addendum to/ suplemento al care1st cal mediconnect … · los proveedores y farmacias. ... ii if o...

Please refer to your 2018 Provider & Pharmacy Directory for important plan information, as well as a listing of additional Care1st Cal Mediconnect plan providers and pharmacies. You can also visit care1st.com/ca/calmediconnect or call Care1st Cal MediConnect Member Services at the telephone number below for provider and pharmacy information.

Care1st Cal MediConnect Member Services: 1-855-905-3825(TTY: 711)

From 8:00 a.m. to 8:00 p.m., seven days a week

This addendum is current as of May 2018.

Por favor consulte su Directorio de Proveedores y Farmacias 2018 para información importante sobre su plan, al igual que la lista de proveedores y farmacias adicionales para el plan Care1st Cal MediConnect. También puede visitar care1st.com/ca/calmediconnect o llamar a Servicios para Miembros de Care1st Cal MediConnect al número de teléfono a continuación para información sobre los proveedores y farmacias.

Servicios para Miembros de Care1st Cal MediConnect: 1-855-905-3825(TTY: 711)

De 8:00 a.m. a 8:00 p.m., siete días a la semana

Este suplemento fue actualizado en mayo de 2018.H0148_18_031_PNO_SD_SPA_MAY NMH0148_18_031_PNO_SD_MAY NM

ADDENDUM TO/ SUPLEMENTO ALCARE1ST CAL MEDICONNECT PLAN

Provider & Pharmacy DirectoryDirectorio de Proveedores y Farmacias

COUNTY / CONDADO: SAN DIEGO

ii

If you have questions, please call Care1st Cal MediConnect Plan at 1-855-905-3825 (TTY: 711), seven days a week, 8:00 a.m. – 8:00 p.m. The call is free. For more information, visit www.care1st.com/ca/calmediconnect. Si tiene alguna pregunta, llame a Care1st Cal MediConnect Plan al 1-855-905-3825 (TTY: 711), los siete días de la semana, 8:00 a.m. – 8:00 p.m. La llamada es gratis. Para obtener más información, visite www.care1st.com/ca/calmediconnect.

Table of ContentsIndice

LIST OF NETWORK PROVIDERS ��1

LISTA DE PROVEEDORES DE LA RED ��1

Community Care IPA ...............................................................................................................1

Family Health Centers of San Diego .......................................................................................2

IHP-Borrego Medical Group .................................................................................................. 18

IHP-Community Health System ............................................................................................31

IHP-Imperial Beach Health Center .........................................................................................43

IHP-North County Health Services ........................................................................................55

IHP-San Diego American Indian Health .................................................................................72

IHP-San Diego Family Care ...................................................................................................84

IHP-San Ysidro Health Center ................................................................................................98

IHP-St Vincent De Paul Villa ..................................................................................................114

IHP-St Vincent de Paul Village ..............................................................................................115

IHP-Vista Community Clinic ................................................................................................ 128

La Maestra Family Clinic ..................................................................................................... 141

Mercy Physicians Medical Group ........................................................................................ 154

Operation Samahan ............................................................................................................ 157

Sharp Community Medical Group ....................................................................................... 169

INDEX/ ÍNDICE �� 170

(*)NP: Nurse Practitioners PA: Physician’s Assistant CNM: Certified Nurse Midwives CNS: Certified Nursing SpecialistAccessibility Code Explanations: “SR” This information is self reported by the provider. Care1st has not verified this information. The presence of the following codes indicate the provider location is accessible with this area. P:Parking EB: Exterior Building IB: Interior Building E: Exam Room R: Restroom T: Exam Table/Scale W: Wheelchair ME: Medical Equipment PTA: Public transportation accessible within half a mile of the provider facility.Cultural Competency: CC : Cultural Competency reported NR: Cultural Competency not reported Interpreting services are available for all providers through Care1st at no cost. An advance notice is needed for face-to- faceand ASL interpreting services. To request services, contact Care1st Cal MediConnect Plan Member Services. If you havequestions, please call Care1st Cal MediConnect Plan at 1-855- 905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days aweek. The call is free. For more information, visit www.care1st.com/ca/calmediconnect. This list is subject to change

1

SAN DIEGO COUNTY PROVIDERSCOMMUNITY CARE IPA

PRIMARY CARE PROVIDERS

INTERNAL MEDICINE

LA MESA

91942

Prabaker, Venugopal MD 7339 El Cajon Blvd Ste I La Mesa, CA 91942 6196980606 www.communitycareipa.com Provider ID: 123698 License: A42653 Accepting New Members: No Hours: M-F 9AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER


2

SAN DIEGO COUNTY PROVIDERSFAMILY HEALTH CENTERS OF SAN DIEGO


CERTIFIED NURSE PRACTITIONER

CHULA VISTA

91911

Soto, Robin J NP* 352 L St Chula Vista, CA 91911 (619) 515-2300 www.fhcsd.org Provider ID: 73137 License: NP11778 Accepting New Members: Yes Hours: M-F 9AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

PHYSICIAN ASSISTANT

SAN DIEGO

92113

Treuner, Julie Ann PA* 1809 National Ave San Diego, CA 92113 (619) 515-2300 www.fhcsd.org Provider ID: 25731 License: PA17478 Accepting New Members: Yes Hours: M - F 8 AM-5 PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: HOURS CHANGES

SPRING VALLEY

91977

Turner, Eric Michael PA* 8788 Jamacha Rd Spring Valley, CA 91977 (619) 515-2555 www.fhcsd.org Provider ID: 25735 License: PA55067 Accepting New Members: Yes Hours: M-F 830 AM-530 PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. P,IB,R,E UPDATE: ADDRESS CHANGES


3


SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093

Furnish, Timothy James MD 9400 Campus Point Dr La Jolla, CA 92093 (858) 647-7072 Provider ID: 124327 License: A99822 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

Wallace, Mark Steven MD 9400 Campus Point Dr La Jolla, CA 92093 (619) 543-5720 Provider ID: 124195 License: G72906 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

CARDIOVASCULAR MED

CHULA VISTA

91911

Sharf, Albert MD 1310 Third Ave Ste B3 Chula Vista, CA 91911 (619) 470-7700 Provider ID: 123164 License: G72122 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER


SAN DIEGO

92101

Urbie-Sagrero, Cynthia Marie NP* 1550 Broadway Ste 2 San Diego, CA 92101 (619) 515-2525 www.fhcsd.org Provider ID: 124048 License: 95007419 Accepting New Members: Yes Hours: M-F 8:30AM-5:30PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. P,EB,IB,E UPDATE: NEW PROVIDER


4


92103

Torres, Karla F NP* 200 W Arbor Dr San Diego, CA 92103 (619) 543-3995 https://health.ucsd.edu/Pages/default.aspx Provider ID: 84927 License: NP22380 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

92108

Jersey, Karen NP* 7525 Metropolitan Dr Ste 302 San Diego, CA 92108 (619) 325-1161 Provider ID: 109682 License: NP21684 Accepting New Members: Yes Hours: M-TH 7:30AM-6:30PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

92127

Moga, Claire S NP* 16918 Dove Canyon Rd Ste 103 San Diego, CA 92127 (858) 649-5100 Provider ID: 124764 License: NP95007255 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

CHIROPRACTOR

CHULA VISTA

91910

Chin, Peggy B DC 251 Landis Ave Chula Vista, CA 91910 (619) 515-2500 www.fhcsd.org Provider ID: 124918 License: DC33652 Accepting New Members: Yes Hours: M-F 8:30AM-5:30PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER


5


SAN DIEGO

92103

Chin, Peggy B DC 4094 4th Ave San Diego, CA 92103 (619) 515-2545 www.fhcsd.org Provider ID: 124915 License: DC33652 Accepting New Members: Yes Hours: M-TH 8:00AM-9:00PM; F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. P,EB,R,E UPDATE: NEW PROVIDER

DERMATOLOGY

LA JOLLA

92037

Gladsjo, Julie Akiko MD 7301 Girard Ave Ste 300 La Jolla, CA 92037 (858) 454-4300 Provider ID: 106571 License: A98641 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

Hemperly, Stephen Erik DO 7301 Girard Ave Ste 300 La Jolla, CA 92037 (858) 454-4300 Provider ID: 115397 License: 20A14658 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

Tompkins, Stacy Deanne MD 7301 Girard Ave Ste 300 La Jolla, CA 92037 (858) 454-4300 Provider ID: 106343 License: A52958 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED


6


INFECTIOUS DISEASE

SAN DIEGO

92103

Hicks, Charles Byron MD 200 W Arbor Dr MC 8681 San Diego, CA 92103 (619) 471-9186 https://health.ucsd.edu/Pages/default.aspx Provider ID: 86234 License: G42891 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

INTERNAL MEDICINE

LA JOLLA

92093

Middleton, Gregory D MD 9400 Campus Point Dr La Jolla, CA 92093 (858) 657-8200 Provider ID: 124158 License: C54037 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

NEPHROLOGY

LA JOLLA

92037

Abdelmalek, Joseph Alexan MD 8939 Villa La Jolla Dr Ste 110 La Jolla, CA 92037 (858) 657-8353 Provider ID: 83075 License: A107185 Accepting New Members: Yes Hours: M-F 9:00PM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: ADDRESS CHANGE


7


NEUROLOGY

CARLSBAD

92011

Zupancic, Michael John MD 6010 Hidden Valley Rd Ste 200 Carlsbad, CA 92011 (760) 631-3000 Provider ID: 63550 License: A91184 Accepting New Members: Yes Hours: M-F 8:30AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

ESCONDIDO

92029

Zupancic, Michael J MD 1955 Citracado Pkwy Ste 102 Escondido, CA 92029 (760) 631-3000 Provider ID: 75417 License: A91184 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

LA JOLLA

92037

Wang, Chunyang Tracy MD 9850 Genesee Ave Ste 470 La Jolla, CA 92037 (760) 631-3000 Provider ID: 124742 License: A105660 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER


8


SAN DIEGO

92120

Alexander, Joshua DO 6645 Alvarado Rd Ste 229 San Diego, CA 92120 (619) 287-0147 https://health.ucsd.edu/Pages/default.aspx Provider ID: 83167 License: 20A11431 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

OBSTETRICS & GYNECOLOGY

CHULA VISTA

91910

Gonzalez, Marisa C MD 480 Fourth Ave Ste 505 Chula Vista, CA 91910 (619) 425-7747 Provider ID: 84683 License: A120499 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

Valdivia, Leopoldo Enrique DO 251 Landis Ave Chula Vista, CA 91910 (619) 515-2500 www.fhcsd.org Provider ID: 120467 License: 20A7040 Accepting New Members: Yes Hours: M-F 8:30AM-5:30PM PTA: Yes Other Language: French Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PROVIDER TERMINATED

91911

Kobayashi, Karen Naomi DO 765 Medical Center Ct Ste 203 Chula Vista, CA 91911 (619) 216-2100 Provider ID: 53708 License: 20A10831 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

EL CAJON

92020

Valdivia, Leopoldo Enrique DO 525 E Main St El Cajon, CA 92020 (619) 515-2498 www.fhcsd.org Provider ID: 120481 License: 20A7040 Accepting New Members: Yes Hours: M-SA 8:30AM-5:30PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Limited. P,EB,IB,E UPDATE: PROVIDER TERMINATED


9


LEMON GROVE

91945

Valdivia, Leopoldo Enrique DO 7592 Broadway Lemon Grove, CA 91945 (619) 515-2550 www.fhcsd.org Provider ID: 120495 License: 20A7040 Accepting New Members: Yes Hours: M-F 8:30AM-5:30PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. P,EB,IB,E UPDATE: PROVIDER TERMINATED

NATIONAL CITY

91950

Gonzalez, Marisa C MD 655 Euclid Ave Ste 409 National City, CA 91950 (619) 267-8313 Provider ID: 62462 License: A120499 Accepting New Members: Yes Hours: M,TH 8:30AM-5:30PM; F 8:30AM-4:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

SAN DIEGO

92102

Valdivia, Leopoldo Enrique DO 4725 Market St San Diego, CA 92102 (619) 515-2420 www.fhcsd.org Provider ID: 120477 License: 20A7040 Accepting New Members: Yes Hours: M-F 8:30AM-5:30PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Limited. P,EB,IB,E UPDATE: PROVIDER TERMINATED

92104

Valdivia, Leopoldo Enrique DO 3544 30th St San Diego, CA 92104 (619) 515-2424 www.fhcsd.org Provider ID: 120496 License: 20A7040 Accepting New Members: Yes Hours: M-TH 8:30AM-5:30PM; F 8:30AM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Limited. UPDATE: PROVIDER TERMINATED


10


92109

Valdivia, Leopoldo Enrique DO 3705 Mission Blvd San Diego, CA 92109 (619) 515-2444 www.fhcsd.org Provider ID: 120459 License: 20A7040 Accepting New Members: Yes Hours: M-W 8:30AM-5:00PM; TH 9:30AM-6:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. EB,IB,R,E UPDATE: PROVIDER TERMINATED

92113

Valdivia, Leopoldo Enrique DO 1809 National Ave San Diego, CA 92113 (619) 515-2300 www.fhcsd.org Provider ID: 120453 License: 20A7040 Accepting New Members: Yes Hours: M 8:00AM-7:00PM; T-TH; 8:00AM-6:00PM; F 8:00AM-5:30PM; SA 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PROVIDER TERMINATED

92115

Valdivia, Leopoldo Enrique DO 5454 El Cajon Blvd San Diego, CA 92115 (619) 515-2400 www.fhcsd.org Provider ID: 120474 License: 20A7040 Accepting New Members: Yes Hours: M-F 8:30AM-5:30PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. P,EB,E UPDATE: PROVIDER TERMINATED

SPRING VALLEY

91977

Valdivia, Leopoldo Enrique DO 8788 Jamacha Rd Spring Valley, CA 91977 (619) 515-2555 www.fhcsd.org Provider ID: 120483 License: 20A7040 Accepting New Members: Yes Hours: M,W-F 8:30AM-5:30PM; T 8:30AM-7:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. P,IB,R,E UPDATE: PROVIDER TERMINATED

OPHTHALMOLOGY

CHULA VISTA

91911

Cooper, Lawrence Nathan MD 865 Third Ave Ste 121 Chula Vista, CA 91911 (619) 426-3400 Provider ID: 35041 License: G27092 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED


11


PHYSICAL MEDICINE & REHAB

CARLSBAD

92011

Fisher, Casey James MD 6010 Hidden Valley Rd Ste 110 Carlsbad, CA 92011 (760) 607-5350 Provider ID: 101416 License: A118592 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

CHULA VISTA

91910

Fisher, Casey James MD 340 Fourth Ave Ste 19 Chula Vista, CA 91910 (619) 761-5308 Provider ID: 101417 License: A118592 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

LA JOLLA

92093

Chang, Douglas G MD 9400 Campus Point Dr La Jolla, CA 92093 (858) 657-8200 Provider ID: 124123 License: A77281 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER


12


POWAY

92064

Fisher, Casey James MD 15725 Pomerado Rd Ste 210 Poway, CA 92064 (858) 432-7880 Provider ID: 101420 License: A118592 Accepting New Members: Yes Hours: T-TH 7:30AM-6:30PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

SAN DIEGO

92108

Fisher, Casey James MD 7525 Metropolitan Dr Ste 302 San Diego, CA 92108 (619) 325-1161 Provider ID: 77698 License: A118592 Accepting New Members: Yes Hours: M-TH 7:30AM-6:30PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

92120

Gavrilyuk, Oleg Mikhaylovich MD 6699 Alvarado Rd Ste 2302 San Diego, CA 92120 (619) 501-6498 https://health.ucsd.edu/Pages/default.aspx Provider ID: 34930 License: A74418 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PHONE UPDATED


13


PHYSICIAN ASSISTANT

ESCONDIDO

92029

Mullen, Ashley Denise PA* 1955 Citracado Pkwy Ste 302 Escondido, CA 92029 (760) 743-5111 Provider ID: 113771 License: PA22997 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

LA JOLLA

92037

Nelms, Michael J PA* 7301 Girard Ave Ste 300 La Jolla, CA 92037 (858) 454-4300 Provider ID: 108340 License: PA14379 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

Vanetsky, Gary Ellis PA* 7301 Girard Ave Ste 300 La Jolla, CA 92037 (858) 454-4300 Provider ID: 108497 License: PA15456 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

RADIATION ONCOLOGY

LA JOLLA

92037

Rose, Brent Shane MD 9300 Campus Point Dr La Jolla, CA 92037 (858) 822-7499 Provider ID: 110732 License: A142735 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Other Language: French Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PHONE UPDATED


14


RADIOLOGY

SANTEE

92071

Brannigan, Thomas Joseph MD 9640 Mission Gorge Rd Ste H Santee, CA 92071 (619) 258-8552 Provider ID: 114570 License: G65789 Accepting New Members: Yes Hours: M-F 7:30AM-6:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: ADDRESS CHANGE

Venkatesh, Vijay Balkrishna MD 9640 Mission Gorge Rd Ste H Santee, CA 92071 (619) 258-8552 Provider ID: 114940 License: A9447 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: ADDRESS CHANGE

SURGERY - ORTHOPEDIC

LA JOLLA

92037

Cidambi, Krishna MD 9350 Campus Point Dr La Jolla, CA 92037 (858) 865-7820 Provider ID: 124274 License: A118350 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

92093

Ball, Scott Taber MD 9400 Campus Point Dr La Jolla, CA 92093 (858) 657-8200 Provider ID: 124052 License: A75221 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER



15


Garfin, Steven Robert MD 9400 Campus Point Dr La Jolla, CA 92093 (858) 657-8200 Provider ID: 123783 License: G29309 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

Gonzales, Francis Balquiedra MD 9400 Campus Point Dr La Jolla, CA 92093 (858) 657-8200 Provider ID: 123851 License: A112963 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

Kulidjian, Anna Andranik MD 9400 Campus Point Dr La Jolla, CA 92093 (858) 657-8200 Provider ID: 123763 License: A97060 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Other Language: Armenian Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

SAN DIEGO

92103

Garfin, Steven Robert MD 200 W Arbor Dr San Diego, CA 92103 (619) 543-6312 https://health.ucsd.edu/Pages/default.aspx Provider ID: 123782 License: G29309 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

SAN MARCOS

92069

Mann, Joseph Mcelroy Lll MD 277 Rancheros Dr Ste 101 San Marcos, CA 92069 (760) 750-1902 Provider ID: 26605 License: G21242 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: ADDRESS CHANGE


16


UROLOGY

CORONADO

92118

Roberts, James Lincoln MD 230 Prospect Pl Ste 300 Coronado, CA 92118 (619) 299-0670 Provider ID: 37464 License: G59945 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PHONE UPDATED

LA MESA

91942

Tanagho, Youssef S MD 8851 Center Dr Ste 501 La Mesa, CA 91942 (619) 697-2456 Provider ID: 124747 License: A125924 Accepting New Members: Yes Hours: M-F 8:30AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

SAN DIEGO

92123

Dato, Paul E MD 3444 Kearny Villa Rd Ste 201 San Diego, CA 92123 (858) 430-1101 Provider ID: 42443 License: A43540 Accepting New Members: Yes Hours: M-F 8:30AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PHONE UPDATED


17


VASCULAR INTERVENTIONIST

SANTEE

92071

Naumann, Michael Todd MD 9640 Mission Gorge Rd Ste H Santee, CA 92071 (619) 258-8552 Provider ID: 113620 License: A116596 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: ADDRESS CHANGE


18

SAN DIEGO COUNTY PROVIDERSIHP-BORREGO MEDICAL GROUP

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



CARDIOLOGY

JULIAN

92036

Schwartz, Joseph Aaron MD 2721 Washington St Julian, CA 92036 (760) 765-1223 www.ihpsocal.org Provider ID: 124013 License: A36637 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

CARDIOVASCULAR MED

CHULA VISTA

91911



19



SAN DIEGO

92103


92108


92127


DERMATOLOGY

LA JOLLA

92037




20



INFECTIOUS DISEASE

SAN DIEGO

92103

Hicks, Charles Byron MD 200 W Arbor Dr Ste 8681 San Diego, CA 92103 (619) 471-9186 https://health.ucsd.edu/Pages/default.aspx Provider ID: 86234 License: G42891 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

INTERNAL MEDICINE

LA JOLLA

92093



21


NEPHROLOGY

LA JOLLA

92037


NEUROLOGY

CARLSBAD

92011


ESCONDIDO

92029



22


LA JOLLA

92037


SAN DIEGO

92120



CHULA VISTA

91910



23


91911


EL CAJON

92020

Papa, Rhett DO 133 W Main St El Cajon, CA 92020 (619) 873-8940 www.ihpsocal.org Provider ID: 123610 License: 20A11733 Accepting New Members: Yes Hours: M-F 8:00AM-8:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER

NATIONAL CITY

91950


OPHTHALMOLOGY

CHULA VISTA

91911



24



CARLSBAD

92011


CHULA VISTA

91910


LA JOLLA

92093



25


POWAY

92064


SAN DIEGO

92108


92120



26


PHYSICIAN ASSISTANT

ESCONDIDO

92029


LA JOLLA

92037



RADIATION ONCOLOGY

LA JOLLA

92037



27


RADIOLOGY

SANTEE

92071




LA JOLLA

92037


92093




28





SAN DIEGO

92103


SAN MARCOS

92069



29


UROLOGY

CORONADO

92118


LA MESA

91942


SAN DIEGO

92123



30



SANTEE

92071



31

SAN DIEGO COUNTY PROVIDERSIHP-COMMUNITY HEALTH SYSTEM

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



CARDIOVASCULAR MED

CHULA VISTA

91911



SAN DIEGO

92103



32


92108


92127


DERMATOLOGY

LA JOLLA

92037





33


INFECTIOUS DISEASE

SAN DIEGO

92103


INTERNAL MEDICINE

LA JOLLA

92093


NEPHROLOGY

LA JOLLA

92037



34


NEUROLOGY

CARLSBAD

92011


ESCONDIDO

92029


LA JOLLA

92037



35


SAN DIEGO

92120



CHULA VISTA

91910


91911



36


NATIONAL CITY

91950


OPHTHALMOLOGY

CHULA VISTA

91911



CARLSBAD

92011



37


CHULA VISTA

91910


LA JOLLA

92093


POWAY

92064



38


SAN DIEGO

92108


92120


PHYSICIAN ASSISTANT

ESCONDIDO

92029



39


LA JOLLA

92037



RADIATION ONCOLOGY

LA JOLLA

92037


RADIOLOGY

SANTEE

92071




40



LA JOLLA

92037


92093






41



SAN DIEGO

92103


SAN MARCOS

92069


UROLOGY

CORONADO

92118



42


LA MESA

91942


SAN DIEGO

92123



SANTEE

92071



43

SAN DIEGO COUNTY PROVIDERSIHP-IMPERIAL BEACH HEALTH CENTER

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



CARDIOVASCULAR MED

CHULA VISTA

91911



SAN DIEGO

92103



44


92108


92127


DERMATOLOGY

LA JOLLA

92037





45


INFECTIOUS DISEASE

SAN DIEGO

92103


INTERNAL MEDICINE

LA JOLLA

92093


NEPHROLOGY

LA JOLLA

92037



46


NEUROLOGY

CARLSBAD

92011


ESCONDIDO

92029


LA JOLLA

92037



47


SAN DIEGO

92120



CHULA VISTA

91910


91911



48


NATIONAL CITY

91950


OPHTHALMOLOGY

CHULA VISTA

91911



CARLSBAD

92011



49


CHULA VISTA

91910


LA JOLLA

92093


POWAY

92064



50


SAN DIEGO

92108


92120


PHYSICIAN ASSISTANT

ESCONDIDO

92029



51


LA JOLLA

92037



RADIATION ONCOLOGY

LA JOLLA

92037


RADIOLOGY

SANTEE

92071




52



LA JOLLA

92037


92093






53



SAN DIEGO

92103


SAN MARCOS

92069


UROLOGY

CORONADO

92118



54


LA MESA

91942


SAN DIEGO

92123



SANTEE

92071



55

SAN DIEGO COUNTY PROVIDERSIHP-NORTH COUNTY HEALTH SERVICES



OCEANSIDE

92054

Binette, Donya Lynn NP* 2210 Mesa Dr Ste 12 Oceanside, CA 92054 (760) 736-6767 www.ihpsocal.org Provider ID: 109796 License: NP95001653 Accepting New Members: Yes Hours: M-S 8AM-5PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Limited. P,EB,IB,E UPDATE: ADDRESS CHANGES

SAN MARCOS

92069

Binette, Donya Lynn NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP95001653 Accepting New Members: Yes Hours: M-S 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Borowiec, Maria Magdalena NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP95004808 Accepting New Members: Yes Hours: M-F 8AM-6PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Clapp, Ryan Russell NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP95004389 Accepting New Members: Yes Hours: M-F 8AM-5PM SAT 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Dejoras, Sasha Nicole NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP95001230 Accepting New Members: Yes Hours: M-F 8AM-5PM SAT 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES


56


Doan, Chinh N NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP18874 Accepting New Members: Yes Hours: M-F 8-6PM; SAT PED ONLY 8-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Fodda, Rami Maamoun NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP18788 Accepting New Members: Yes Hours: M-F 8AM-5PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Freeman, Wanda NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP95003903 Accepting New Members: Yes Hours: M-S 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Macias, Alissa Marie NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP21368 Accepting New Members: Yes Hours: M-F 800 AM-500 PM SAT 8AM-5PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Palen, Barbara A NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP3108 Accepting New Members: Yes Hours: M-F 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Peterson, Meara Elaine NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP95002545 Accepting New Members: Yes Hours: M-F 8 AM-5 PM SAT 8AM-5 PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES


57


Prieto, Alejandra Janet NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP95004873 Accepting New Members: Yes Hours: M-F 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Vega, Beatriz A NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP15232 Accepting New Members: Yes Hours: M-F 8AM-6PMSAT 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Viader, Meghan NP* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: NP22198 Accepting New Members: Yes Hours: M-F 8AM-6PMSAT 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

FAMILY PRACTICE

SAN MARCOS

92069

Chen, Bridget Mercy MD 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: A66849 Accepting New Members: Yes Hours: M-F 8AM-5PM S 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Nath, Devarshi MD 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: C54157 Accepting New Members: Yes Hours: M-F 800-500 PM SAT 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Ventura, Gloria Michelle MD 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: A144192 Accepting New Members: Yes Hours: M-F 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES


58


Walker, Shayna Tanise MD 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: A107393 Accepting New Members: Yes Hours: M-SAT 8AM-5PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

HIV SPECIALIST

SAN MARCOS

92069

Poniachik, Samuel Israel MD 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: G74757 Accepting New Members: Yes Hours: M-F 8AM-5PM SAT 8AM-5PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

INTERNAL MEDICINE

SAN MARCOS

92069

Witczak, Izabela MD 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: A71311 Accepting New Members: Yes Hours: M-F 8AM-5PM S 8AM-5PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

PHYSICIAN ASSISTANT

SAN MARCOS

92069

Bernardo, Rachelle A PA* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: PA17718 Accepting New Members: Yes Hours: M-S 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Dodge, Geraldine Mercedes PA* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: PA19831 Accepting New Members: Yes Hours: M-F 8AM-6PMSAT 8AM-5PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES


59


Kosel, Matthew John PA* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: PA17101 Accepting New Members: Yes Hours: M-S 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Mullen, Ashley Denise PA* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: PA22997 Accepting New Members: Yes Hours: M-S 8AM-5PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Russo, Krista Leann PA* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: PA53036 Accepting New Members: Yes Hours: M-S 8AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

Shlomo, Daphna Tovah PA* 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 25511 License: PA23238 Accepting New Members: Yes Hours: M-F 8AM-6PM PTA: Yes Other Language: Hebrew Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: PHONE CHANGES

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



60



CARDIOVASCULAR MED

CHULA VISTA

91911



SAN DIEGO

92103


92108


92127



61


DERMATOLOGY

LA JOLLA

92037




INFECTIOUS DISEASE

SAN DIEGO

92103



62


INTERNAL MEDICINE

LA JOLLA

92093


NEPHROLOGY

LA JOLLA

92037


NEUROLOGY

CARLSBAD

92011



63


ESCONDIDO

92029


LA JOLLA

92037


SAN DIEGO

92120



64



CHULA VISTA

91910


91911


NATIONAL CITY

91950



65


SAN MARCOS

92069

Muhtaseb, Talal Rajab MD 150 Valpreda Rd San Marcos, CA 92069 (760) 736-6767 www.ihpsocal.org Provider ID: 124101 License: A40901 Accepting New Members: Yes Hours: M-F 8:00AM-8:00PM; SA 8:00AM-5:00PM PTA: Yes Other Language: Arabic Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER

OPHTHALMOLOGY

CHULA VISTA

91911



CARLSBAD

92011



66


CHULA VISTA

91910


LA JOLLA

92093


POWAY

92064



67


SAN DIEGO

92108


92120


PHYSICIAN ASSISTANT

ESCONDIDO

92029



68


LA JOLLA

92037



RADIATION ONCOLOGY

LA JOLLA

92037


RADIOLOGY

SANTEE

92071




69



LA JOLLA

92037


92093






70



SAN DIEGO

92103


SAN MARCOS

92069


UROLOGY

CORONADO

92118



71


LA MESA

91942


SAN DIEGO

92123



SANTEE

92071



72

SAN DIEGO COUNTY PROVIDERSIHP-SAN DIEGO AMERICAN INDIAN HEALTH

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



CARDIOVASCULAR MED

CHULA VISTA

91911



SAN DIEGO

92103



73


92108


92127


DERMATOLOGY

LA JOLLA

92037





74


INFECTIOUS DISEASE

SAN DIEGO

92103


INTERNAL MEDICINE

LA JOLLA

92093


NEPHROLOGY

LA JOLLA

92037



75


NEUROLOGY

CARLSBAD

92011


ESCONDIDO

92029


LA JOLLA

92037



76


SAN DIEGO

92120



CHULA VISTA

91910


91911



77


NATIONAL CITY

91950


OPHTHALMOLOGY

CHULA VISTA

91911



CARLSBAD

92011



78


CHULA VISTA

91910


LA JOLLA

92093


POWAY

92064



79


SAN DIEGO

92108


92120


PHYSICIAN ASSISTANT

ESCONDIDO

92029



80


LA JOLLA

92037



RADIATION ONCOLOGY

LA JOLLA

92037


RADIOLOGY

SANTEE

92071




81



LA JOLLA

92037


92093






82



SAN DIEGO

92103


SAN MARCOS

92069


UROLOGY

CORONADO

92118



83


LA MESA

91942


SAN DIEGO

92123



SANTEE

92071



84

SAN DIEGO COUNTY PROVIDERSIHP-SAN DIEGO FAMILY CARE


FAMILY PRACTICE

SAN DIEGO

92111

Marston, Jacqueline Nicole DO 6973 Linda Vista Rd San Diego, CA 92111 (858) 279-0925 www.ihpsocal.org Provider ID: 25504 License: 20A12402 Accepting New Members: Yes Hours: M-W-Th-F 8 AM-5 PM T 8 AM-12 PM 2 PM-8 PM Sa 9 AM-1 PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

GENERAL PRACTICE

SAN DIEGO

92111

Romero, Camila Ximena MD 6973 Linda Vista Rd San Diego, CA 92111 (858) 279-0925 www.ihpsocal.org Provider ID: 25504 License: A93812 Accepting New Members: Yes Hours: M-W-Th-F 8 AM-5 PM T 8 AM-12 PM 2 PM-8 PM Sa 9 AM-1 PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

INTERNAL MEDICINE

SAN DIEGO

92111

Naranjo, Rodrigo Alexander MD 6973 Linda Vista Rd San Diego, CA 92111 (858) 279-0925 www.ihpsocal.org Provider ID: 25504 License: A119010 Accepting New Members: Yes Hours: M-W-Th-F 8 AM-5 PM T 8 AM-12 PM 2 PM-8 PM Sa 9 AM-1 PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER


85


SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



CARDIOVASCULAR MED

CHULA VISTA

91911



SAN DIEGO

92103



86


92108


92127


DERMATOLOGY

LA JOLLA

92037





87


INFECTIOUS DISEASE

SAN DIEGO

92103


INTERNAL MEDICINE

LA JOLLA

92093


NEPHROLOGY

LA JOLLA

92037



88


NEUROLOGY

CARLSBAD

92011


ESCONDIDO

92029


LA JOLLA

92037



89


SAN DIEGO

92120



CHULA VISTA

91910


91911



90


NATIONAL CITY

91950


SAN DIEGO

92105

Kelly, Thomas Francis MD 4290 Polk Ave San Diego, CA 92105 (619) 563-0250 www.ihpsocal.org Provider ID: 123723 License: G60630 Accepting New Members: Yes Hours: M,W-F 8:00AM-5:00PM; T 9:00AM-5:00PM; SA 8:00AM-2:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER

92111

Shuckett, Ariel MD 6973 Linda Vista Rd San Diego, CA 92111 (858) 810-8787 www.ihpsocal.org Provider ID: 123760 License: A144372 Accepting New Members: Yes Hours: M,W-F 8:30AM-5:30PM; T 8:30AM-9:00PM; SA 9:00AM-4:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

OPHTHALMOLOGY

CHULA VISTA

91911



91



CARLSBAD

92011


CHULA VISTA

91910


LA JOLLA

92093



92


POWAY

92064


SAN DIEGO

92108


92120



93


PHYSICIAN ASSISTANT

ESCONDIDO

92029


LA JOLLA

92037



RADIATION ONCOLOGY

LA JOLLA

92037



94


RADIOLOGY

SANTEE

92071




LA JOLLA

92037


92093




95





SAN DIEGO

92103


SAN MARCOS

92069



96


UROLOGY

CORONADO

92118


LA MESA

91942


SAN DIEGO

92123



97



SANTEE

92071



98

SAN DIEGO COUNTY PROVIDERSIHP-SAN YSIDRO HEALTH CENTER


FAMILY PRACTICE

NATIONAL CITY

91950

Roberts, Pomai MD 1136 D Ave National City, CA 91950 (619) 336-2300 www.ihpsocal.org Provider ID: 25520 License: A103218 Accepting New Members: Yes Hours: M-F 830 AM-530 PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: HOURS CHANGES

Snook, Brian P DO 2400 E 8th St Ste A National City, CA 91950 (619) 662-4100 www.ihpsocal.org Provider ID: 42839 License: 20A11518 Accepting New Members: Yes Hours: M-F 8 AM-5 PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PHONE CHANGES

SAN DIEGO

92113

Kaufhold, Anne Dorothy MD 3177 Ocean View Blvd San Diego, CA 92113 (619) 231-9300 www.ihpsocal.org Provider ID: 37723 License: A88893 Accepting New Members: Yes Hours: M-F 830 AM-530 PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. IB UPDATE: PHONE AND HOURS CHANGES

Kidder, Brendan James MD 3177 Ocean View Blvd San Diego, CA 92113 (619) 231-4100 www.ihpsocal.org Provider ID: 37723 License: A112379 Accepting New Members: Yes Hours: M-F 8 AM-5 PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. IB UPDATE: PHONE CHANGES

Rodriguez, Sean Josue MD 3177 Ocean View Blvd San Diego, CA 92113 (619) 231-4100 www.ihpsocal.org Provider ID: 37723 License: A120576 Accepting New Members: Yes Hours: M-F 8 AM-5 PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. IB UPDATE: PHONE CHANGES


99


SAN YSIDRO

92173

Coronado, Myrna Luzette MD 4004 Beyer Blvd San Ysidro, CA 92173 (619) 428-4463 www.ihpsocal.org Provider ID: 120966 License: A112627 Accepting New Members: Yes Hours: M-F 830 AM - 530 PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: HOURS CHANGES

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



CARDIOVASCULAR MED

CHULA VISTA

91911



100



SAN DIEGO

92103


92108


92127


CHIROPRACTOR

SAN DIEGO

92114

Assadian, Mehrak Sadig DC 950 S Euclid Ave San Diego, CA 92114 (619) 662-4100 www.ihpsocal.org Provider ID: 124463 License: DC27523 Accepting New Members: Yes Hours: M, W-F 8:30AM-5:30PM; SA 8:00AM-2:30PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER


101


DERMATOLOGY

LA JOLLA

92037




GERIATRICS

SAN YSIDRO

92173

Chau, Diane Lynn MD 3364 Beyer Blvd Ste 101 San Ysidro, CA 92173 (619) 205-4585 www.ihpsocal.org Provider ID: 124098 License: A65089 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

INFECTIOUS DISEASE

SAN DIEGO

92103



102


92114

Aldous, Jeannette Lapsansky MD 950 S Euclid Ave San Diego, CA 92114 (619) 662-4100 www.ihpsocal.org Provider ID: 123785 License: A101017 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM; SA 8:00AM-4:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

SAN YSIDRO

92173

Aldous, Jeannette Lapsansky MD 4004 Beyer Blvd San Ysidro, CA 92173 (619) 662-4100 www.ihpsocal.org Provider ID: 123791 License: A101017 Accepting New Members: Yes Hours: M-F 8:00AM-7:30PM; SA 8:30AM-2:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

INTERNAL MEDICINE

LA JOLLA

92093


INTERVENTIONAL CARDIOLOGY

EL CAJON

92020

Kafri, Hassan MD 436 S Magnolia Ave Ste 101 El Cajon, CA 92020 (619) 662-4100 www.ihpsocal.org Provider ID: 124218 License: A96002 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Other Language: Arabic Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER


103


NEPHROLOGY

LA JOLLA

92037


NEUROLOGY

CARLSBAD

92011


ESCONDIDO

92029



104


LA JOLLA

92037


SAN DIEGO

92120



CHULA VISTA

91910



105


91911


NATIONAL CITY

91950


SAN YSIDRO

92173

Casele, Holly Lynn MD 4050 Beyer Blvd San Ysidro, CA 92173 (619) 662-4100 www.ihpsocal.org Provider ID: 124056 License: G87630 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

Catanzarite, Valerian A MD 4050 Beyer Blvd San Ysidro, CA 92173 (619) 662-4100 www.ihpsocal.org Provider ID: 124061 License: G46026 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER


106


Daneshmand, Shahram Sean MD 4050 Beyer Blvd San Ysidro, CA 92173 (619) 662-4100 www.ihpsocal.org Provider ID: 124100 License: A63844 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

Dinh, My T DO 4050 Beyer Blvd San Ysidro, CA 92173 (619) 662-4100 www.ihpsocal.org Provider ID: 124105 License: 20A9907 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

Faksh, Arij DO 4050 Beyer Blvd San Ysidro, CA 92173 (619) 662-4100 www.ihpsocal.org Provider ID: 124107 License: 20A14222 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

Jenkins, Enchanta L MD 4050 Beyer Blvd San Ysidro, CA 92173 (619) 662-4100 www.ihpsocal.org Provider ID: 124215 License: C143625 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E,T UPDATE: NEW PROVIDER

OPHTHALMOLOGY

CHULA VISTA

91910

Jardon, Javier Antonio MD 678 Third Ave Chula Vista, CA 91910 (619) 662-4100 www.ihpsocal.org Provider ID: 124210 License: A131365 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. P,EB,IB,E,T UPDATE: NEW PROVIDER

91911



107


EL CAJON

92020

Jardon, Javier Antonio MD 436 S Magnolia Ave Ste 101 El Cajon, CA 92020 (619) 662-4100 www.ihpsocal.org Provider ID: 124214 License: A131365 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER


CARLSBAD

92011


CHULA VISTA

91910



108


LA JOLLA

92093


POWAY

92064


SAN DIEGO

92108



109


92120


PHYSICIAN ASSISTANT

ESCONDIDO

92029


LA JOLLA

92037




110


RADIATION ONCOLOGY

LA JOLLA

92037


RADIOLOGY

SANTEE

92071




LA JOLLA

92037



111


92093






SAN DIEGO

92103



112


SAN MARCOS

92069


UROLOGY

CORONADO

92118


LA MESA

91942



113


SAN DIEGO

92123



SANTEE

92071



114

SAN DIEGO COUNTY PROVIDERSIHP-ST VINCENT DE PAUL VILLA


FAMILY PRACTICE

SAN DIEGO

92101

Le, Julie Lu DO 1501 Imperial Ave San Diego, CA 92101 (619) 233-8500 www.ihpsocal.org Provider ID: 68183 License: 20A9208 Accepting New Members: Yes Hours: M-F 8-530 PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Limited. EB,IB,E UPDATE: NEW PROVIDER


115

SAN DIEGO COUNTY PROVIDERSIHP-ST VINCENT DE PAUL VILLAGE

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



CARDIOVASCULAR MED

CHULA VISTA

91911



SAN DIEGO

92103



116


92108


92127


DERMATOLOGY

LA JOLLA

92037





117


INFECTIOUS DISEASE

SAN DIEGO

92103


INTERNAL MEDICINE

LA JOLLA

92093


NEPHROLOGY

LA JOLLA

92037



118


NEUROLOGY

CARLSBAD

92011


ESCONDIDO

92029


LA JOLLA

92037



119


SAN DIEGO

92120



CHULA VISTA

91910


91911



120


NATIONAL CITY

91950


OPHTHALMOLOGY

CHULA VISTA

91911


SAN DIEGO

92101

Zablit, Karim Victor MD 1501 Imperial Ave San Diego, CA 92101 (619) 233-8500 www.ihpsocal.org Provider ID: 123853 License: A42127 Accepting New Members: Yes Hours: M-F 8:30AM-4:45PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Limited. EB,IB,E UPDATE: NEW PROVIDER


121



CARLSBAD

92011


CHULA VISTA

91910


LA JOLLA

92093



122


POWAY

92064


SAN DIEGO

92108


92120



123


PHYSICIAN ASSISTANT

ESCONDIDO

92029


LA JOLLA

92037



RADIATION ONCOLOGY

LA JOLLA

92037



124


RADIOLOGY

SANTEE

92071




LA JOLLA

92037


92093




125





SAN DIEGO

92103


SAN MARCOS

92069



126


UROLOGY

CORONADO

92118


LA MESA

91942


SAN DIEGO

92123



127



SANTEE

92071



128

SAN DIEGO COUNTY PROVIDERSIHP-VISTA COMMUNITY CLINIC


GENERAL PRACTICE

VISTA

92083

Whitney, Janet DO 134 Grapevine Rd Vista, CA 92083 (760) 631-5000 www.ihpsocal.org Provider ID: 41589 License: 20A7126 Accepting New Members: Yes Hours: M-W-Th-F 8 AM-5 PM T 1030 AM-730 PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



CARDIOVASCULAR MED

CHULA VISTA

91911



129



SAN DIEGO

92103


92108


92127


DERMATOLOGY

LA JOLLA

92037




130



INFECTIOUS DISEASE

SAN DIEGO

92103


INTERNAL MEDICINE

LA JOLLA

92093



131


NEPHROLOGY

LA JOLLA

92037


NEUROLOGY

CARLSBAD

92011


ESCONDIDO

92029



132


LA JOLLA

92037


SAN DIEGO

92120



CHULA VISTA

91910



133


91911


NATIONAL CITY

91950


OCEANSIDE

92054

Klausen, Jack Harold MD 517 N Horne St Oceanside, CA 92054 (760) 631-5000 www.ihpsocal.org Provider ID: 124044 License: C31268 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Limited. EB,IB,E UPDATE: NEW PROVIDER

Klausen, Jack Harold MD 818 Pier View Way Oceanside, CA 92054 (760) 631-5000 www.ihpsocal.org Provider ID: 124045 License: C31268 Accepting New Members: Yes Hours: M,T,TH,F 8:00AM-5:00PM; W 8:00AM-7:00PM; SA 9:00AM-4:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER


134


92057

Klausen, Jack Harold MD 4700 N River Rd Oceanside, CA 92057 (760) 631-5000 www.ihpsocal.org Provider ID: 123662 License: C31268 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM; SA 9:00AM-4:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: NEW PROVIDER

OPHTHALMOLOGY

CHULA VISTA

91911



CARLSBAD

92011



135


CHULA VISTA

91910


LA JOLLA

92093


POWAY

92064



136


SAN DIEGO

92108


92120


PHYSICIAN ASSISTANT

ESCONDIDO

92029



137


LA JOLLA

92037



RADIATION ONCOLOGY

LA JOLLA

92037


RADIOLOGY

SANTEE

92071




138



LA JOLLA

92037


92093






139



SAN DIEGO

92103


SAN MARCOS

92069


UROLOGY

CORONADO

92118



140


LA MESA

91942


SAN DIEGO

92123



SANTEE

92071



141

SAN DIEGO COUNTY PROVIDERSLA MAESTRA FAMILY CLINIC



EL CAJON

92019

Tillar, Shannon NP* 165 S 1st St El Cajon, CA 92019 (619) 312-0347 www.lamaestra.org Provider ID: 36508 License: NP95000138 Accepting New Members: Yes Hours: M-F 830 AM-530 PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. P,EB,IB,E UPDATE: HOURS CHANGES

Williams, Breahna Antonece NP* 165 S 1st St El Cajon, CA 92019 (619) 312-0347 www.lamaestra.org Provider ID: 36508 License: NP95001840 Accepting New Members: Yes Hours: M-F 9 AM-6 PM PTA: Yes Cultural Competency: NR Accessibility: SR Limited. P,EB,IB,E UPDATE: HOURS CHANGES

CLINIC (MIX SPEC)

SAN DIEGO

92105

La Maestra Family Clinic - Main Clinic, 4060 Fairmount Ave San Diego, CA 92105 (619) 280-4213 www.lamaestra.org Provider ID: 46039 License: 090000378 Accepting New Members: Yes Hours: M-F 830 AM-6 PM PTA: Yes Other Language: Burmese Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: HOURS CHANGES

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



142



CARDIOVASCULAR MED

CHULA VISTA

91911



SAN DIEGO

92103


92108


92127



143


DERMATOLOGY

LA JOLLA

92037




INFECTIOUS DISEASE

SAN DIEGO

92103



144


INTERNAL MEDICINE

LA JOLLA

92093


NEPHROLOGY

LA JOLLA

92037


NEUROLOGY

CARLSBAD

92011



145


ESCONDIDO

92029


LA JOLLA

92037


SAN DIEGO

92120



146



CHULA VISTA

91910


91911


NATIONAL CITY

91950



147


OPHTHALMOLOGY

CHULA VISTA

91911



CARLSBAD

92011


CHULA VISTA

91910



148


LA JOLLA

92093


POWAY

92064


SAN DIEGO

92108



149


92120


PHYSICIAN ASSISTANT

ESCONDIDO

92029


LA JOLLA

92037




150


RADIATION ONCOLOGY

LA JOLLA

92037


RADIOLOGY

SANTEE

92071




LA JOLLA

92037



151


92093






SAN DIEGO

92103



152


SAN MARCOS

92069


UROLOGY

CORONADO

92118


LA MESA

91942



153


SAN DIEGO

92123



SANTEE

92071



154

SAN DIEGO COUNTY PROVIDERSMERCY PHYSICIANS MEDICAL GROUP


INTERNAL MEDICINE

CHULA VISTA

91911

De La Rosa, Renato MD 754 Medical Center Ct Ste 103 Chula Vista, CA 91911 6193975001 www.mpmgdocs.com/ Provider ID: 124009 License: A65330 Accepting New Members: N Hours: M-F 9AM-5PM PTA: Yes Other Language: Tagalog Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

LA MESA

91942

Prabaker, Venugopal MD 7339 El Cajon Blvd Ste I La Mesa, CA 91942 (619) 698-0606 www.mpmgdocs.com/ Provider ID: 62815 License: A42653 Accepting New Members: Yes Hours: M-F 9AM-5PM PTA: Yes Cultural Competency: NR Accessibility: SR Basic. P,EB,IB,R,E UPDATE: ZIP CHANGE

SPECIALISTS

ENDOCRINOLOGY

SAN DIEGO

92103

Rogers, Megan Olson MD 3900 5th Ave Ste 110 San Diego, CA 92103 (858) 554-1212 www.mpmgdocs.com/ Provider ID: 123842 License: A122784 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER


155



NATIONAL CITY

91950

Martinson, Marsha Lucille MD 911 E Plaza Blvd National City, CA 91950 (619) 434-0299 www.mpmgdocs.com/ Provider ID: 107347 License: A103306 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Other Language: Spanish Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

Seif, Medhat MD 911 E Plaza Blvd National City, CA 91950 (619) 434-0299 www.mpmgdocs.com/ Provider ID: 105376 License: A33932 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

PAIN MEDICINE SPECIALIST

CHULA VISTA

91910

Lao, Jesus Herrera MD 340 Fourth Ave Ste 19 Chula Vista, CA 91910 (619) 761-5308 www.mpmgdocs.com/ Provider ID: 123429 License: A72729 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER


156


SAN DIEGO

92108

Lao, Jesus Herrera MD 7525 Metropolitan Dr Ste 302 San Diego, CA 92108 (619) 325-1161 www.mpmgdocs.com/ Provider ID: 108588 License: A72729 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Other Language: Tagalog Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

Lutfy, Patricia Marie MD 7525 Metropolitan Dr Ste 302 San Diego, CA 92108 (619) 325-1161 www.mpmgdocs.com/ Provider ID: 110601 License: A133725 Accepting New Members: Yes Hours: M, T,TH 7:30AM-6:30PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: NEW PROVIDER

SURGERY - CARDIOTHORACIC

LA JOLLA

92037

Moasis, Ghassan Al MD 10666 N Torrey Pines Rd Ste 209 La Jolla, CA 92037 (858) 554-8122 www.mpmgdocs.com/ Provider ID: 117862 License: C134031 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

SAN DIEGO

92103

Moasis, Ghassan Al MD 4033 3rd Ave Ste 210 San Diego, CA 92103 (619) 297-5600 www.mpmgdocs.com/ Provider ID: 117863 License: C134031 Accepting New Members: Yes Hours: M-F 9:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED


157

SAN DIEGO COUNTY PROVIDERSOPERATION SAMAHAN

SPECIALISTS

ANESTHESIOLOGY

LA JOLLA

92093



CARDIOVASCULAR MED

CHULA VISTA

91911



SAN DIEGO

92103



158


92108


92127


DERMATOLOGY

LA JOLLA

92037





159


INFECTIOUS DISEASE

SAN DIEGO

92103


INTERNAL MEDICINE

LA JOLLA

92093


NEPHROLOGY

LA JOLLA

92037



160


NEUROLOGY

CARLSBAD

92011


ESCONDIDO

92029


LA JOLLA

92037



161


SAN DIEGO

92120



CHULA VISTA

91910


91911



162


NATIONAL CITY

91950


OPHTHALMOLOGY

CHULA VISTA

91911



CARLSBAD

92011



163


CHULA VISTA

91910


LA JOLLA

92093


POWAY

92064



164


SAN DIEGO

92108


92120


PHYSICIAN ASSISTANT

ESCONDIDO

92029



165


LA JOLLA

92037



RADIATION ONCOLOGY

LA JOLLA

92037


RADIOLOGY

SANTEE

92071




166



LA JOLLA

92037


92093






167



SAN DIEGO

92103


SAN MARCOS

92069


UROLOGY

CORONADO

92118



168


LA MESA

91942


SAN DIEGO

92123



SANTEE

92071



169

SAN DIEGO COUNTY PROVIDERSSHARP COMMUNITY MEDICAL GROUP


INTERNAL MEDICINE

LA MESA

91942

Prabaker, Venugopal MD 7339 El Cajon Blvd Ste I La Mesa, CA 91942 6196980606 www.scmg.org/ Provider ID: 80584 License: A42653 Accepting New Members: N Hours: M-F 9AM-5PM PTA: Yes Cultural Competency: NR Accessibility: Basic. P,EB,IB,R,E UPDATE: ZIP CHANGE

SPECIALISTS

CARDIOLOGY

OCEANSIDE

92054

Pashmforoush, Mohammad MD 2424 Vista Way Ste 300-301 Oceanside, CA 92054 (760) 439-6581 www.scmg.org/ Provider ID: 121796 License: A60730 Accepting New Members: Yes Hours: M-F 8:00AM-5:00PM PTA: Yes Cultural Competency: NR Accessibility: Members should call the provider’s office to discuss their accessibility needs UPDATE: PROVIDER TERMINATED

INDEX

For more information, please call Care1st Cal MediConnect Member Services at 1-855-905-3825, (TTY: 711), 8 a.m. to 8 p.m., seven days a week. This list is subject to change.

170

AAbdelmalek, Joseph Alexan MD ... 6, 21, 33, 45, 62, 74, 87, 103, 117, 131, 144, 159Aldous, Jeannette Lapsansky MD ................................. 102Alexander, Joshua DO ...8, 22, 35, 47, 63, 76, 89, 104, 119, 132, 145, 161Assadian, Mehrak Sadig DC ......................................... 100

BBall, Scott Taber MD ....14, 27, 40, 52, 69, 81, 94, 111, 124, 138, 151, 166Bernardo, Rachelle A PA* ................................................ 58Binette, Donya Lynn NP* ................................................. 55Borowiec, Maria Magdalena NP* ..................................... 55Brannigan, Thomas Joseph MD . 14, 27, 39, 51, 68, 80, 94, 110, 124, 137, 150, 165

CCasele, Holly Lynn MD .................................................. 105Catanzarite, Valerian A MD ............................................ 105Chang, Douglas G MD 11, 24, 37, 49, 66, 78, 91, 108, 121, 135, 148, 163Chau, Diane Lynn MD ................................................... 101Chen, Bridget Mercy MD ................................................. 57Chin, Peggy B DC .......................................................... 4-5Cidambi, Krishna MD ....14, 27, 40, 52, 69, 81, 94, 110-111, 124, 138, 150-151, 166Clapp, Ryan Russell NP* ................................................. 55Cooper, Lawrence Nathan MD ... 10, 23, 36, 48, 65, 77, 90, 106, 120, 134, 147, 162Coronado, Myrna Luzette MD ......................................... 99

DDaneshmand, Shahram Sean MD ................................. 106Dato, Paul E MD ..16, 29, 42, 54, 71, 83, 96, 113, 126, 140, 153, 168De La Rosa, Renato MD ............................................... 154Dejoras, Sasha Nicole NP* .............................................. 55Dinh, My T DO ............................................................... 106Doan, Chinh N NP* .......................................................... 56Dodge, Geraldine Mercedes PA* ..................................... 58

F

Faksh, Arij DO ............................................................... 106Fisher, Casey James MD .........11-12, 24-25, 36-38, 48-50, 65-67, 77-79, 91-92, 107-108, 121-122, 134-136, 147-148, 162-164Fodda, Rami Maamoun NP* ............................................ 56Freeman, Wanda NP* ..................................................... 56Furnish, Timothy James MD ... 3, 18, 31, 43, 59, 72, 85, 99, 115, 128, 141, 157

GGarfin, Steven Robert MD .......15, 28, 40-41, 52-53, 69-70, 81-82, 95, 111, 125, 138-139, 151, 166-167Gavrilyuk, Oleg Mikhaylovich MD 12, 25, 38, 50, 67, 79, 92, 109, 122, 136, 149, 164Gladsjo, Julie Akiko MD .5, 19, 32, 44, 61, 73, 86, 101, 116, 129, 143, 158Gonzales, Francis Balquiedra MD .... 15, 28, 40, 52, 69, 81, 95, 111, 125, 138, 151, 166Gonzalez, Marisa C MD .........8-9, 22-23, 35-36, 47-48, 64, 76-77, 89-90, 104-105, 119-120, 132-133, 146, 161-162

HHemperly, Stephen Erik DO . 5, 19, 32, 44, 61, 73, 86, 101, 116, 129, 143, 158Hicks, Charles Byron MD ..... 6, 20, 33, 45, 61, 74, 87, 101, 117, 130, 143, 159

JJardon, Javier Antonio MD ..................................... 106-107Jenkins, Enchanta L MD ................................................ 106Jersey, Karen NP* .4, 19, 32, 44, 60, 73, 86, 100, 116, 129, 142, 158

KKafri, Hassan MD .......................................................... 102Kaufhold, Anne Dorothy MD ............................................ 98Kelly, Thomas Francis MD ............................................... 90Kidder, Brendan James MD ............................................. 98Klausen, Jack Harold MD ....................................... 133-134Kobayashi, Karen Naomi DO 8, 23, 35, 47, 64, 76, 89, 105, 119, 133, 146, 161Kosel, Matthew John PA* ................................................ 59Kulidjian, Anna Andranik MD ...... 15, 28, 41, 53, 70, 82, 95, 111, 125, 139, 151, 167

INDEX


171

LLa Maestra Family Clinic - Main Clinic, ....................... 141Lao, Jesus Herrera MD .......................................... 155-156Le, Julie Lu DO ...............................................................114Lutfy, Patricia Marie MD ................................................ 156

MMacias, Alissa Marie NP* ................................................ 56Mann, Joseph Mcelroy Lll MD .... 15, 28, 41, 53, 70, 82, 95, 112, 125, 139, 152, 167Marston, Jacqueline Nicole DO ....................................... 84Martinson, Marsha Lucille MD ....................................... 155Middleton, Gregory D MD ..... 6, 20, 33, 45, 62, 74, 87, 102, 117, 130, 144, 159Moasis, Ghassan Al MD ................................................ 156Moga, Claire S NP* .......4, 19, 32, 44, 60, 73, 86, 100, 116, 129, 142, 158Muhtaseb, Talal Rajab MD .............................................. 65Mullen, Ashley Denise PA* ... 13, 26, 38, 50, 59, 67, 79, 93, 109, 123, 136, 149, 164

NNaranjo, Rodrigo Alexander MD ...................................... 84Nath, Devarshi MD .......................................................... 57Naumann, Michael Todd MD ...... 17, 30, 42, 54, 71, 83, 97, 113, 127, 140, 153, 168Nelms, Michael J PA* . 13, 26, 39, 51, 68, 80, 93, 109, 123, 137, 149, 165

PPalen, Barbara A NP* ...................................................... 56Papa, Rhett DO ............................................................... 23Pashmforoush, Mohammad MD .................................... 169Peterson, Meara Elaine NP* ............................................ 56Poniachik, Samuel Israel MD .......................................... 58Prabaker, Venugopal MD ................................... 1, 154, 169Prieto, Alejandra Janet NP* ............................................. 57

RRoberts, James Lincoln MD 16, 29, 41, 53, 70, 82, 96, 112, 126, 139, 152, 167Roberts, Pomai MD ......................................................... 98Rodriguez, Sean Josue MD ............................................. 98

Rogers, Megan Olson MD ............................................. 154Romero, Camila Ximena MD ........................................... 84Rose, Brent Shane MD 13, 26, 39, 51, 68, 80, 93, 110, 123, 137, 150, 165Russo, Krista Leann PA* ................................................. 59

SSchwartz, Joseph Aaron MD ........................................... 18Seif, Medhat MD ............................................................ 155Sharf, Albert MD ......3, 18, 31, 43, 60, 72, 85, 99, 115, 128, 142, 157Shlomo, Daphna Tovah PA* ............................................ 59Shuckett, Ariel MD ........................................................... 90Snook, Brian P DO .......................................................... 98Soto, Robin J NP* .............................................................. 2

TTanagho, Youssef S MD ......16, 29, 42, 54, 71, 83, 96, 112, 126, 140, 152, 168Tillar, Shannon NP* ....................................................... 141Tompkins, Stacy Deanne MD 5, 20, 32, 44, 61, 73, 86, 101, 116, 130, 143, 158Torres, Karla F NP* 4, 19, 31, 43, 60, 72, 85, 100, 115, 129, 142, 157Treuner, Julie Ann PA* ....................................................... 2Turner, Eric Michael PA* .................................................... 2

UUrbie-Sagrero, Cynthia Marie NP* .................................... 3

VValdivia, Leopoldo Enrique DO ..................................... 8-10Vanetsky, Gary Ellis PA* ..... 13, 26, 39, 51, 68, 80, 93, 109, 123, 137, 149, 165Vega, Beatriz A NP* ......................................................... 57Venkatesh, Vijay Balkrishna MD . 14, 27, 39, 51, 68, 80, 94, 110, 124, 137, 150, 165Ventura, Gloria Michelle MD ............................................ 57Viader, Meghan NP* ........................................................ 57

WWalker, Shayna Tanise MD .............................................. 58Wallace, Mark Steven MD ...... 3, 18, 31, 43, 60, 72, 85, 99, 115, 128, 142, 157

INDEX


172

Wang, Chunyang Tracy MD . 7, 22, 34, 46, 63, 75, 88, 104, 118, 132, 145, 160Whitney, Janet DO ......................................................... 128Williams, Breahna Antonece NP* .................................. 141Witczak, Izabela MD ........................................................ 58

ZZablit, Karim Victor MD .................................................. 120Zupancic, Michael J MD 7, 21, 34, 46, 63, 75, 88, 103, 118, 131, 145, 160Zupancic, Michael John MD . 7, 21, 34, 46, 62, 75, 88, 103, 118, 131, 144, 160

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