Athanasia N Kakoyannis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982895371 PECOS PAC ID: 6204963671 Enrollment ID: I20100416000673 |
| Provider Name | Tarin Molly Koehler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518163013 PECOS PAC ID: 4981735214 Enrollment ID: I20100629000955 |
| Provider Name | Ginny Tal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710207659 PECOS PAC ID: 2264624485 Enrollment ID: I20101006000981 |
| Provider Name | Anjali Mahoney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851553564 PECOS PAC ID: 1759570351 Enrollment ID: I20110113000299 |
| Provider Name | Rian Rutherford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447477500 PECOS PAC ID: 9234213323 Enrollment ID: I20110218000044 |
| Provider Name | Lili C Orellana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700182680 PECOS PAC ID: 5193901445 Enrollment ID: I20110520000402 |
| Provider Name | Kurene Tima Ma'o |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922103860 PECOS PAC ID: 9931375250 Enrollment ID: I20120106000761 |
| Provider Name | Nancy M Pierre-paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518127869 PECOS PAC ID: 6305006818 Enrollment ID: I20120320000970 |
| Provider Name | Yasaman Omidvar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235366584 PECOS PAC ID: 5193986115 Enrollment ID: I20120418000192 |
| Provider Name | Cambria L Garell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982831376 PECOS PAC ID: 1052574985 Enrollment ID: I20120511000566 |
| Provider Name | Yeymi W De Leon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831320852 PECOS PAC ID: 9133376189 Enrollment ID: I20120827000051 |
| Provider Name | Anika A Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629396213 PECOS PAC ID: 9537316013 Enrollment ID: I20120906000456 |
| Provider Name | Jacqueline N Marston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417205055 PECOS PAC ID: 3375792625 Enrollment ID: I20121003000019 |
| Provider Name | Gilmore S Chung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992027072 PECOS PAC ID: 2961653472 Enrollment ID: I20121109000465 |
| Provider Name | Michelle I Aguilar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992021810 PECOS PAC ID: 3678710704 Enrollment ID: I20130509000483 |
| Provider Name | Christopher J Nochez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285867846 PECOS PAC ID: 6901040112 Enrollment ID: I20130909000799 |
| Provider Name | Ligaya Joy L Scarlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588098594 PECOS PAC ID: 4183850795 Enrollment ID: I20131203001326 |
| Provider Name | Diana E Hoffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144451345 PECOS PAC ID: 5597993675 Enrollment ID: I20140117000656 |
| Provider Name | Alma D Guerrero |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619997871 PECOS PAC ID: 7012911191 Enrollment ID: I20140308000003 |
| Provider Name | Phoebe Shinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952464133 PECOS PAC ID: 2365510161 Enrollment ID: I20140521000331 |
| Provider Name | Nicole Fanelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306942719 PECOS PAC ID: 7719101096 Enrollment ID: I20140605001690 |
| Provider Name | Maria J Enriquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770868549 PECOS PAC ID: 2860619525 Enrollment ID: I20140804002487 |
| Provider Name | Samantha A Stewart |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588655047 PECOS PAC ID: 5395844294 Enrollment ID: I20140821000570 |
| Provider Name | Jessica A Stroik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275820631 PECOS PAC ID: 5698995256 Enrollment ID: I20141002000005 |
| Provider Name | Laura Hassen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164850020 PECOS PAC ID: 7719109826 Enrollment ID: I20141105000609 |
| Provider Name | Suzanne E Parra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215123112 PECOS PAC ID: 4385967785 Enrollment ID: I20141216000099 |
| Provider Name | Heba K Elzawahry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356507990 PECOS PAC ID: 3971631516 Enrollment ID: I20150128001232 |
| Provider Name | Patricia E Alba |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518097765 PECOS PAC ID: 0648595314 Enrollment ID: I20150223000029 |
| Provider Name | David J Solomon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366680464 PECOS PAC ID: 6507042967 Enrollment ID: I20150310000021 |
| Provider Name | Stephanie T Do |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649533555 PECOS PAC ID: 3678890647 Enrollment ID: I20150401000300 |
| Provider Name | Ebony N Funches |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639569247 PECOS PAC ID: 3971805847 Enrollment ID: I20160108001769 |
| Provider Name | David H Bolour |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326308495 PECOS PAC ID: 8820391469 Enrollment ID: I20160114002131 |
| Provider Name | Bridget M Kelleher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245695006 PECOS PAC ID: 2163714692 Enrollment ID: I20160701001295 |
| Provider Name | Janet Chaidez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588027932 PECOS PAC ID: 2567759913 Enrollment ID: I20160928001515 |
| Provider Name | Danielle S Sinkford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265808547 PECOS PAC ID: 7012204472 Enrollment ID: I20160928001853 |
| Provider Name | Lauren Wu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265757108 PECOS PAC ID: 9931497336 Enrollment ID: I20161018002797 |
| Provider Name | Kimberly Grueneisen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992148126 PECOS PAC ID: 2668799362 Enrollment ID: I20170203000524 |
| Provider Name | Gabriella O Oloye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013376029 PECOS PAC ID: 4183907272 Enrollment ID: I20170215003147 |
| Provider Name | Tobin Shelton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962898981 PECOS PAC ID: 4486931805 Enrollment ID: I20170511001703 |
| Provider Name | Jennifer L Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255745980 PECOS PAC ID: 5991071839 Enrollment ID: I20171020002938 |
| Provider Name | Iliniza Baty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508983321 PECOS PAC ID: 1759640543 Enrollment ID: I20180124002895 |
| Provider Name | Skyler S Galindo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730446808 PECOS PAC ID: 5597045393 Enrollment ID: I20180420001040 |
| Provider Name | Natalie E Mckenna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467854513 PECOS PAC ID: 6901161389 Enrollment ID: I20180606001409 |
| Provider Name | Maria Auxiliadora Jarquin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144436205 PECOS PAC ID: 2567749930 Enrollment ID: I20180921002248 |
| Provider Name | Jennifer Amaya Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043610553 PECOS PAC ID: 1759625411 Enrollment ID: I20181206001470 |
| Provider Name | Lilian E Ore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861885196 PECOS PAC ID: 0244543353 Enrollment ID: I20181213003185 |
| Provider Name | Nadia M El Fakih |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942751623 PECOS PAC ID: 7113266644 Enrollment ID: I20190228000825 |
| Provider Name | Monte Coleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366730855 PECOS PAC ID: 5193066769 Enrollment ID: I20190408002631 |
| Provider Name | Krystin Marie Conroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811491301 PECOS PAC ID: 4981946944 Enrollment ID: I20190424000489 |
| Provider Name | Yasmin Safdie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205133428 PECOS PAC ID: 6608131099 Enrollment ID: I20190522000927 |
| Provider Name | Fanta Michelle Bayoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427555218 PECOS PAC ID: 7113275892 Enrollment ID: I20191017001875 |
| Provider Name | Keith A Simon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821069311 PECOS PAC ID: 7719319532 Enrollment ID: I20191118000673 |
| Provider Name | Mimie H Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578926986 PECOS PAC ID: 8628403284 Enrollment ID: I20200124002503 |
| Provider Name | Victor L Mleczko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851741896 PECOS PAC ID: 6901167386 Enrollment ID: I20200127000302 |
| Provider Name | John E Singidas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760020408 PECOS PAC ID: 9234565854 Enrollment ID: I20200130000777 |
| Provider Name | Joanna Burga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245879337 PECOS PAC ID: 7416384565 Enrollment ID: I20200302000798 |
| Provider Name | Miranda P Harwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972909133 PECOS PAC ID: 4082042965 Enrollment ID: I20200309001701 |
| Provider Name | Lovelee E Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326579814 PECOS PAC ID: 4385070507 Enrollment ID: I20200521002443 |
| Provider Name | Alexander Pappas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033596143 PECOS PAC ID: 8123356219 Enrollment ID: I20200911000793 |
| Provider Name | Meagan Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568818227 PECOS PAC ID: 3779858352 Enrollment ID: I20201023000863 |
| Provider Name | Nereida Carrasco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497061428 PECOS PAC ID: 5890102842 Enrollment ID: I20210318002405 |
| Provider Name | Cesar L Barba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699938571 PECOS PAC ID: 5597907329 Enrollment ID: I20210506002571 |
| Provider Name | Adam F Lowy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871505537 PECOS PAC ID: 9234119744 Enrollment ID: I20210510002045 |
| Provider Name | Rohith Mohan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346731080 PECOS PAC ID: 4587064183 Enrollment ID: I20210618002139 |
| Provider Name | Katelyn Hope Anderson Klein |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336600261 PECOS PAC ID: 3870903172 Enrollment ID: I20230918004042 |
| Provider Name | Saya Yusa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346803665 PECOS PAC ID: 2062861453 Enrollment ID: I20231211002070 |
| Provider Name | Lenny Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922449602 PECOS PAC ID: 3678926102 Enrollment ID: I20240131002153 |
| Provider Name | Lisa Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063827343 PECOS PAC ID: 8224330105 Enrollment ID: I20240202002531 |
| Provider Name | Amy Leah Asheroff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770014086 PECOS PAC ID: 7214370949 Enrollment ID: I20240208004071 |
| Provider Name | Veronica Marie Couture |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770792764 PECOS PAC ID: 8123461704 Enrollment ID: I20240212000022 |
| Provider Name | Arturo Barrios Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871120196 PECOS PAC ID: 9133537368 Enrollment ID: I20240215004341 |
| Provider Name | Reina Rufo Amiling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073138020 PECOS PAC ID: 3779959804 Enrollment ID: I20240216002555 |
| Provider Name | Latoya Green-smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962601500 PECOS PAC ID: 6507058088 Enrollment ID: I20240220004103 |
| Provider Name | Pablo Orozco-castro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265813653 PECOS PAC ID: 1052755592 Enrollment ID: I20240222004100 |
| Provider Name | Kelsey Breig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578076055 PECOS PAC ID: 2365709839 Enrollment ID: I20240223003253 |
| Provider Name | Lorna Ocampo-tatel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609071422 PECOS PAC ID: 6608185277 Enrollment ID: I20240304002990 |
| Provider Name | Kimberly Alison Kopp Mcnally |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831474576 PECOS PAC ID: 9032338710 Enrollment ID: I20240304003034 |
| Provider Name | Yoseline Bogna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801202486 PECOS PAC ID: 6901238948 Enrollment ID: I20240406000635 |
| Provider Name | Alba Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487165494 PECOS PAC ID: 5092153064 Enrollment ID: I20240410000573 |
| Provider Name | Dayana Perez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265814198 PECOS PAC ID: 5395183214 Enrollment ID: I20240410002878 |
| Provider Name | Jaspreet Kaur |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1588859375 PECOS PAC ID: 5496195109 Enrollment ID: I20240429001880 |
| Provider Name | Ana Rosa Balarezo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1326598004 PECOS PAC ID: 7618317009 Enrollment ID: I20240502001341 |
| Provider Name | Bertha Janet Menjivar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801171228 PECOS PAC ID: 9537509765 Enrollment ID: I20240503002867 |
| Provider Name | Rita Evazyan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568662617 PECOS PAC ID: 8224570858 Enrollment ID: I20240611000290 |
| Provider Name | Michael Alan Donath |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083125207 PECOS PAC ID: 2961931472 Enrollment ID: I20250129001378 |
Venice Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2469 Lincoln Blvd, Venice, CA 90291 Phone: 310-392-8636 | |
Venice Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Sunset Ave, Venice, CA 90291 Phone: 310-392-8630 | |
El Dorado Community Service Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 717 Lincoln Blvd, Venice, CA 90291 Phone: 310-399-9883 Fax: 310-399-9678 | |
Venice Family Clinic - Venice, Ca Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 622 Rose Ave, Venice, CA 90291 Phone: 310-664-7941 | |
Venice Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 Venice Blvd, Venice, CA 90291 Phone: 310-392-8638 | |
Venice Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 622 Rose Ave, Venice, CA 90291 Phone: 310-392-8636 | |
Venice Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 604 Rose Ave, Venice, CA 90291 Phone: 310-392-8630 |