Table: enrolled_medi_cal_fee_for_service_ffs_providers , legal_name like E*

A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  *

objectid	provider_source	provider_number	npi	owner_number	service_location_number	legal_name	enroll_status_eff_dt	provider_taxonomy	nemt_nmt_provider_type	anc_provider_type	fi_provider_type_cd	fi_provider_type	provider_license	fi_provider_specialty_cd	fi_provider_specialty	out_of_state_indicator	in_out_state	address_attention	address	address2	city	state	zip	zip_4	dhcs_county_cd	fips_county_cd	latitude	longitude	countyname
63	Fee-for-Service	1699965228	1699965228	2	1	ELKHOURY, NABIL MD	2/10/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	127516	None	None	0	In state provider	None	1107 POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
112	Fee-for-Service	1174818439	1174818439	1	1	ESTARIS, JUSTIN MD	3/2/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	143441	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
138	Fee-for-Service	1295704047	1295704047	2	1	EHTESHAMI, MANI MD	2/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	74263	22	Pathology (M.D. only)	0	In state provider	None	27 CLERMONT	None	NEWPORT BEACH	CA	92657	1069	30	06059	33.61364148	-117.8359875	Orange County
232	Fee-for-Service	1821120858	1821120858	1	1	EVANS, GARY D MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38435	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
358	Fee-for-Service	1063512473	1063512473	1	1	EL-BIALY, ADEL K MD	10/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53313	41	Internal Medicine	0	In state provider	None	5301 F ST	STE 100	SACRAMENTO	CA	95819	3220	34	06067	38.571354	-121.4368695	Sacramento County
512	Fee-for-Service	1942257852	1942257852	1	1	EL-GHONEIMY, AHMED E MD	8/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93235	41	Internal Medicine	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
567	Fee-for-Service	1407139314	1407139314	1	1	EATESAM, MAMAK MD	10/12/2021	207R00000X	NA	Other	026	PHYSICIANS	157965	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	0001	39	06077	37.97026329	-121.2890849	San Joaquin County
639	Fee-for-Service	1023191459	1023191459	1	1	EIN, MICHAEL E MD	6/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	27748	01	General Practice	0	In state provider	None	2485 HIGH SCHOOL AVE	STE 303	CONCORD	CA	94520	1818	07	06013	37.98507961	-122.034189	Contra Costa County
646	Fee-for-Service	1063512473	1063512473	1	1	EL-BIALY, ADEL K MD	10/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53313	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5301 F ST	STE 100	SACRAMENTO	CA	95819	3220	34	06067	38.571354	-121.4368695	Sacramento County
670	Fee-for-Service	1689414120	1689414120	1	1	EL SEGUNDO PHARMACY INC	8/9/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	827 N DOUGLAS ST	None	EL SEGUNDO	CA	90245	2801	19	06037	33.92755185	-118.38324	Los Angeles County
697	Fee-for-Service	1679791305	1679791305	1	1	EISELE, CHRISTIANE N MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	84490	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
708	Fee-for-Service	1609923556	1609923556	1	1	ESCONDIDO UNION HSD	8/4/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	302 N MIDWAY DR	None	ESCONDIDO	CA	92027	2708	37	06073	33.13619959	-117.0509061	San Diego County
729	Fee-for-Service	1346475803	1346475803	1	1	EYMAN, CANDACE T MD	9/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146833	40	Pediatrics	0	In state provider	None	2825 CAPITOL AVE	None	SACRAMENTO	CA	95816	5615	34	06067	38.570805	-121.4696385	Sacramento County
772	Fee-for-Service	1679847578	1679847578	1	1	ENRIQUEZ, GILBERT M LMFT	4/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 E GARVEY AVE N	B2	WEST COVINA	CA	91791	1544	19	06037	34.07280989	-117.8995249	Los Angeles County
835	Fee-for-Service	1619051034	1619051034	1	1	EDWARDS, MICHAEL S MD	11/23/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	37469	78	Neoplastic Diseases/Oncology	0	In state provider	None	2800 L ST	STE 340	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
845	Fee-for-Service	1144393778	1144393778	1	1	EDGE BOOTH, HOLLY PHD	7/17/2024	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	625 S FAIR OAKS AVE	#325	PASADENA	CA	91105	2675	19	06037	34.134894	-118.1504155	Los Angeles County
913	Fee-for-Service	1619381779	1619381779	1	1	ENGLE, MICHELLE Y MD	8/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	139134	01	General Practice	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
930	Fee-for-Service	1023191459	1023191459	1	1	EIN, MICHAEL E MD	6/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	27748	41	Internal Medicine	0	In state provider	None	2485 HIGH SCHOOL AVE	STE 303	CONCORD	CA	94520	1818	07	06013	37.98507961	-122.034189	Contra Costa County
932	Fee-for-Service	1013037779	1013037779	1	1	EPSTEIN, JOEL D MD	2/28/1983	207RP1001X	NA	Pulmonology	026	PHYSICIANS	39220	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	10250 ARTESIA BLVD	None	BELLFLOWER	CA	90706	6720	19	06037	33.8728535	-118.1154555	Los Angeles County
935	Fee-for-Service	1144715707	1144715707	2	1	ER CARE GROUP EL MONTE A MED	12/7/2021	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ICAL CORPORATION	1701 SANTA ANITA AVE	None	SOUTH EL MONTE	CA	91733	3482	19	06037	34.04810648	-118.0424794	Los Angeles County
992	Fee-for-Service	1326488743	1326488743	1	1	ELDER SERVICES INC	12/16/2013	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	1460 MERCED AVE	None	MERCED	CA	95341	5332	24	06047	37.29153108	-120.4585481	Merced County
1012	Fee-for-Service	1922143817	1922143817	1	1	ESPINOZA, SAMUEL LCSW	11/27/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	29995 TECHNOLOGY DR	103	MURRIETA	CA	92563	0000	33	06065	33.56041691	-117.1370428	Riverside County
1061	Fee-for-Service	1578671764	1578671764	1	1	ENDERBY, SCOTT F DO	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	6530	None	None	0	In state provider	None	2450 ASHBY AVE	RM 1002	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
1092	Fee-for-Service	1689710618	1689710618	1	1	ELLIOTT, CORAZON C MD MPH	12/3/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	53480	-	NOT APPLICABLE	0	In state provider	None	24 EAST MAIN STREET	None	VENTURA	CA	93001	2660	56	06111	34.28096357	-119.3003485	Ventura County
1121	Fee-for-Service	1619051034	1619051034	1	1	EDWARDS, MICHAEL S MD	11/23/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	37469	14	Neurological Surgery	0	In state provider	None	2800 L ST	STE 340	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
1140	Fee-for-Service	1467524272	1467524272	1	1	ESPY, CHARLIE IV MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69625	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
1143	Fee-for-Service	1891021762	1891021762	1	1	EBADAT, FARNOOSH N NP	9/28/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
1265	Fee-for-Service	1437475886	1437475886	1	1	ESPINA, SHEILA D	5/25/2010	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	24012 CALLE LA PLATA	STE 300	LAGUNA HILLS	CA	92653	7602	30	06059	33.61012113	-117.7115908	Orange County
1353	Fee-for-Service	1740573120	1740573120	1	1	ESMAILZADEGAN, ARASH MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136449	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	SUITE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
1373	Fee-for-Service	1144572264	1144572264	1	1	ETTIEN, A'MAYA	6/2/2020	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	3101 TELEGRAPH AVE	None	BERKELEY	CA	94705	1984	01	06001	37.85361291	-122.2600247	Alameda County
1409	Fee-for-Service	1619051034	1619051034	1	1	EDWARDS, MICHAEL S MD	11/23/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	37469	79	Neurology-Child	0	In state provider	None	2800 L ST	STE 340	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
1428	Fee-for-Service	1467524272	1467524272	1	1	ESPY, CHARLIE IV MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69625	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
1488	Fee-for-Service	1871668897	1871668897	1	1	ESBERTO LOAR, MARY GRACE LM	7/8/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	41591 FLORIDA AVE	STE. D	HEMET	CA	92544	4991	33	06065	33.7476747	-116.9146249	Riverside County
1535	Fee-for-Service	1174708804	1174708804	1	1	EAGLE VISION EYE CARE	11/17/2010	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC GROUP	5777 GREENBACK LANE	STE 100	SACRAMENTO	CA	95841	2013	34	06067	38.682756	-121.327839	Sacramento County
1604	Fee-for-Service	1700959848	1700959848	1	1	ESQUENAZI, LUIS MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	63530	08	Family Practice	0	In state provider	None	145 THUNDER DR	None	VISTA	CA	92083	6010	37	06073	33.18535652	-117.288201	San Diego County
1642	Fee-for-Service	1902908858	1902908858	1	1	EVANS, TANYA Y MD	6/21/2019	174400000X	NA	Other	026	PHYSICIANS	68285	07	Dermatology	0	In state provider	None	27020 ALICIA PKWY	SUITE G	LAGUNA NIGUEL	CA	92677	3420	30	06059	33.57034461	-117.7145124	Orange County
1668	Fee-for-Service	1699302240	1699302240	1	1	EBRAHEEM HAMED	1/30/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	13849 COBBLESTONE CT	None	FONTANA	CA	92335	0504	36	06071	34.10412972	-117.5033739	San Bernardino County
1768	Fee-for-Service	1780680025	1780680025	1	1	ESKATON PROPERTIES INC	4/19/1993	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3939 WALNUT AVENUE	None	CARMICHAEL	CA	95608	2191	34	06067	38.636523	-121.348341	Sacramento County
1811	Fee-for-Service	1720420854	1720420854	1	1	EVERTON-LOVELL, STEFANIE A L	10/7/2021	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	PCC	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
1994	Fee-for-Service	1306992953	1306992953	1	1	ESPINOZA, DANIELLE M LMFT	9/18/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
2016	Fee-for-Service	1881859981	1881859981	1	1	ENTABI, FATEH MD	6/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	124555	02	General Surgery	0	In state provider	None	1070 N CHERRY STREET	SUITE C	TULARE	CA	93274	2251	54	06107	36.22361913	-119.3373351	Tulare County
2078	Fee-for-Service	1164654331	1164654331	1	1	EARHART, CHRISTINA MD	9/30/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108038	30	Radiology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
2220	Fee-for-Service	1326044355	1326044355	1	1	ERNEST RUDOLPH ANDERS I I I,	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5102 W.CAMPBELL	None	PHOENIX	AZ	85031	1703	00	None	33.502932	-112.171095	Maricopa County
2269	Fee-for-Service	1841301371	1841301371	1	1	ELDER, MAHR DDS MD	10/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	93771	None	None	0	In state provider	None	1805 NOVATO BLVD	SUITE #1	NOVATO	CA	94947	2934	21	06041	38.10838371	-122.5838215	Marin County
2299	Fee-for-Service	1730596115	1730596115	1	1	EMANUEL, HINA MD	10/8/2023	2080P0214X	NA	Pulmonology	026	PHYSICIANS	184562	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
2466	Fee-for-Service	1154718062	1154718062	1	1	EVANS, SARAH S MD	11/16/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	143420	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
2561	Fee-for-Service	1962872705	1962872705	1	1	ESPINO, NAISHA T CRNA	12/1/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
2716	Fee-for-Service	1689700122	1689700122	1	1	EMMANUEL C ACHOLONU	11/6/1992	183500000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	10TH AVENUE PHARMACY	2706 WEST M.L.K. BLVD	None	LOS ANGELES	CA	90008	0000	19	06037	34.01059614	-118.3225682	Los Angeles County
2835	Fee-for-Service	1093165896	1093165896	1	1	ESKEW, JARED PT	7/18/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	13019 STOCKDALE HWY	500	BAKERSFIELD	CA	93314	9570	15	06029	35.35418947	-119.147103	Kern County
2881	Fee-for-Service	1265731392	1265731392	1	1	ECKERT, AJ B DO	3/11/2024	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	22535	None	None	0	In state provider	None	5000 W SUNSET BLVD	FL 4	LOS ANGELES	CA	90027	5861	19	06037	34.0981066	-118.2986382	Los Angeles County
2929	Fee-for-Service	1386440097	1386440097	1	1	EAST BAY DOULA SISTERS	2/24/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
2982	Fee-for-Service	1003179276	1003179276	1	1	ERKKINEN, MICHAEL G MD	4/7/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	143213	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
3011	Fee-for-Service	1033165139	1033165139	1	1	EBRAHIMI, BEHNAM MD	5/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81045	68	Hematology	0	In state provider	None	8283 GROVE AVE	STE 207	RANCHO CUCAMONGA	CA	91730	3141	36	06071	34.10380433	-117.6285116	San Bernardino County
3023	Fee-for-Service	1083188148	1083188148	1	1	EVANS, CATHLENE	12/4/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
3027	Fee-for-Service	1649463191	1649463191	1	2	ELLINGSON, DAVID LMFT	12/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6347 COYLE AVE	None	CARMICHAEL	CA	95608	0438	34	06067	38.668257	-121.316301	Sacramento County
3028	Fee-for-Service	1518539048	1518539048	1	1	EXCEPTIONAL HEALTH CARE MARI	12/27/2021	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	19060 NORTH JOHN WAYNE P	None	MARICOPA	AZ	85139	2923	00	None	33.052824	-112.0478715	Pinal County
3061	Fee-for-Service	1770209025	1770209025	1	1	ERHAHON-ILEN-OTUMA, KATHRYN	3/27/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	CNP	23357 MULHOLLAND DR	None	WOODLAND HILLS	CA	91364	2734	19	06037	34.15788221	-118.6355139	Los Angeles County
3067	Fee-for-Service	1770670515	1770670515	1	1	EISENBERG, DANIEL MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	43184	None	None	0	In state provider	None	12629 RIVERSIDE DR	None	NORTH HOLLYWOOD	CA	91607	3488	19	06037	34.15763646	-118.408473	Los Angeles County
3231	Fee-for-Service	1083890099	1083890099	1	1	ELGOHARY, BASSEM G MD	5/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103788	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
3283	Fee-for-Service	1013440932	1013440932	1	1	ESSENTIAL ORTHOTICS AND PROS	2/11/2021	335E00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	THETICS INC	360 GRAND CYPRESS AVE	SUITE 304	PALMDALE	CA	93551	3646	19	06037	34.61368852	-118.1360475	Los Angeles County
3295	Fee-for-Service	1003044728	1003044728	1	1	EDMONDS, KYLE P MD	7/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121683	08	Family Practice	0	In state provider	None	4311 THIRD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
3299	Fee-for-Service	1033165139	1033165139	1	1	EBRAHIMI, BEHNAM MD	5/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81045	78	Neoplastic Diseases/Oncology	0	In state provider	None	8283 GROVE AVE	STE 207	RANCHO CUCAMONGA	CA	91730	3141	36	06071	34.10380433	-117.6285116	San Bernardino County
3316	Fee-for-Service	1518539048	1518539048	1	1	EXCEPTIONAL HEALTH CARE MARI	12/27/2021	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	19060 NORTH JOHN WAYNE P	None	MARICOPA	AZ	85139	2923	00	None	33.052824	-112.0478715	Pinal County
3317	Fee-for-Service	1447348024	1447348024	1	1	EBRAHIMIAN, SHAHIN MD INC	8/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88201	05	Anesthesiology	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
3336	Fee-for-Service	1881144848	1881144848	1	1	EMERY, CHEYENNE LMFT	3/8/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	811 W. 7TH ST.	12TH FLOOR	LOS ANGELES	CA	90017	3403	19	06037	34.0489635	-118.2591312	Los Angeles County
3343	Fee-for-Service	1225584584	1225584584	1	1	EAWAZ, LEYDIS M CNP	9/29/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2630 W EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	1117	43	06085	37.40212151	-122.1149462	Santa Clara County
3519	Fee-for-Service	1083890099	1083890099	1	1	ELGOHARY, BASSEM G MD	5/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103788	10	Gastroenterology (M.D. only)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
3632	Fee-for-Service	1922533314	1922533314	1	1	EMERSON, NATACHA PHD	8/29/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
3637	Fee-for-Service	1164853347	1164853347	1	1	ESQUIVEL, MELISA N LMFT	9/28/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
3679	Fee-for-Service	1003852674	1003852674	1	1	EPSTEIN, HOWARD D MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67834	22	Pathology (M.D. only)	0	In state provider	None	301 N NEWPORT BLVD	None	NEWPORT BEACH	CA	92658	0000	30	06059	33.6242782	-117.9284249	Orange County
3747	Fee-for-Service	1972179141	1972179141	1	1	EASY HEALTH MEDICAL SOLUTION	7/24/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	S	1180 BEVERLY DR	SUITE 700	LOS ANGELES	CA	90035	1153	19	06037	34.05550055	-118.395555	Los Angeles County
3882	Fee-for-Service	1689092728	1689092728	1	1	ELKHOURY, FUAD F MD	3/23/2020	208800000X	NA	Other	026	PHYSICIANS	138701	34	Urology and Urological Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
3888	Fee-for-Service	1306812979	1306812979	1	1	EIFRIG, CHARLES W MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53104	18	Ophthalmology	0	In state provider	None	23521 PASEO DE VALENCIA	STE 305	LAGUNA HILLS	CA	92653	3144	30	06059	33.61113028	-117.7126684	Orange County
4022	Fee-for-Service	1801989280	1801989280	1	1	EIGNER, DANIELLE A DO	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10329	01	General Practice	0	In state provider	None	350 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94117	3608	38	06075	37.76403932	-122.4561371	San Francisco County
4029	Fee-for-Service	1619930500	1619930500	1	1	ELIOPULOS, JOHN J OD INC	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9074 ELK GROVE BLVD	None	ELK GROVE	CA	95624	2046	34	06067	38.408913	-121.3631685	Sacramento County
4038	Fee-for-Service	1972179141	1972179141	1	1	EASY HEALTH MEDICAL SOLUTION	7/24/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	S	1180 BEVERLY DR	SUITE 700	LOS ANGELES	CA	90035	1153	19	06037	34.05550055	-118.395555	Los Angeles County
4136	Fee-for-Service	1487180501	1487180501	1	1	EPIONE HOME HEALTH CARE INC	9/10/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	8345 RESEDA BLVD	SUITE 207	NORTHRIDGE	CA	91324	5943	19	06037	34.222005	-118.5360975	Los Angeles County
4150	Fee-for-Service	1750710034	1750710034	1	1	EYE MEDICAL CLINIC OF FRESNO	5/21/2014	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1360 E HERNDON AVE	STE 301	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
4324	Fee-for-Service	1891846671	1891846671	1	1	EMERALD HEALTH SERVICES INC	1/26/2015	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	17520 CASTLETON ST	STE 103	CITY OF INDUSTRY	CA	91748	5798	19	06037	33.99237	-117.9230625	Los Angeles County
4340	Fee-for-Service	1427359447	1427359447	2	1	EMERGENCY MEDICINE PHYSICIAN	12/31/2012	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	1	Border provider	OF CLARK UMC MCCOURT	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
4370	Fee-for-Service	1770693863	1770693863	1	1	ENRIQUEZ, ANNETTE L D MD	12/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90466	01	General Practice	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
4378	Fee-for-Service	1902171234	1902171234	1	1	ELAINE WESTLAKE	7/6/2012	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	1278 INDIANA STREET	SUITE 300	SAN FRANCISCO	CA	94107	7346	38	06075	37.75427856	-122.3908849	San Francisco County
4402	Fee-for-Service	1013146307	1013146307	1	1	ELBULUK, NADA M MD	9/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154630	07	Dermatology	0	In state provider	None	1450 SAN PABLO ST	SUITE 2000	LOS ANGELES	CA	90033	5300	19	06037	34.06189518	-118.203256	Los Angeles County
4481	Fee-for-Service	1003831124	1003831124	1	1	ETIZ, WILLIAM B DO	6/27/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	6060	None	None	0	In state provider	None	1411 7TH ST	None	SANGER	CA	93657	2420	10	06019	36.70628837	-119.5576566	Fresno County
4659	Fee-for-Service	1770693863	1770693863	1	1	ENRIQUEZ, ANNETTE L D MD	12/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90466	08	Family Practice	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
4704	Fee-for-Service	1093343105	1093343105	1	1	EMPIE, KRISTEN MD	9/11/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	186707	None	None	0	In state provider	None	8881 FLETCHER PKWY	200	LA MESA	CA	91942	3134	37	06073	32.78442148	-117.0073814	San Diego County
4773	Fee-for-Service	1447301593	1447301593	1	1	EYE MD LASER & SURGERY	8/31/1999	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER, LLC	481 30TH ST	None	OAKLAND	CA	94609	3209	01	06001	37.81926665	-122.2664677	Alameda County
4956	Fee-for-Service	1639267966	1639267966	1	1	EMOTO, CHERYL A MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	55837	40	Pediatrics	0	In state provider	None	565 N MOUNT VERNON AVE	None	SAN BERNARDINO	CA	92411	2661	36	06071	34.109406	-117.313813	San Bernardino County
5102	Fee-for-Service	1407463847	1407463847	1	1	EVANO, TWYLA PT	12/3/2021	2251N0400X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5350 OLIVE ST	None	MONTCLAIR	CA	91763	1639	36	06071	34.09054746	-117.6886395	San Bernardino County
5110	Fee-for-Service	1982960084	1982960084	1	1	EAST BAY TRAUMA & ACUTE CARE	7/18/2019	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	SURGERY INC.	19845 LAKE CHABOT RD	200	CASTRO VALLEY	CA	94546	4055	01	06001	37.69995352	-122.087795	Alameda County
5119	Fee-for-Service	1629500244	1629500244	1	1	ERIKSSON, NIKLAS E MD	12/1/2019	207P00000X	NA	Other	026	PHYSICIANS	159138	66	Emergency Medicine (Urgent Care)	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
5233	Fee-for-Service	1306308366	1306308366	1	1	ENCOMPASS HEALTH	3/13/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION HOSPITAL	35470 WHITEWOOD ROAD	None	MURRIETA	CA	92563	2415	33	06065	33.60671588	-117.1628131	Riverside County
5336	Fee-for-Service	1003378142	1003378142	1	1	ETERNAL GRACE HOSPICE, INC	9/10/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6742 VAN NUYS BLVD	STE 102	VAN NUYS	CA	91405	4611	19	06037	34.19343344	-118.4487213	Los Angeles County
5396	Fee-for-Service	1598139891	1598139891	1	1	ENCOMPASS HEALTH	12/5/2016	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION HOSPITAL	1303 MABLE AVENUE	None	MODESTO	CA	95355	1120	50	06099	37.69613281	-120.9756292	Stanislaus County
5410	Fee-for-Service	1134221252	1134221252	1	1	EATON, MARTIN PHD	1/12/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	100 S IMPERIAL HWY	None	ANAHEIM	CA	92807	3943	30	06059	33.85001282	-117.7903584	Orange County
5437	Fee-for-Service	1811371081	1811371081	1	1	ELSHIKH, FADY M MD	10/19/2023	207R00000X	NA	Other	026	PHYSICIANS	191029	None	None	0	In state provider	None	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
5528	Fee-for-Service	1306308366	1306308366	1	1	ENCOMPASS HEALTH	3/13/2020	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION HOSPITAL	35470 WHITEWOOD ROAD	None	MURRIETA	CA	92563	2415	33	06065	33.60671588	-117.1628131	Riverside County
5529	Fee-for-Service	1215163084	1215163084	1	1	EDWARDS, GEOFFREY D CRNA	4/20/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
5592	Fee-for-Service	1275609547	1275609547	1	1	ECKINGER, PAUL M MD	6/1/1999	207L00000X	NA	Other	026	PHYSICIANS	62217	05	Anesthesiology	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
5623	Fee-for-Service	1003378142	1003378142	1	1	ETERNAL GRACE HOSPICE, INC	9/10/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6742 VAN NUYS BLVD	STE 102	VAN NUYS	CA	91405	4611	19	06037	34.19343344	-118.4487213	Los Angeles County
5651	Fee-for-Service	1447855218	1447855218	1	1	EASE IN HOSPICE CARE INC	5/24/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	715 N CENTRAL AVE	STE 214	GLENDALE	CA	91203	4254	19	06037	34.15695962	-118.2580155	Los Angeles County
5683	Fee-for-Service	1598139891	1598139891	1	1	ENCOMPASS HEALTH	12/5/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION HOSPITAL	1303 MABLE AVENUE	None	MODESTO	CA	95355	1120	50	06099	37.69613281	-120.9756292	Stanislaus County
5753	Fee-for-Service	1437614310	1437614310	1	1	ESLANI, MEDI MD	5/30/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	182546	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
5805	Fee-for-Service	1154401297	1154401297	1	1	ELIAS, ALAN N MD	8/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	30358	67	Endocrinology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
5808	Fee-for-Service	1144310038	1144310038	1	1	EDWARD CARTER	4/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
5913	Fee-for-Service	1134182884	1134182884	1	1	EILERS, HELGE MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67047	05	Anesthesiology	0	In state provider	None	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
5940	Fee-for-Service	1447855218	1447855218	1	1	EASE IN HOSPICE CARE INC	5/24/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	715 N CENTRAL AVE	STE 214	GLENDALE	CA	91203	4254	19	06037	34.15695962	-118.2580155	Los Angeles County
5977	Fee-for-Service	1831133073	1831133073	1	1	ERSKINE, JAMES M MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	61533	30	Radiology	0	In state provider	None	995 SAINT JOHN PL	None	HEMET	CA	92543	4436	33	06065	33.74848448	-116.9616465	Riverside County
6037	Fee-for-Service	1104888072	1104888072	1	1	EAPEN, JACOB MD	8/24/2004	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51082	40	Pediatrics	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
6048	Fee-for-Service	1053003087	1053003087	1	4	ELITE FAMILY MEDICINE	2/12/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1901 W BADILLO STREET	None	WEST COVINA	CA	97190	1133	19	06037	34.08730047	-117.9444827	Los Angeles County
6051	Fee-for-Service	1902974694	1902974694	1	1	EMMANOUEL, MARKOS D MD	5/17/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	112764	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
6092	Fee-for-Service	1154401297	1154401297	1	1	ELIAS, ALAN N MD	8/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	30358	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
6155	Fee-for-Service	1184801839	1184801839	1	1	ESTRADA,JAIME OPTOMETRIC APC	11/9/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4511 E GAGE AVE	None	BELL	CA	90201	1308	19	06037	33.97797496	-118.1864256	Los Angeles County
6190	Fee-for-Service	1790933521	1790933521	1	1	EPSTEIN, MATTHEW D MD	6/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119143	None	None	0	In state provider	None	2125 OAK GROVE RD	STE 200	WALNUT CREEK	CA	94598	2520	07	06013	37.930767	-122.0177917	Contra Costa County
6280	Fee-for-Service	1649374398	1649374398	1	1	EDEN COUNSELING SERVICES INC	3/17/2025	No Taxonomy Provided	NA	None	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	20253 REDWOOD RD	#A	CASTRO VALLEY	CA	94546	4331	01	06001	37.697652	-122.0739785	Alameda County
6335	Fee-for-Service	1053003087	1053003087	1	2	ELITE FAMILY MEDICINE	7/10/2024	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1911 W GLENOAKS BLVD	B	GLENDALE	CA	91201	4744	19	06037	34.17434179	-118.2939072	Los Angeles County
6338	Fee-for-Service	1962245308	1962245308	1	1	EARLEY, CAROL DOULA	6/16/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
6459	Fee-for-Service	1952488801	1952488801	1	1	EMOND, STEPHEN D MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86187	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
6483	Fee-for-Service	1275623811	1275623811	2	1	E & M PHARMACIES INC	4/25/2014	332BP3500X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2105 BEVERLY BLVD	STE 107	LOS ANGELES	CA	90057	2216	19	06037	34.06682861	-118.2706286	Los Angeles County
6540	Fee-for-Service	1255560447	1255560447	1	1	ENGEL, CINDY LCSW	2/18/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 N PALM CANYON DR	215	PALM SPRINGS	CA	92262	5658	33	06065	33.827652	-116.5468485	Riverside County
6623	Fee-for-Service	1053003087	1053003087	1	2	ELITE FAMILY MEDICINE	4/4/2024	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1911 W GLENOAKS BLVD	B	GLENDALE	CA	91201	4744	19	06037	34.17434179	-118.2939072	Los Angeles County
6687	Fee-for-Service	1396800231	1396800231	1	1	ESPINOSA, JAMES C OD	8/29/2005	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27949 GREENSPOT RD	STE F	HIGHLAND	CA	92346	4444	36	06071	34.10815182	-117.1950228	San Bernardino County
6721	Fee-for-Service	1760694897	1760694897	1	1	ER AMBULANCE	5/2/2012	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1365 NORTH JOHNSON AVE	SUITE 116	EL CAJON	CA	92020	1649	37	06073	32.813955	-116.9709805	San Diego County
6732	Fee-for-Service	1891195210	1891195210	1	1	ENRIQUEZ, THERESA MD INC	6/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	49327	01	General Practice	0	In state provider	None	210 W 7TH STREET	None	OXNARD	CA	93030	7173	56	06111	34.1950215	-119.179116	Ventura County
6733	Fee-for-Service	1336760446	1336760446	1	1	EILAT DAY CARE INC	5/26/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1606 S HOLT AVE	None	LOS ANGELES	CA	90035	3613	19	06037	34.04931475	-118.3790959	Los Angeles County
6745	Fee-for-Service	1952488801	1952488801	1	1	EMOND, STEPHEN D MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86187	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
6793	Fee-for-Service	1023156130	1023156130	1	1	ELLIS, GLEN	6/14/2000	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	5880 W LAS POSITAS BLVD	STE 31	PLEASANTON	CA	94588	8552	01	06001	37.68371601	-121.8980138	Alameda County
6810	Fee-for-Service	1306105473	1306105473	1	1	EDI, RINA S MD	5/3/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	136357	01	General Practice	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
6821	Fee-for-Service	1467913251	1467913251	1	1	ESTRADA, ALLISON M MD	9/23/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	179598	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
7054	Fee-for-Service	1215284880	1215284880	1	1	ERB, DARRIN LMFT	3/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5850 EL CAMINO REAL	None	ATASCADERO	CA	93422	3318	40	06079	35.48962035	-120.670989	San Luis Obispo County
7150	Fee-for-Service	1518036037	1518036037	1	1	EL DORADO COMM SVS CTR	7/30/2001	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	BAKERSFIELD MED & MENTAL	1010 1/2 S UNION AVE	None	BAKERSFIELD	CA	93307	3642	15	06029	35.34390262	-119.0029241	Kern County
7327	Fee-for-Service	1073749792	1073749792	1	1	ENGKATANAKORN, NARUCHON MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112719	41	Internal Medicine	0	In state provider	None	2752 HARRISON AVENUE	SUITE A	EUREKA	CA	95501	4738	12	06023	40.7831071	-124.139684	Humboldt County
7363	Fee-for-Service	1659333540	1659333540	1	1	EGBERT, JAMES E MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	60005	18	Ophthalmology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
7385	Fee-for-Service	1578259891	1578259891	1	1	ELEPHANT EAR HEARING SERVICE	8/5/2023	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	S, INC.	500 PROFESSIONAL CENTER	STE 511	NOVATO	CA	94947	4361	21	06041	38.09574302	-122.5780834	Marin County
7481	Fee-for-Service	1922238112	1922238112	1	1	EQUIHUA, PAULINO A MD	9/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102615	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
7503	Fee-for-Service	1982655668	1982655668	1	1	EL-TOBGY, ERIC K MD	7/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85213	66	Emergency Medicine (Urgent Care)	0	In state provider	None	616 WITMER ST	None	LOS ANGELES	CA	90017	2308	19	06037	34.0549933	-118.2658354	Los Angeles County
7542	Fee-for-Service	1386840460	1386840460	1	2	ENVISION HOME HEALTH SRVCS	5/20/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	17725 CRENSHAW BLVD	SUITE 302	TORRANCE	CA	90504	4157	19	06037	33.86941815	-118.3265141	Los Angeles County
7563	Fee-for-Service	1609089556	1609089556	1	1	EMED TRANSPORT SERV INC	7/10/2006	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	AMADI, EJIMOFOR	1810 5TH ST	None	LINCOLN	CA	95648	2328	31	06061	38.89178837	-121.31116	Placer County
7572	Fee-for-Service	1396312526	1396312526	1	1	ESMAEILY, LEONA LMFT	12/7/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
7577	Fee-for-Service	1790751188	1790751188	1	1	EVORA, DARRYL K MD	1/31/1995	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	76577	30	Radiology	0	In state provider	None	1109 W LA VETA AVE	None	ORANGE	CA	92868	4201	30	06059	33.7803783	-117.8641904	Orange County
7590	Fee-for-Service	1528695269	1528695269	1	1	ETEMADI, KIMIA DO	4/23/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	20487	15	Obstetrics (D.O. only)	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
7726	Fee-for-Service	1124607676	1124607676	1	1	EL-HENDI, TONYA R LCSW	8/2/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4199 CAMPUS DR	SUITE 550, OFFICE 57	IRVINE	CA	92612	4684	30	06059	33.650775	-117.838296	Orange County
7809	Fee-for-Service	1407952427	1407952427	1	1	EVANS, DAVID G MD	1/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	55686	30	Radiology	0	In state provider	None	229 W PUEBLO ST	None	SANTA BARBARA	CA	93105	3804	42	06083	34.43090309	-119.7214977	Santa Barbara County
7853	Fee-for-Service	1790367191	1790367191	1	1	ELITE COMFORT HOME HEALTH CA	9/8/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE	21405 DEVONSHIRE ST	SUITE 221	CHATSWORTH	CA	91311	2941	19	06037	34.25726452	-118.598076	Los Angeles County
7878	Fee-for-Service	1528695269	1528695269	1	1	ETEMADI, KIMIA DO	4/23/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	20487	09	Gynecology (D.O. only)	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
7919	Fee-for-Service	1346258753	1346258753	1	1	ESCAJEDA, DANIEL L MD	6/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	40259	05	Anesthesiology	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
7975	Fee-for-Service	1447506373	1447506373	1	1	EXPERT MEDICAL MANAGEMENT	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	2913 N GLENOAKS BLVD	None	BURBANK	CA	91504	2606	19	06037	34.20400579	-118.3357798	Los Angeles County
7997	Fee-for-Service	1871577759	1871577759	1	1	ENNIS, LISA K PT	3/27/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	27722 CLINTON KEITH RD.,	None	MURRIETA	CA	92562	0000	33	06065	33.59891845	-117.1765297	Riverside County
8097	Fee-for-Service	1407952427	1407952427	1	1	EVANS, DAVID G MD	1/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	55686	42	Nuclear Medicine	0	In state provider	None	229 W PUEBLO ST	None	SANTA BARBARA	CA	93105	3804	42	06083	34.43090309	-119.7214977	Santa Barbara County
8152	Fee-for-Service	1366814048	1366814048	1	1	EDDY, TASHA LCSW	6/23/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
8163	Fee-for-Service	1295220499	1295220499	1	2	EXCLUSIVE SENIOR CARE, INC.	11/25/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6486 E CALLE DEL NORTE	None	ANAHEIM HILLS	CA	92807	4204	30	06059	33.84668174	-117.7657926	Orange County
8253	Fee-for-Service	1225271497	1225271497	1	2	ECLIPSE HOME HEALTH CARE INC	2/8/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	13758 VICTORY BLVD	STE 206	VAN NUYS	CA	91401	6728	19	06037	34.18664549	-118.4332815	Los Angeles County
8260	Fee-for-Service	1447506373	1447506373	1	1	EXPERT MEDICAL MANAGEMENT	2/1/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	2913 N GLENOAKS BLVD	None	BURBANK	CA	91504	2606	19	06037	34.20400579	-118.3357798	Los Angeles County
8308	Fee-for-Service	1669935342	1669935342	1	1	EUGENIO, FELISHA J MD	7/20/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180002	None	None	0	In state provider	None	2625 W ALAMEDA AVE	300, 322	BURBANK	CA	91505	4819	19	06037	34.1577056	-118.329779	Los Angeles County
8316	Fee-for-Service	1467589614	1467589614	1	1	EPIPHANY CARE HOMES, INC	8/1/2003	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1101 IVYWOOD DR	None	OXNARD	CA	93030	3415	56	06111	34.21604917	-119.1902603	Ventura County
8426	Fee-for-Service	1407906894	1407906894	1	1	EXPERT IMAGING INCORPORATED	10/19/2010	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2593 LA PALOMA CIRCLE	None	THOUSAND OAKS	CA	91360	1533	56	06111	34.21485135	-118.8887399	Ventura County
8435	Fee-for-Service	1295768265	1295768265	1	1	ELEAS CHAFOULEAS	4/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	281 HARTFORD TPKE	STE 210	VERNON	CT	06066	4759	00	None	41.82639614	-72.49315107	Capitol Planning Region
8638	Fee-for-Service	1952354607	1952354607	1	1	ELLIS, RICHARD R MD	2/28/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	23337	22	Pathology (M.D. only)	0	In state provider	None	19951 MARINER AVE	STE 150	TORRANCE	CA	90503	1738	19	06037	33.85129396	-118.3504889	Los Angeles County
8698	Fee-for-Service	1669835005	1669835005	1	1	EAJAZI, ALIREZA MD	7/14/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	171288	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
8712	Fee-for-Service	1285740712	1285740712	1	1	EDWARD ROBERT SMITH MD	11/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9191 GRANT ST	None	THORNTON	CO	80229	4361	00	None	39.86420881	-104.9846155	Adams County
8888	Fee-for-Service	1417093782	1417093782	1	1	EISEN, KATHERINE P PHD	6/23/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94303	3341	43	06085	37.43304542	-122.1759654	Santa Clara County
8891	Fee-for-Service	1487008082	1487008082	1	1	EZIMORA, CANDY O	8/4/2021	207L00000X	NA	Other	026	PHYSICIANS	166500	None	None	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
8941	Fee-for-Service	1154613677	1154613677	1	1	EDWARDS, JORDAN W MD	7/21/2020	208M00000X	NA	Other	026	PHYSICIANS	122477	41	Internal Medicine	0	In state provider	None	7590 MIRAMAR RD	STE C	SAN DIEGO	CA	92126	4232	37	06073	32.88443824	-117.1520684	San Diego County
8971	Fee-for-Service	1083125462	1083125462	1	1	EMPIRE SENIOR TRANSPORT	4/2/2019	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1515 THE ALAMEDA	SUITE 101	SAN JOSE	CA	95126	2321	43	06085	37.33442226	-121.915582	Santa Clara County
8973	Fee-for-Service	1710934310	1710934310	1	1	EZEH, UCHECHUKWU I MD	5/1/2003	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	81034	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	350 30TH ST	STE 205	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
9062	Fee-for-Service	1306049499	1306049499	1	1	ENGELKEMIER, DAWN R MD	1/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	108096	40	Pediatrics	0	In state provider	None	300 FIR ST	None	SAN DIEGO	CA	92101	2327	37	06073	32.72513447	-117.1616355	San Diego County
9131	Fee-for-Service	1205898806	1205898806	2	1	EGSIEKER, ERIK L MD	11/1/2018	207P00000X	NA	Other	026	PHYSICIANS	156675	66	Emergency Medicine (Urgent Care)	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
9237	Fee-for-Service	1588977151	1588977151	1	1	EKHOLM, JANNA L CNM	2/8/2015	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
9253	Fee-for-Service	1003812744	1003812744	1	1	ELLIS, MARK G MD	3/18/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65432	40	Pediatrics	0	In state provider	None	2800 HARRIS ST	None	EUREKA	CA	95503	4809	12	06023	40.78047245	-124.1361392	Humboldt County
9258	Fee-for-Service	1235645169	1235645169	1	1	ETHERTON, MELISSA PT	7/12/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3908 10 STREET	None	RIVERSIDE	CA	92501	3522	33	06065	33.98117228	-117.3785355	Riverside County
9281	Fee-for-Service	1548575061	1548575061	1	2	ECO OPTOMETRY, INC	10/3/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	VALLEY INC	24250 POSTAL AVE	100	MORENO VALLEY	CA	92553	7722	33	06065	33.94038473	-117.239417	Riverside County
9311	Fee-for-Service	1720188550	1720188550	1	1	ENGSTROM, KELLY AIMEE R NMW	2/8/2015	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	555 E VALLEY PKWY	None	ESCONDIDO	CA	92025	3048	37	06073	33.12542915	-117.0764725	San Diego County
9348	Fee-for-Service	1306049499	1306049499	1	1	ENGELKEMIER, DAWN R MD	1/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	108096	30	Radiology	0	In state provider	None	300 FIR ST	None	SAN DIEGO	CA	92101	2327	37	06073	32.72513447	-117.1616355	San Diego County
9428	Fee-for-Service	1902417124	1902417124	1	1	EMBRADO, FELY T NP	5/18/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
9560	Fee-for-Service	1821429978	1821429978	1	1	EL MIRADOR SURGERY CENTER	12/1/2013	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	1180 N INDIAN CANYON DR	SUITE 110	PALM SPRINGS	CA	92262	4886	33	06065	33.839505	-116.5455735	Riverside County
9691	Fee-for-Service	1417055948	1417055948	1	1	EAST COUNTY URGENT CARE	7/31/1992	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	INDUSTRIAL MEDICAL CLINI	7586 BROADWAY	None	LEMON GROVE	CA	91945	1604	37	06073	32.74274949	-117.03474	San Diego County
9724	Fee-for-Service	1891768768	1891768768	1	1	ERLY, WILLIAM K MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL	None	TUCSON	AZ	85724	0002	00	None	32.240493	-110.9460825	Pima County
9782	Fee-for-Service	1184073165	1184073165	1	1	ELKHAYAT, SALEM MD	9/6/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
9963	Fee-for-Service	1598853491	1598853491	1	1	ECHOLS, MINA A MD	7/31/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	34088	40	Pediatrics	0	In state provider	None	17705 HALE AVE	STE I1	MORGAN HILL	CA	95037	4348	43	06085	37.13056972	-121.6603764	Santa Clara County
9976	Fee-for-Service	1013275874	1013275874	2	1	ELITE BIOMECHANICAL DESIGN	2/23/2016	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2208 5TH AVE	None	OROVILLE	CA	95965	5816	04	06007	39.50224134	-121.564901	Butte County
9978	Fee-for-Service	1487914503	1487914503	1	1	ESPINOZA, JUAN C MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121058	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
10024	Fee-for-Service	1598415937	1598415937	1	1	EDQUILANG, JESUS MD	11/14/2024	207R00000X	NA	Other	026	PHYSICIANS	187191	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
10064	Fee-for-Service	1821146804	1821146804	1	1	ESFAHANI, POONEH DO	11/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7825	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
10087	Fee-for-Service	1942379474	1942379474	1	1	EHRLICH, SUSAN P MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79518	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
10110	Fee-for-Service	1386198489	1386198489	1	1	ESMAEILI, AZADEH MD	12/15/2022	207ZP0102X	NA	Other	026	PHYSICIANS	181222	None	None	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
10127	Fee-for-Service	1922756378	1922756378	1	1	EUGENE THOMAS KAHN M D P C	6/23/2022	208600000X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	3801 KATELLA AVE	STE 320	LOS ALAMITOS	CA	90720	3344	30	06059	33.80318951	-118.066068	Orange County
10221	Fee-for-Service	1912552183	1912552183	1	1	EDGINGTON, ANNA NP	8/4/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
10229	Fee-for-Service	1104858059	1104858059	1	1	EVANS, JAMES T MD	8/6/1990	207P00000X	NA	Other	026	PHYSICIANS	69416	66	Emergency Medicine (Urgent Care)	0	In state provider	None	29101 HOSPITAL RD	None	LAKE ARROWHEAD	CA	92352	0000	36	06071	34.26577765	-117.1695461	San Bernardino County
10415	Fee-for-Service	1891292231	1891292231	1	1	EUWING, TASAUNA	10/24/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8421 AUBURN BLVD	SUITE 110	CITRUS HEIGHTS	CA	95610	0359	34	06067	38.719026	-121.291335	Sacramento County
10419	Fee-for-Service	1932107331	1932107331	1	3	EAST BAY MEDICAL ONCOLOGY	7/8/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2485 HIGH SCHOOL AVE	STE 107	CONCORD	CA	94520	1816	07	06013	37.98507961	-122.034189	Contra Costa County
10447	Fee-for-Service	1689345746	1689345746	1	1	ESKANDER FOOT & ANKLE INC	11/5/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
10511	Fee-for-Service	1295265908	1295265908	1	1	ELGHAFRI, AMANI MD	10/19/2020	207R00000X	NA	Other	026	PHYSICIANS	164949	41	Internal Medicine	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
10565	Fee-for-Service	1508944414	1508944414	1	1	ESTRADA, RODERICK L MD	11/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83224	40	Pediatrics	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
10605	Fee-for-Service	1336587658	1336587658	1	1	ELANGOVAN, RAGAVI DO	8/7/2020	390200000X	NA	Other	026	PHYSICIANS	14118	41	Internal Medicine	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
10676	Fee-for-Service	1306086731	1306086731	1	1	ESPINOZA, VERONICA MARIE	5/18/2009	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	17271 EL CAMINO RD	None	MADERA	CA	93636	1427	20	06039	37.00014796	-119.9769879	Madera County
10757	Fee-for-Service	1104895846	1104895846	1	1	EAST BAY NEUROSURGERY AND	10/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83573	14	Neurological Surgery	0	In state provider	SPINE AMC	2999 REGENT STREET	STE 715	BERKELEY	CA	94507	2122	01	06001	37.85592021	-122.2566436	Alameda County
10762	Fee-for-Service	1558806372	1558806372	1	1	ERIN BYOUS MFT LICENSED	9/1/2016	261QM0850X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MARRIAGE AND FAMILY	205 KELLER ST	STE 202A	PETALUMA	CA	94952	2878	49	06097	38.23578264	-122.6434068	Sonoma County
10923	Fee-for-Service	1902804289	1902804289	1	1	ENGEL, MARVIN L MD INC	2/8/2015	207N00000X	NA	Dermatology	026	PHYSICIANS	19111	07	Dermatology	0	In state provider	None	130 LA CASA VIA	STE 2-110	WALNUT CREEK	CA	94598	3045	07	06013	37.91175467	-122.0414101	Contra Costa County
10950	Fee-for-Service	1083726798	1083726798	1	1	ELLER, JORGE L MD	7/1/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	178389	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3220	33	06065	33.763572	-116.4056895	Riverside County
10965	Fee-for-Service	1306086731	1306086731	1	1	ESPINOZA, VERONICA MARIE	5/18/2009	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	17271 EL CAMINO RD	None	MADERA	CA	93636	1427	20	06039	37.00014796	-119.9769879	Madera County
11039	Fee-for-Service	1629442728	1629442728	1	1	EMERGENCY PHYSICIANS URGENT	1/11/2021	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	212 COFFEE RD	SUITE 100	BAKERSFIELD	CA	93309	1273	15	06029	35.356392	-119.092153	Kern County
11043	Fee-for-Service	1003221037	1003221037	1	1	ELLIS, JOHN D DO	1/1/2025	207P00000X	NA	Other	026	PHYSICIANS	22891	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6200	07	06013	37.98252	-121.8030615	Contra Costa County
11051	Fee-for-Service	1336760446	1336760446	1	2	EILAT DAY CARE INC	5/26/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1621 S SHERBOURNE DRIVE	None	LOS ANGELES	CA	90035	4414	19	06037	34.04911543	-118.3802456	Los Angeles County
11065	Fee-for-Service	1780702209	1780702209	1	3	ELITE PHYSICAL THERAPY AND W	2/3/2020	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ELLNESS, INC.	1090 N PALM CANYON DR.	None	PALM SPRINGS	CA	92262	0000	33	06065	33.83736372	-116.5467476	Riverside County
11168	Fee-for-Service	1932107331	1932107331	1	12	EAST BAY MEDICAL ONCOLOGY	9/5/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	HEMATOLOGY MEDICAL ASSOC	2633 TELEGRAPH AVE	STE 104	OAKLAND	CA	94612	1744	01	06001	37.81569491	-122.2680696	Alameda County
11202	Fee-for-Service	1285678953	1285678953	1	1	EDHOLM, THOMAS W MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	79-1019 HAUKAPILA ST	None	KEALAKEKUA	HI	96750	0000	00	None	19.519965	-155.918154	Hawaii County
11204	Fee-for-Service	1821176637	1821176637	1	1	ESTEBAN, MICHAEL J MD	10/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81995	41	Internal Medicine	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
11267	Fee-for-Service	1033162771	1033162771	1	1	ENGLAND, KEITH R MD	3/1/1999	207ZP0102X	NA	Other	026	PHYSICIANS	54413	22	Pathology (M.D. only)	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
11323	Fee-for-Service	1629442728	1629442728	1	1	EMERGENCY PHYSICIANS URGENT	9/18/2018	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	212 COFFEE RD	SUITE 100	BAKERSFIELD	CA	93309	1273	15	06029	35.356392	-119.092153	Kern County
11352	Fee-for-Service	1780702209	1780702209	1	3	ELITE PHYSICAL THERAPY AND W	5/15/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ELLNESS, INC.	1090 N PALM CANYON DR.	None	PALM SPRINGS	CA	92262	0000	33	06065	33.83736372	-116.5467476	Riverside County
11401	Fee-for-Service	1336466937	1336466937	1	1	ERSHOFF, BRENT D MD	7/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120246	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
11455	Fee-for-Service	1932107331	1932107331	1	12	EAST BAY MEDICAL ONCOLOGY	9/5/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	HEMATOLOGY MEDICAL ASSOC	2633 TELEGRAPH AVE	STE 104	OAKLAND	CA	94612	1744	01	06001	37.81569491	-122.2680696	Alameda County
11543	Fee-for-Service	1750395729	1750395729	1	1	EMERGENCY MED GRP OF	7/1/1999	193400000X	NA	Other	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	WATSONVILLE COMM HOSP	75 NEILSON ST	None	WATSONVILLE	CA	95076	2468	44	06087	36.92823955	-121.792905	Santa Cruz County
11600	Fee-for-Service	1255461398	1255461398	1	1	ENRIQUEZ, HAROLD LMFT	6/10/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
11624	Fee-for-Service	1720141237	1720141237	1	1	E & M MEDICAL SUPPLY	6/16/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	E & M MEDICAL SUPPLY	2818 W JEFFERSON BLVD	None	LOS ANGELES	CA	90018	3323	19	06037	34.02557652	-118.326708	Los Angeles County
11743	Fee-for-Service	1932107331	1932107331	1	12	EAST BAY MEDICAL ONCOLOGY	9/5/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	HEMATOLOGY MEDICAL ASSOC	2633 TELEGRAPH AVE	STE 104	OAKLAND	CA	94612	1744	01	06001	37.81569491	-122.2680696	Alameda County
11765	Fee-for-Service	1669478590	1669478590	1	1	EASTERN PLUMAS HOSPITAL	12/1/2003	261Q00000X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	LOYALTON MEDICAL CLINIC	701 MAIN ST	None	LOYALTON	CA	96118	5744	46	06091	39.6758373	-120.2416536	Sierra County
11827	Fee-for-Service	1750395729	1750395729	1	1	EMERGENCY MED GRP OF	3/31/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	WATSONVILLE COMM HOSP	75 NEILSON ST	None	WATSONVILLE	CA	95076	2468	44	06087	36.92823955	-121.792905	Santa Cruz County
11974	Fee-for-Service	1902224462	1902224462	1	1	EL HAJJAOUI, RAED MD	7/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144196	41	Internal Medicine	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4897	36	06071	34.03717616	-117.2046115	San Bernardino County
12053	Fee-for-Service	1669478590	1669478590	1	1	EASTERN PLUMAS HOSPITAL	12/1/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	LOYALTON MEDICAL CLINIC	701 MAIN ST	None	LOYALTON	CA	96118	5744	46	06091	39.6758373	-120.2416536	Sierra County
12087	Fee-for-Service	1467656603	1467656603	1	1	ELLIOTT, NATASHA C LCSW	6/12/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
12176	Fee-for-Service	1053361790	1053361790	1	1	ELLY, MEHRAN K	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	61716	30	Radiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
12201	Fee-for-Service	1003057274	1003057274	1	1	ECHEVERRIA, JUAN C MD	6/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107324	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
12350	Fee-for-Service	1235266479	1235266479	1	1	EPIPHANY CARE HOMES INC	8/1/2003	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1910 RHONDA ST	None	OXNARD	CA	93036	7732	56	06111	34.22057947	-119.1986965	Ventura County
12416	Fee-for-Service	1831517929	1831517929	1	1	EXETER UNIFIED SCHOOL	7/1/2014	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	215 NORTH CRESPI AVE	None	EXETER	CA	93221	1303	54	06107	36.29970497	-119.1324734	Tulare County
12554	Fee-for-Service	1619910338	1619910338	1	1	EVERTS, WILLIAM CARLTON OD	3/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	8294	01	General Practice	0	In state provider	None	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	18	06035	40.43816059	-120.6279677	Lassen County
12556	Fee-for-Service	1144647819	1144647819	1	1	EHSAN, FARZANEH PSYD	7/21/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA STREET	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
12559	Fee-for-Service	1457378374	1457378374	1	1	EKDAWY, ASHRAF S MD	6/1/1998	208600000X	NA	General Surgery	026	PHYSICIANS	66199	02	General Surgery	0	In state provider	None	800 3RD ST	None	MARYSVILLE	CA	95901	5831	58	06115	39.13757487	-121.5949642	Yuba County
12656	Fee-for-Service	1710178934	1710178934	1	1	ELKHUNOVICH, MARSHA A MD	10/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111539	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
12675	Fee-for-Service	1639565633	1639565633	1	1	ELSON, SAMUEL LMFT	5/14/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3960 INDUSTRIAL BLVD	200	WEST SACRAMENTO	CA	95691	5024	57	06113	38.57029234	-121.5767941	Yolo County
12821	Fee-for-Service	1992756506	1992756506	1	1	EISENBERG, MICHAEL J MD	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
12945	Fee-for-Service	1710178934	1710178934	1	1	ELKHUNOVICH, MARSHA A MD	10/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111539	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
12997	Fee-for-Service	1578521472	1578521472	1	1	ELITE EYECARE MEDICAL GROUP	5/25/2004	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	AMC	910 E STOWELL RD	None	SANTA MARIA	CA	93454	7001	42	06083	34.93834649	-120.422502	Santa Barbara County
13135	Fee-for-Service	1588626469	1588626469	1	1	EDSALL, SIDNEY A MD	5/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	120384	36	Psychiatry	0	In state provider	None	2250 HAYES ST	STE 302	SAN FRANCISCO	CA	94117	1082	38	06075	37.77302042	-122.45342	San Francisco County
13283	Fee-for-Service	1578521472	1578521472	1	1	ELITE EYECARE MEDICAL GROUP	12/17/1999	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	AMC	910 E STOWELL RD	None	SANTA MARIA	CA	93454	7001	42	06083	34.93834649	-120.422502	Santa Barbara County
13594	Fee-for-Service	1992741268	1992741268	1	1	EPSTEIN, GORDON H MD	12/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	49805	04	Otology, Laryngology, Rhinology	0	In state provider	None	2557 MOWRY AVE	STE 30	FREMONT	CA	94538	1614	01	06001	37.55561575	-121.9826617	Alameda County
13657	Fee-for-Service	1578698247	1578698247	1	1	EDDY, CAROLYN LCSW	8/20/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1067 4TH ST	None	SOUTH LAKE TAHOE	CA	96150	3459	09	06017	38.91384447	-119.9985861	El Dorado County
13708	Fee-for-Service	1700882156	1700882156	1	1	EL DORADO COMMUNITY SERVICE	11/6/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	4450 W. CENTURY BLVD.	None	INGLEWOOD	CA	90304	1504	19	06037	33.94541353	-118.3540815	Los Angeles County
13717	Fee-for-Service	1962807339	1962807339	1	1	ESTRELLA, JOSEPHINE	10/28/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	90 FOREST GROVE DRIVE	STE 17	DALY CITY	CA	94015	1242	41	06081	37.69980595	-122.4795932	San Mateo County
13729	Fee-for-Service	1366830507	1366830507	1	1	ENLOE MEDICAL CENTER	5/24/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1421 MAGNOLIA AVE	None	CHICO	CA	95926	3226	04	06007	39.74064528	-121.84991	Butte County
13944	Fee-for-Service	1508314980	1508314980	1	1	ELIASH, EMILY S LCSW	9/23/2021	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
13995	Fee-for-Service	1700882156	1700882156	1	1	EL DORADO COMMUNITY SERVICE	7/24/1981	261QP2300X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	4450 W. CENTURY BLVD.	None	INGLEWOOD	CA	90304	1504	19	06037	33.94541353	-118.3540815	Los Angeles County
14003	Fee-for-Service	1962807339	1962807339	1	1	ESTRELLA, JOSEPHINE	10/28/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	90 FOREST GROVE DRIVE	STE 17	DALY CITY	CA	94015	1242	41	06081	37.69980595	-122.4795932	San Mateo County
14006	Fee-for-Service	1033390562	1033390562	1	1	ESMAILI, ALI MD	3/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107978	41	Internal Medicine	0	In state provider	None	147 NORTH BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
14198	Fee-for-Service	1083922462	1083922462	1	1	EKANAYAKE, PREETHIKA S MD	8/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126503	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
14239	Fee-for-Service	1750843827	1750843827	1	1	EHRIE, JARROD M MD	7/17/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	182822	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
14282	Fee-for-Service	1548673411	1548673411	1	1	ELITE CARE HOME HEALTH	9/15/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY INC	533 AIRPORT BLVD	STE 315	BURLINGAME	CA	94010	2002	41	06081	37.5900636	-122.3408061	San Mateo County
14441	Fee-for-Service	1942442496	1942442496	1	1	EMANUEL, LAKIETA CCC-SLP	8/7/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	16785 BEAR VALLEY RD	SUITE 2	HESPERIA	CA	92345	0825	36	06071	34.47087433	-117.2973498	San Bernardino County
14466	Fee-for-Service	1700921442	1700921442	1	1	ERICK, MELISA A MD	1/1/1998	207L00000X	NA	Other	026	PHYSICIANS	64088	05	Anesthesiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
14483	Fee-for-Service	1255466405	1255466405	1	1	ESPOSITO, LORI E	2/8/2015	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	382 S TUSTIN ST	None	ORANGE	CA	92866	2502	30	06059	33.78258174	-117.8357676	Orange County
14520	Fee-for-Service	1598364440	1598364440	1	1	ELOY ROMERO, MD, INC., A PRO	2/6/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	ESSIONAL CORPORATION, DB	1332 NATIVIDAD RD	C	SALINAS	CA	93906	3133	27	06053	36.69909137	-121.635247	Monterey County
14634	Fee-for-Service	1578790283	1578790283	1	1	ETHAN J ROWIN MD	1/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 WASHINGTON ST	None	BOSTON	MA	02111	1552	00	None	42.349662	-71.063514	Suffolk County
14648	Fee-for-Service	1063591139	1063591139	1	1	EFFIOM, OKU	11/14/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	DEPENDABLE MED SUPPLY	12036 BARLETT AVE	STE B	ADELANTO	CA	92301	1733	36	06071	34.57931348	-117.402111	San Bernardino County
14667	Fee-for-Service	1477975613	1477975613	1	2	ENLOE MEDICAL CENTER	1/16/2020	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	89	Surgery-Traumatic	0	In state provider	NIC	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
14806	Fee-for-Service	1003881442	1003881442	1	1	ERIC N NOVACK, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5605 W EUGIE AVENUE	SUITE 111	GLENDALE	AZ	85304	0000	00	None	33.607089	-112.181706	Maricopa County
14894	Fee-for-Service	1952849499	1952849499	1	1	EZ SLEEP CLUB INC	2/5/2018	291U00000X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	4301 N STAR WAY	STE D	MODESTO	CA	95356	9262	50	06099	37.70164551	-121.0023186	Stanislaus County
14904	Fee-for-Service	1952160111	1952160111	1	1	EDMONDSON, SARAH	9/9/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	48	06095	0	0	None
14915	Fee-for-Service	1366420523	1366420523	1	1	EGLER, JEFFREY M MD	1/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87469	08	Family Practice	0	In state provider	None	1090 3RD ST	STE I	SOUTH LAKE TAHOE	CA	96150	3450	09	06017	38.91492536	-119.9966528	El Dorado County
14922	Fee-for-Service	1669490264	1669490264	1	1	ERIC PROMERSBERGER MD	4/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 BROADWAY N	None	FARGO	ND	58102	3641	00	None	46.885068	-96.7872375	Cass County
15017	Fee-for-Service	1225004310	1225004310	1	1	ENTWISTLE, WARREN R. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1221 PINE GROVE AVE	None	PORT HURON	MI	48060	3511	00	None	42.986844	-82.42983	St. Clair County
15133	Fee-for-Service	1124538939	1124538939	2	1	ESCALANTE, NANCY V LMFT	9/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1533 7TH ST	111	SANGER	CA	93657	2490	10	06019	36.70603599	-119.5595654	Fresno County
15170	Fee-for-Service	1144675117	1144675117	1	1	EUM, DANIEL S MD	11/16/2018	207P00000X	NA	Other	026	PHYSICIANS	144179	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
15183	Fee-for-Service	1750666418	1750666418	1	1	ENGLUND, CARI L LCSW	12/23/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
15194	Fee-for-Service	1487093076	1487093076	1	1	ECKFORD, TIMOTHY S MD	8/11/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	1850 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	18	06035	40.43814074	-120.6259249	Lassen County
15210	Fee-for-Service	1184018079	1184018079	1	1	EREZ, AARON DO	7/29/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18844	None	None	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
15215	Fee-for-Service	1831100635	1831100635	1	1	ELLER, MARK A MD	12/5/1985	207P00000X	NA	Other	026	PHYSICIANS	32802	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1025 CHESTER AVE	None	BAKERSFIELD	CA	93301	5427	15	06029	35.367165	-119.0188885	Kern County
15245	Fee-for-Service	1770782591	1770782591	1	1	EHRENSAFT, DIANE PHD	2/22/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
15464	Fee-for-Service	1316301948	1316301948	1	1	EASTMAN, BORYANA MD	7/8/2021	261QX0203X	NA	Other	026	PHYSICIANS	173254	None	None	0	In state provider	None	44151 15TH ST W	101	LANCASTER	CA	93534	4079	19	06037	34.68551775	-118.1568686	Los Angeles County
15502	Fee-for-Service	1831100635	1831100635	1	1	ELLER, MARK A MD	12/5/1985	207P00000X	NA	Other	026	PHYSICIANS	32802	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1025 CHESTER AVE	None	BAKERSFIELD	CA	93301	5427	15	06029	35.367165	-119.0188885	Kern County
15546	Fee-for-Service	1477872430	1477872430	1	1	EAST BAY EYECARE	10/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	37042	18	Ophthalmology	0	In state provider	PROFESSIONALS INC	1860 MOWRY AVE	#101	FREMONT	CA	94538	1730	01	06001	37.55887933	-121.9797796	Alameda County
15554	Fee-for-Service	1063010817	1063010817	1	1	EUPHORIC HOME HEALTH	6/16/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4119 W BURBANK BLVD	STE 118	BURBANK	CA	91505	2122	19	06037	34.1730175	-118.3553514	Los Angeles County
15587	Fee-for-Service	1750328506	1750328506	1	1	ELLIOTT, KEVIN S MD	9/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	71336	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6620 COYLE AVE	STE 400	CARMICHAEL	CA	95608	6338	34	06067	38.66751	-121.310028	Sacramento County
15601	Fee-for-Service	1265858724	1265858724	1	1	EVERLOVING HOSPICE INC	2/8/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6930 OWENSMOUTH AVE	SUITE 202	CANOGA PARK	CA	91303	2096	19	06037	34.19656125	-118.6015075	Los Angeles County
15661	Fee-for-Service	1588661094	1588661094	1	1	ESCOBAR, JUAN MD	5/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1800 N. OREGON	None	EL PASO	TX	79902	0000	00	None	31.77031111	-106.4985786	El Paso County
15699	Fee-for-Service	1528182540	1528182540	1	1	ELIZONDO, SUSAN A LMFT	9/11/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
15790	Fee-for-Service	1831100635	1831100635	1	1	ELLER, MARK A MD	12/5/1985	207P00000X	NA	Other	026	PHYSICIANS	32802	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1025 CHESTER AVE	None	BAKERSFIELD	CA	93301	5427	15	06029	35.367165	-119.0188885	Kern County
15819	Fee-for-Service	1184665200	1184665200	2	1	EDWARDS, CHARLES H MD	6/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81670	40	Pediatrics	0	In state provider	None	3555 CESAR CHAVEZ	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.74802705	-122.4207367	San Francisco County
15888	Fee-for-Service	1265858724	1265858724	1	1	EVERLOVING HOSPICE INC	2/8/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6930 OWENSMOUTH AVE	SUITE 202	CANOGA PARK	CA	91303	2096	19	06037	34.19656125	-118.6015075	Los Angeles County
15909	Fee-for-Service	1295864544	1295864544	1	1	ECHOLINE MED SUPPLY, INC	10/29/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ECHOLINE MED SUPPLY, INC	2908 OREGON CT	SUITE I-12	TORRANCE	CA	90503	2648	19	06037	33.84639662	-118.3389295	Los Angeles County
15929	Fee-for-Service	1659594547	1659594547	1	2	ENCOMPASS COMMUNITY SERVICES	12/17/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	241 EAST LAKE AVENUE	None	WATSONVILLE	CA	95076	4717	44	06087	36.91439331	-121.7546492	Santa Cruz County
15941	Fee-for-Service	1639517949	1639517949	1	1	EL MAGHRABY, AMR MD	7/11/2024	2084A2900X	NA	Neurology	026	PHYSICIANS	167315	13	Neurology (M.D. only)	0	In state provider	None	152 PIONEER LANE	A-H	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
15946	Fee-for-Service	1154480887	1154480887	1	1	EVANGELISTA, ALLAN DPM	4/23/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1500 S CENTRAL AVE	STE 200A	GLENDALE	CA	91204	2786	19	06037	34.12736888	-118.257777	Los Angeles County
15976	Fee-for-Service	1760950109	1760950109	1	1	ESPY, AMANDA M LMFT	3/10/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	185 PIER AVENUE	#104	SANTA MONICA	CA	90405	5360	19	06037	33.99841834	-118.4803803	Los Angeles County
16079	Fee-for-Service	1982787412	1982787412	1	1	ERICKSON, DAN W DO	10/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9426	None	None	0	In state provider	None	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
16218	Fee-for-Service	1235206095	1235206095	1	1	ELIAS, CELIA NP	10/18/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
16257	Fee-for-Service	1427313345	1427313345	1	1	EADULA, SEKHAR U MD	9/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121680	01	General Practice	0	In state provider	None	625 LINCOLN AVE	None	SAN JOSE	CA	95126	3518	43	06085	37.31809479	-121.9082315	Santa Clara County
16292	Fee-for-Service	1043847171	1043847171	1	1	ESTANISLAO, DIANE E CRNA	8/10/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
16366	Fee-for-Service	1538827480	1538827480	1	1	EMERALD HEARTS HEALTHCARE	7/1/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	19626 VENTURA BLVD	UNIT 220A	TARZANA	CA	91356	2944	19	06037	34.17266732	-118.5610251	Los Angeles County
16533	Fee-for-Service	1710989793	1710989793	1	1	EMERGENCY CARE DYNAMICS INC	7/31/1993	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NT CARE AND MORE	3434 MIDWAY DR	STE 1002	SAN DIEGO	CA	92110	4924	37	06073	32.75065153	-117.2126147	San Diego County
16575	Fee-for-Service	1295140895	1295140895	1	1	ELAYYAN, ALA M A MD	5/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152177	40	Pediatrics	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
16774	Fee-for-Service	1750348405	1750348405	1	1	ELISABETH BACKER MD	5/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MEDICAL	None	OMAHA	NE	68198	7400	00	None	0	0	None
16786	Fee-for-Service	1487059390	1487059390	1	1	ELKA HOSPICE CARE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	11755 VICTORY BLVD	SUITE 213	NORTH HOLLYWOOD	CA	91606	3423	19	06037	34.18670448	-118.389699	Los Angeles County
16905	Fee-for-Service	1275994451	1275994451	1	1	EISENBERG, LAUREN M NP	5/6/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5865 E NAPLES PLZ	None	LONG BEACH	CA	90803	5040	19	06037	33.75569352	-118.1195343	Los Angeles County
16985	Fee-for-Service	1841348729	1841348729	1	1	ENDO, ERIC G MD	12/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81943	18	Ophthalmology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
17037	Fee-for-Service	1346594736	1346594736	1	1	EXPRESS DRUGS	1/16/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3400 CALLOWAY DR	STE #302	BAKERSFIELD	CA	93312	2513	15	06029	35.39110123	-119.1097878	Kern County
17045	Fee-for-Service	1821164377	1821164377	1	1	ENGSTROM, FRANCES	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	901 NEVIN AVENUE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
17074	Fee-for-Service	1487059390	1487059390	1	1	ELKA HOSPICE CARE, INC	6/28/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	11755 VICTORY BLVD	SUITE 213	NORTH HOLLYWOOD	CA	91606	3423	19	06037	34.18670448	-118.389699	Los Angeles County
17099	Fee-for-Service	1871758698	1871758698	1	1	ENGLISH, DAVID A MD	7/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121324	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
17161	Fee-for-Service	1366784274	1366784274	1	1	EGGERT, LAUREN E MD	7/28/2020	207RP1001X	NA	Pulmonology	026	PHYSICIANS	148609	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
17271	Fee-for-Service	1205946555	1205946555	1	1	EAST BAY INTEGRATED CARE INC	9/25/1991	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3470 BUSKIRK AVE	None	PLEASANT HILL	CA	94523	4316	07	06013	37.93916118	-122.0594466	Contra Costa County
17306	Fee-for-Service	1881731032	1881731032	1	1	ERICSON, JAMES C MD	10/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	84428	41	Internal Medicine	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
17350	Fee-for-Service	1841978509	1841978509	1	1	EUREKA PHARMACY LLC	9/6/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	525 5TH ST	None	EUREKA	CA	95501	1032	12	06023	40.8020516	-124.1653625	Humboldt County
17381	Fee-for-Service	1366695439	1366695439	1	2	EVANS, MAYA C MD	7/1/2015	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	2425 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2215	34	06067	38.553012	-121.45545	Sacramento County
17388	Fee-for-Service	1154162238	1154162238	1	1	ECHAORRE, CELESTE G PT	9/18/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
17397	Fee-for-Service	1134438153	1134438153	1	1	ELY, JOSEPH M LCSW	9/30/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1505 WEST AVE J	SUITE 303	LANCASTER	CA	93534	2531	19	06037	34.68945168	-118.1571066	Los Angeles County
17413	Fee-for-Service	1275681074	1275681074	1	1	EASTMAN, MARK F MD	7/1/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	55132	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
17450	Fee-for-Service	1366784274	1366784274	1	1	EGGERT, LAUREN E MD	7/28/2020	207RP1001X	NA	Pulmonology	026	PHYSICIANS	148609	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
17559	Fee-for-Service	1205946555	1205946555	1	1	EAST BAY INTEGRATED CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3470 BUSKIRK AVE	None	PLEASANT HILL	CA	94523	4316	07	06013	37.93916118	-122.0594466	Contra Costa County
17567	Fee-for-Service	1477687051	1477687051	1	2	ESGUERRA, CHRIS	5/21/2021	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	96869	-	NOT APPLICABLE	0	In state provider	None	3209 GALINDO STREET	None	OAKLAND	CA	94601	2507	01	06001	37.78673159	-122.2212171	Alameda County
17691	Fee-for-Service	1932452380	1932452380	1	1	ENDERS, CAROLYN MD	9/12/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	125495	41	Internal Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
17704	Fee-for-Service	1467437525	1467437525	1	1	EVANS, GREGORY F F MD	6/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	52060	30	Radiology	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
17824	Fee-for-Service	1265527980	1265527980	1	1	EAST BAY NEPHROLOGY MED	12/27/1992	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP, INC	3043 SUMMIT ST	None	OAKLAND	CA	94609	3408	01	06001	37.81991034	-122.2644496	Alameda County
17963	Fee-for-Service	1750598587	1750598587	1	1	EAKINS, SHERRY M	7/6/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8250 WOODMAN AVENUE	None	PANORAMA CITY	CA	91402	5427	19	06037	34.22078654	-118.4326211	Los Angeles County
18034	Fee-for-Service	1174611099	1174611099	1	1	EGAN, SARAH C CNM	1/9/2015	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
18175	Fee-for-Service	1073710745	1073710745	1	1	ELAINE HIMADI	12/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
18234	Fee-for-Service	1871767673	1871767673	1	1	EHMER, NATHAN R DO	8/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10366	None	None	0	In state provider	None	1001 POTRERO AVENUE	RM 3A36	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
18248	Fee-for-Service	1457919862	1457919862	1	1	EBBESEN, CARTER B LMFT	5/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
18283	Fee-for-Service	1811104417	1811104417	1	1	EDWARDS, MARY ELLEN LCSW	9/19/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2810 E DEL MAR BLVD	10B	PASADENA	CA	91107	4321	19	06037	34.14212984	-118.092328	Los Angeles County
18322	Fee-for-Service	1396771358	1396771358	1	1	EGAN, ROBERT A MD	10/14/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	88201	13	Neurology (M.D. only)	0	In state provider	None	10 WOODLAND RD	STE 502	ST HELENA	CA	94574	9554	28	06055	38.54196972	-122.4751787	Napa County
18408	Fee-for-Service	1114145968	1114145968	1	1	EDISON SCHOOL DISTRICT	3/11/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	11518 SCHOOL ST	None	EDISON	CA	93307	9148	15	06029	35.3472735	-118.876032	Kern County
18447	Fee-for-Service	1215937388	1215937388	1	2	ECKERLING, GARRETT M MD	7/21/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	61177	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
18484	Fee-for-Service	1568597250	1568597250	1	1	EL-ATTAR, OSAMAH A	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	26314	06	Cardiovascular Disease (M.D. only)	0	In state provider	INC	1234 N VERMONT AVE	STE 2	LOS ANGELES	CA	90029	1704	19	06037	34.093971	-118.2917315	Los Angeles County
18648	Fee-for-Service	1225412836	1225412836	1	1	ESCOTO, STEPHANIE LCSW	5/11/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	155 HOSPITALITY LN	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
18651	Fee-for-Service	1639824949	1639824949	1	1	EUSTICE, JAMIE CCC-SLP	6/22/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
18704	Fee-for-Service	1831489533	1831489533	1	1	EVANS, MICHELLE L PSYD	8/21/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5005 CANYON CREST DR	None	RIVERSIDE	CA	92507	7721	33	06065	33.95957554	-117.3311659	Riverside County
18792	Fee-for-Service	1235787821	1235787821	1	1	ENCOURAGERS FAMILY COUNSELIN	9/15/2019	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	G, INC.	1101 CALIFORNIA AVE.	STE. 202	CORONA	CA	92881	4278	33	06065	33.86171794	-117.5440764	Riverside County
18926	Fee-for-Service	1467898478	1467898478	1	1	EKMEKJIAN, NELLIE R MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132561	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
18944	Fee-for-Service	1407567274	1407567274	1	1	EXPRESS 8 LLC	12/14/2022	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	521 BELLEVUE RD	None	ATWATER	CA	95301	2928	24	06047	37.36051354	-120.5983273	Merced County
19024	Fee-for-Service	1194718056	1194718056	1	1	ENDOSCOPY CENTER MARIN	4/6/1999	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	1100 SOUTH ELISEO DR	STE 3	GREENBRAE	CA	94904	2017	21	06041	37.94358265	-122.5345035	Marin County
19063	Fee-for-Service	1053922575	1053922575	1	1	ESMERALDA HOME HEALTH, INC	4/6/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	8123 FOOTHILL BLVD	None	SUNLAND	CA	91040	2955	19	06037	34.2596885	-118.3099545	Los Angeles County
19081	Fee-for-Service	1235787821	1235787821	1	1	ENCOURAGERS FAMILY COUNSELIN	9/15/2019	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	G, INC.	1101 CALIFORNIA AVE.	STE. 202	CORONA	CA	92881	4278	33	06065	33.86171794	-117.5440764	Riverside County
19201	Fee-for-Service	1265939383	1265939383	1	1	ELHALWAGI, SHEREEF B MD	5/1/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	185161	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
19311	Fee-for-Service	1952368318	1952368318	1	1	EVITTS, MATTHEW P DO	8/4/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	18329	30	Radiology	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
19407	Fee-for-Service	1215460506	1215460506	1	1	ESTAKHRI, PEJMON P MD	11/4/2024	208C00000X	NA	General Surgery	026	PHYSICIANS	157582	02	General Surgery	0	In state provider	None	6121 N THESTA ST	202	FRESNO	CA	93710	8603	10	06019	36.82493955	-119.783139	Fresno County
19429	Fee-for-Service	1831120849	1831120849	1	1	ESTELA, CESAR A MD	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141462	25	Physical Medicine and Rehabilitation	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
19449	Fee-for-Service	1215776414	1215776414	1	1	ENGLISH, RILEY CRNA	3/22/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
19459	Fee-for-Service	1699970673	1699970673	1	1	EBERST, SARAH H LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
19569	Fee-for-Service	1316134885	1316134885	1	1	ENNEN, MELISSA MD	1/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	95735	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
19571	Fee-for-Service	1619598497	1619598497	1	1	EVITA HOSPICE	9/16/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14640 VICTORY BLVD	STE 215	VAN NUYS	CA	91411	1623	19	06037	34.18663255	-118.452402	Los Angeles County
19600	Fee-for-Service	1780679563	1780679563	1	1	ERIKSEN, BRENDA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4321 FIR ST	None	EAST CHICAGO	IN	46312	3049	00	None	41.634684	-87.4478025	Lake County
19618	Fee-for-Service	1053559575	1053559575	1	1	EMOLE, MURPHY E DC	3/20/2022	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3623 MACARTHUR BLVD	SUITE B	OAKLAND	CA	94619	1311	01	06001	37.79264429	-122.1996436	Alameda County
19634	Fee-for-Service	1104192590	1104192590	1	1	EINSTEIN MEDICAL CENTER MONT	5/28/2019	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	GOMERY	559 W GERMANTOWN PIKE	None	EAST NORRITON	PA	19403	4250	00	None	40.153212	-75.343806	Montgomery County
19683	Fee-for-Service	1477975613	1477975613	1	1	ENLOE MEDICAL CENTER	9/13/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3310	04	06007	39.74352822	-121.8495394	Butte County
19693	Fee-for-Service	1215460506	1215460506	1	1	ESTAKHRI, PEJMON P MD	11/4/2024	208C00000X	NA	General Surgery	026	PHYSICIANS	157582	28	Proctology (colon and rectal)	0	In state provider	None	6121 N THESTA ST	202	FRESNO	CA	93710	8603	10	06019	36.82493955	-119.783139	Fresno County
19746	Fee-for-Service	1245627348	1245627348	1	1	ENG, KATHERINE Y NP	5/29/2019	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
19857	Fee-for-Service	1619598497	1619598497	1	1	EVITA HOSPICE	9/16/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14640 VICTORY BLVD	STE 215	VAN NUYS	CA	91411	1623	19	06037	34.18663255	-118.452402	Los Angeles County
19914	Fee-for-Service	1376205641	1376205641	1	1	ELYSIUM HOME HEALTH INC	3/20/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5958 VINELAND AVE	UNIT J	NORTH HOLLYWOOD	CA	91601	1329	19	06037	34.179174	-118.370272	Los Angeles County
19924	Fee-for-Service	1104192590	1104192590	1	1	EINSTEIN MEDICAL CENTER MONT	5/28/2019	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	GOMERY	559 W GERMANTOWN PIKE	None	EAST NORRITON	PA	19403	4250	00	None	40.153212	-75.343806	Montgomery County
20042	Fee-for-Service	1194454215	1194454215	1	1	ELSALEH, HANA	6/29/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4211 B VALLEY VIEW AVE	None	NORCO	CA	92860	3502	33	06065	33.943446	-117.5498725	Riverside County
20049	Fee-for-Service	1679757769	1679757769	1	1	EMDAD, PAYAM MD	9/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105336	25	Physical Medicine and Rehabilitation	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
20179	Fee-for-Service	1710458245	1710458245	1	1	ENLIGHTENED HEALTHCARE ALLIA	10/14/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	320 SANTA FE DRIVE	107-B	ENCINITAS	CA	92024	1334	37	06073	33.038847	-117.285579	San Diego County
20270	Fee-for-Service	1083040216	1083040216	1	1	ELDORADO COMMUNITY SERVICE	6/4/2014	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	540 S SAN PEDRO ST	None	LOS ANGELES	CA	90013	2102	19	06037	34.04316943	-118.2445676	Los Angeles County
20308	Fee-for-Service	1538385562	1538385562	1	2	ENCOMPASS COMMUNITY SERVICES	4/29/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ERY	125 RIGG ST	COTTAGE A	SANTA CRUZ	CA	95060	4203	44	06087	36.96970793	-122.0340723	Santa Cruz County
20428	Fee-for-Service	1033596556	1033596556	1	1	EVANS, AUSTIN G DO	12/19/2018	207R00000X	NA	Other	026	PHYSICIANS	15229	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
20594	Fee-for-Service	1295220499	1295220499	1	1	EXCLUSIVE SENIOR CARE, INC.	11/25/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6482 VIA ARBOLES	None	ANAHEIM HILLS	CA	92807	4219	30	06059	33.84856614	-117.7666556	Orange County
20601	Fee-for-Service	1750533345	1750533345	1	1	ESHRAGHI, SAYEH MD	11/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115846	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
20644	Fee-for-Service	1205869427	1205869427	1	1	EDRIS, MARWAN MD APC	7/21/1986	207R00000X	NA	Other	026	PHYSICIANS	42896	41	Internal Medicine	0	In state provider	None	25283 CABOT ROAD	STE 106	LAGUNA HILLS	CA	92653	5509	30	06059	33.59495207	-117.6757167	Orange County
20664	Fee-for-Service	1184685364	1184685364	1	1	ERIC DAVID NELSON, M.D	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3801 SOUTH NATIONAL	None	SPRINGFIELD	MO	65807	5210	00	None	37.1451107	-93.27863681	Greene County
20696	Fee-for-Service	1942232228	1942232228	1	1	ELCAVAGE, PAUL J MD	1/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	69102	05	Anesthesiology	0	In state provider	None	16795 LARK AVE	STE 108	LOS GATOS	CA	95032	7691	43	06085	37.25302151	-121.966891	Santa Clara County
20752	Fee-for-Service	1770908725	1770908725	1	1	ELICA HEALTH CENTERS	2/10/2015	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3701 J STREET	STE 201	SACRAMENTO	CA	95816	5562	34	06067	38.571237	-121.4566245	Sacramento County
20894	Fee-for-Service	1871087395	1871087395	1	1	ESPINOZA, LILIAN I	7/17/2018	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	742 N ETHAN WAY	None	ANAHEIM	CA	92805	2072	30	06059	0	0	None
20940	Fee-for-Service	1316385131	1316385131	1	1	ELLIS, DOROTHEA H	5/18/2020	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	163438	25	Physical Medicine and Rehabilitation	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
20982	Fee-for-Service	1942232228	1942232228	1	1	ELCAVAGE, PAUL J MD	1/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	69102	01	General Practice	0	In state provider	None	16795 LARK AVE	STE 108	LOS GATOS	CA	95032	7691	43	06085	37.25302151	-121.966891	Santa Clara County
21133	Fee-for-Service	1598093262	1598093262	1	1	EASTERN MEDICAL CENTER	1/26/2010	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	PROFESSIONAL MEDICAL COR	2930 EASTERN AVE	None	SACRAMENTO	CA	95821	4210	34	06067	38.618712	-121.3641045	Sacramento County
21141	Fee-for-Service	1497951636	1497951636	1	1	ELLYSON, DAVID S DC	2/1/2006	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	605 E ST	None	MARYSVILLE	CA	95901	5502	58	06115	39.14152304	-121.5906329	Yuba County
21181	Fee-for-Service	1871087395	1871087395	1	1	ESPINOZA, LILIAN I	7/17/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	742 N ETHAN WAY	None	ANAHEIM	CA	92805	2072	30	06059	0	0	None
21239	Fee-for-Service	1790748481	1790748481	1	1	ENGFELT, ANN M MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	77826	09	Gynecology (D.O. only)	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
21269	Fee-for-Service	1477975613	1477975613	1	3	ENLOE MEDICAL CENTER	9/6/2023	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	NIC	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
21341	Fee-for-Service	1821178856	1821178856	1	1	ELITE DIAGNOSTIC IMAGING	9/24/2007	174400000X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	LLC	17260 BEAR VALLEY RD	STE 109	VICTORVILLE	CA	92395	7778	36	06071	34.47103651	-117.2855205	San Bernardino County
21377	Fee-for-Service	1013078625	1013078625	1	1	EHRLICH, NEIL MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	23599	36	Psychiatry	0	In state provider	None	171 N HIGH ST	None	SEBASTOPOL	CA	95472	3704	49	06097	38.40260761	-122.8262139	Sonoma County
21420	Fee-for-Service	1598093262	1598093262	1	1	EASTERN MEDICAL CENTER	1/26/2010	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	PROFESSIONAL MEDICAL COR	2930 EASTERN AVE	None	SACRAMENTO	CA	95821	4210	34	06067	38.618712	-121.3641045	Sacramento County
21525	Fee-for-Service	1790748481	1790748481	1	1	ENGFELT, ANN M MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	77826	40	Pediatrics	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
21559	Fee-for-Service	1477975613	1477975613	1	3	ENLOE MEDICAL CENTER	9/6/2023	193400000X	NA	Other	022	PHYSICIANS GROUP	-	89	Surgery-Traumatic	0	In state provider	NIC	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
21569	Fee-for-Service	1730293952	1730293952	1	1	EDWARD DENNIS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10 EAST 31ST ST	None	KEARNEY	NE	68847	0000	00	None	40.70647332	-99.08130081	Buffalo County
21581	Fee-for-Service	1144902347	1144902347	1	1	EVANGELISTA, ROME DIOSTONNE	7/2/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	CNP	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
21884	Fee-for-Service	1669887337	1669887337	1	1	EDELHEIT, ARI MD	7/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155962	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
21898	Fee-for-Service	1508878471	1508878471	1	1	EIFFERT, MICHAEL E MD	6/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79039	41	Internal Medicine	0	In state provider	None	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2751	41	06081	37.48093988	-122.2531826	San Mateo County
21922	Fee-for-Service	1629230487	1629230487	1	2	ESCUETA, DANELA S MD	8/13/2018	208M00000X	NA	Other	026	PHYSICIANS	115651	40	Pediatrics	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
21968	Fee-for-Service	1366695439	1366695439	1	1	EVANS, MAYA C MD	6/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135464	25	Physical Medicine and Rehabilitation	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
21980	Fee-for-Service	1760757132	1760757132	1	1	ESFAHANI, DARIAN R MD	8/19/2020	207T00000X	NA	General Surgery	026	PHYSICIANS	168633	14	Neurological Surgery	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
22020	Fee-for-Service	1700033099	1700033099	1	1	EMMERSON, BRYAN C MD	8/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	94891	20	Orthopedic Surgery	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
22132	Fee-for-Service	1518237619	1518237619	1	1	ETERNAL HOSPICE CARE INC	8/1/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2155 E GARVEY AVE N	STE B-10	WEST COVINA	CA	91791	1509	19	06037	34.07280989	-117.8995249	Los Angeles County
22185	Fee-for-Service	1750657565	1750657565	1	2	ESPINDOLA, MARIO	7/9/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	128570	-	NOT APPLICABLE	0	In state provider	None	2150 N VICTORIA AVE	None	OXNARD	CA	93036	7791	56	06111	34.22559401	-119.2209704	Ventura County
22260	Fee-for-Service	1497501332	1497501332	1	1	ENANO, ASHARANI H	6/5/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	8988 PANAMINT CT	None	ELK GROVE	CA	95624	3713	34	06067	38.431341	-121.3845885	Sacramento County
22273	Fee-for-Service	1184058315	1184058315	1	1	EARLY, HEATHER M MD	6/22/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	167948	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
22303	Fee-for-Service	1831438001	1831438001	1	1	ENA RIOS CORP	4/20/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	140 MAYHEW WAY	300	PLEASANT HILL	CA	94523	4398	07	06013	37.93664097	-122.0572179	Contra Costa County
22310	Fee-for-Service	1053003087	1053003087	1	1	ELITE FAMILY MEDICINE	9/29/2023	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	345 N RIVERSIDE AVE	None	RIALTO	CA	92376	5925	36	06071	34.10524305	-117.3702612	San Bernardino County
22386	Fee-for-Service	1184670549	1184670549	1	1	EVANSTON NW HEALTHCARE	4/15/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	EVANSTON HOSPITAL	2650 RIDGE AVE	None	EVANSTON	IL	60201	1718	00	None	42.06623373	-87.68310622	Cook County
22406	Fee-for-Service	1285639773	1285639773	1	1	EISMAN, PAUL M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	31479	08	Family Practice	0	In state provider	None	10900 WARNER AVE	STE 118	FOUNTAIN VALLEY	CA	92708	3846	30	06059	33.71628153	-117.9388215	Orange County
22420	Fee-for-Service	1518237619	1518237619	1	1	ETERNAL HOSPICE CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2155 E GARVEY AVE N	STE B-10	WEST COVINA	CA	91791	1509	19	06037	34.07280989	-117.8995249	Los Angeles County
22437	Fee-for-Service	1295220499	1295220499	1	3	EXCLUSIVE SENIOR CARE, INC.	12/2/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2202 E VALLEY GLEN LANE	None	ORANGE	CA	92867	1714	30	06059	33.83567764	-117.8304777	Orange County
22471	Fee-for-Service	1104905975	1104905975	1	1	EFIRD, TERRIL A MD	3/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35127	30	Radiology	0	In state provider	None	FRESNO & R STREETS	None	FRESNO	CA	93715	0000	10	06019	36.741663	-119.7841005	Fresno County
22511	Fee-for-Service	1598420044	1598420044	1	1	EZIMORA, CINDY C NP	1/1/2022	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
22549	Fee-for-Service	1497501332	1497501332	1	1	ENANO, ASHARANI H	6/5/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	8988 PANAMINT CT	None	ELK GROVE	CA	95624	3713	34	06067	38.431341	-121.3845885	Sacramento County
22671	Fee-for-Service	1184670549	1184670549	1	1	EVANSTON NW HEALTHCARE	4/15/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	EVANSTON HOSPITAL	2650 RIDGE AVE	None	EVANSTON	IL	60201	1718	00	None	42.06623373	-87.68310622	Cook County
22722	Fee-for-Service	1780702209	1780702209	1	6	ELITE PHYSICAL THERAPY AND W	10/30/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ELLNESS, INC.	81880 DR CARREON BLVD	SUITE C202	INDIO	CA	92201	0000	33	06065	33.70742953	-116.23572	Riverside County
22979	Fee-for-Service	1629599279	1629599279	2	1	ELSHEIKH, HUDA H MD	5/22/2023	207R00000X	NA	Other	026	PHYSICIANS	172963	None	None	0	In state provider	None	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
23002	Fee-for-Service	1548470826	1548470826	1	1	EDDLEMON, EUGENE D MD	4/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	68376	02	General Surgery	0	In state provider	INC	111 RALEY BLVD	STE 140	CHICO	CA	95928	8351	04	06007	39.71601447	-121.790817	Butte County
23011	Fee-for-Service	1780702209	1780702209	1	6	ELITE PHYSICAL THERAPY AND W	10/30/2020	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ELLNESS, INC.	81880 DR CARREON BLVD	SUITE C202	INDIO	CA	92201	0000	33	06065	33.70742953	-116.23572	Riverside County
23034	Fee-for-Service	1215918750	1215918750	1	1	ELLIOT, STEVEN T MD	3/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	97275	02	General Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
23116	Fee-for-Service	1538174347	1538174347	1	1	EAST JEFFERSON GENERAL	9/2/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	4200 HOUMA BLVD	None	METAIRIE	LA	70006	2996	00	None	30.01429536	-90.18149593	Jefferson Parish
23140	Fee-for-Service	1598815110	1598815110	1	1	EXECUTIVE ENDOSCOPY INC	12/27/2004	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SAN JOSE	2100 FOREST AVE	STE 109	SAN JOSE	CA	95128	1422	43	06085	37.3270195	-121.9368645	Santa Clara County
23214	Fee-for-Service	1588922801	1588922801	1	1	EDIRIWICKREMA, LILANGI S MD	6/27/2017	207W00000X	NA	Ophthalmology	026	PHYSICIANS	131244	18	Ophthalmology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
23383	Fee-for-Service	1073647202	1073647202	2	1	EAST BAY CARDIOVASCULAR AND	7/17/2020	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	THORACIC ASSOCIATES, INC	1320 EL CAPITAN DRIVE	SUITE 120	DANVILLE	CA	94526	6258	07	06013	37.78476866	-121.9658691	Contra Costa County
23403	Fee-for-Service	1538174347	1538174347	1	1	EAST JEFFERSON GENERAL	9/2/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	4200 HOUMA BLVD	None	METAIRIE	LA	70006	2996	00	None	30.01429536	-90.18149593	Jefferson Parish
23404	Fee-for-Service	1174693659	1174693659	1	1	ENZENSPERGER, IRENE K MD	11/21/1978	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	23211	01	General Practice	0	In state provider	None	1060 E FOOTHILL BLVD	None	UPLAND	CA	91786	4027	36	06071	34.1070235	-117.6371235	San Bernardino County
23466	Fee-for-Service	1710036694	1710036694	1	1	ELEEN, FARZANEH PHD	10/16/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
23483	Fee-for-Service	1437492097	1437492097	1	1	EMERSON, PITTAWAT N NP	11/5/2018	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
23651	Fee-for-Service	1689616377	1689616377	1	1	ESCALONA, LOURDES	5/28/1991	207P00000X	NA	Other	026	PHYSICIANS	71420	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
23668	Fee-for-Service	1114157179	1114157179	1	1	EWALD, ERIC J MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118819	08	Family Practice	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
23669	Fee-for-Service	1225226806	1225226806	1	1	ERNEY, ERICA J LCSW	3/10/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1263 E ARQUES AVE	DEPARTMENT 27	SUNNYVALE	CA	94085	4701	43	06085	37.38060846	-121.9896672	Santa Clara County
23671	Fee-for-Service	1073647202	1073647202	2	1	EAST BAY CARDIOVASCULAR AND	7/17/2020	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	THORACIC ASSOCIATES, INC	1320 EL CAPITAN DRIVE	SUITE 120	DANVILLE	CA	94526	6258	07	06013	37.78476866	-121.9658691	Contra Costa County
23701	Fee-for-Service	1003953530	1003953530	1	1	ESTWICK, BRIAN K MD INC	6/28/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	41775	18	Ophthalmology	0	In state provider	None	12524 W WASHINGTON BLVD	None	LOS ANGELES	CA	90066	5506	19	06037	33.99678514	-118.4309642	Los Angeles County
23796	Fee-for-Service	1508091711	1508091711	1	1	EASTON-CARR, SHANNON M MD	7/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111411	36	Psychiatry	0	In state provider	None	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
23824	Fee-for-Service	1194254375	1194254375	1	2	ELSHAFIE, SAMIA M LCSW	4/1/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
23904	Fee-for-Service	1609211176	1609211176	1	1	ELDABAJE, ROBERT J MD	3/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136378	41	Internal Medicine	0	In state provider	None	2340 CLAY ST	2ND FLOOR	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
23907	Fee-for-Service	1700862547	1700862547	1	1	EHRLICH, STEVEN MD	2/28/1990	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	58587	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	616 WITMER ST	None	LOS ANGELES	CA	90017	2308	19	06037	34.0549933	-118.2658354	Los Angeles County
23939	Fee-for-Service	1689616377	1689616377	1	1	ESCALONA, LOURDES	5/28/1991	207P00000X	NA	Other	026	PHYSICIANS	71420	40	Pediatrics	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
23955	Fee-for-Service	1114157179	1114157179	1	1	EWALD, ERIC J MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118819	01	General Practice	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
23957	Fee-for-Service	1851331946	1851331946	1	1	ERVIN, KIM S MD	6/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	65433	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	NORTH COAST WOMENS HEALT	1930 MYRTLE AVE	None	EUREKA	CA	95501	1406	12	06023	40.790329	-124.1337607	Humboldt County
23991	Fee-for-Service	1396935862	1396935862	1	1	ELIDO-FLORENDO, LIZA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	100877	41	Internal Medicine	0	In state provider	None	655 S CENTRAL VALLEY HWY	None	SHAFTER	CA	93263	2790	15	06029	35.49504475	-119.264496	Kern County
23998	Fee-for-Service	1871921916	1871921916	1	1	EYE RX, AN OPTOMETRIC GROUP	1/30/2017	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8450 LA PALMA AVE	None	BUENA PARK	CA	90620	3210	30	06059	33.8466207	-117.9862725	Orange County
24228	Fee-for-Service	1689616377	1689616377	1	1	ESCALONA, LOURDES	5/28/1991	207P00000X	NA	Other	026	PHYSICIANS	71420	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
24347	Fee-for-Service	1285327510	1285327510	1	1	ENLOE MEDICAL CENTER	7/17/2023	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
24356	Fee-for-Service	1063613982	1063613982	1	1	ERBY, TRINA D LMFT	1/28/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
24398	Fee-for-Service	1205341336	1205341336	1	1	ELICA HEALTH CENTERS	2/22/2019	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95691	3412	57	06113	38.573118	-121.5501275	Yolo County
24450	Fee-for-Service	1235263443	1235263443	1	1	ESCATEL, HANAA LMFT	10/4/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16152 BEACH BLVD	131	HUNTINGTON BEACH	CA	92647	3820	30	06059	33.72889962	-117.9891397	Orange County
24550	Fee-for-Service	1962050757	1962050757	1	1	EVN DIALYSIS CENTER LLC	5/27/2021	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	18040 SHERMAN WAY	STE 100	RESEDA	CA	91335	4631	19	06037	34.20103048	-118.526787	Los Angeles County
24555	Fee-for-Service	1174728778	1174728778	1	1	ESLAVA, CINDY C PT	10/18/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
24580	Fee-for-Service	1922398510	1922398510	1	1	ERFANZADEH, GHAZALEH MD	2/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124365	41	Internal Medicine	0	In state provider	None	17909 SOLEDAD CANYON RD	None	CANYON COUNTRY	CA	91387	3210	19	06037	34.41652621	-118.4458684	Los Angeles County
24581	Fee-for-Service	1689782039	1689782039	1	1	EAST BAY CENTER FOR	2/1/1998	193400000X	NA	Other	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	DIGESTIVE HEALTH MEDICAL	300 FRANK H OGAWA	STE 450	OAKLAND	CA	94612	2037	01	06001	37.80542149	-122.2710615	Alameda County
24636	Fee-for-Service	1285327510	1285327510	1	1	ENLOE MEDICAL CENTER	7/17/2023	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
24686	Fee-for-Service	1205341336	1205341336	1	1	ELICA HEALTH CENTERS	1/28/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95691	3412	57	06113	38.573118	-121.5501275	Yolo County
24749	Fee-for-Service	1447205547	1447205547	1	1	ESFAHANI, MAHSA MD	11/14/2007	207R00000X	NA	Other	026	PHYSICIANS	86986	41	Internal Medicine	0	In state provider	None	625 LINCOLN AVE	None	SAN JOSE	CA	95126	3704	43	06085	37.31809479	-121.9082315	Santa Clara County
24762	Fee-for-Service	1245604354	1245604354	1	1	EVERS, VANESSA CNM	8/25/2022	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
24869	Fee-for-Service	1710340195	1710340195	1	1	ENGLISH, SHERRI MD	10/31/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158074	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
24918	Fee-for-Service	1467537480	1467537480	1	1	EHSAN, REZA R MD	7/4/2019	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	50372	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	15424 NORDHOFF ST	None	NORTH HILLS	CA	91343	6951	19	06037	34.23550347	-118.468656	Los Angeles County
24950	Fee-for-Service	1124376363	1124376363	1	1	ECHIVERRI, ANGELA T MD	10/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129632	01	General Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
24974	Fee-for-Service	1205341336	1205341336	1	1	ELICA HEALTH CENTERS	8/2/2021	No Taxonomy Provided	NA	None	102	DIABETES PREVENTION PROGRAM SUPPLIER	-	-	NOT APPLICABLE	0	In state provider	None	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95691	3412	57	06113	38.573118	-121.5501275	Yolo County
24981	Fee-for-Service	1457346231	1457346231	1	1	EBACH, DAWN R MD	6/17/2022	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
24991	Fee-for-Service	1629034194	1629034194	1	1	ESPARZA, LUIS MD	11/22/2023	207L00000X	NA	Other	026	PHYSICIANS	76887	None	None	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
24994	Fee-for-Service	1285951905	1285951905	1	1	EL-NACHEF, WAEL N MD	11/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119400	41	Internal Medicine	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
25058	Fee-for-Service	1245074616	1245074616	1	1	EDWARDS, KRYSTAL B	1/10/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
25119	Fee-for-Service	1699871525	1699871525	1	1	ELLENHORN, JOSHUA D MD	8/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	57872	02	General Surgery	0	In state provider	None	50 BELLEFONTAINE ST	STE 140	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
25206	Fee-for-Service	1467537480	1467537480	1	1	EHSAN, REZA R MD	7/4/2019	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	50372	01	General Practice	0	In state provider	None	15424 NORDHOFF ST	None	NORTH HILLS	CA	91343	6951	19	06037	34.23550347	-118.468656	Los Angeles County
25262	Fee-for-Service	1205341336	1205341336	1	1	ELICA HEALTH CENTERS	1/28/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95691	3412	57	06113	38.573118	-121.5501275	Yolo County
25271	Fee-for-Service	1851479588	1851479588	1	1	EMERZIAN, MICHAEL A MD	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66200	41	Internal Medicine	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
25384	Fee-for-Service	1962141705	1962141705	1	1	ENCORE HOME HEALTH	8/18/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1315 S GRAND AVE	STE 204	GLENDORA	CA	91740	5053	19	06037	34.11549628	-117.8727712	Los Angeles County
25401	Fee-for-Service	1457988933	1457988933	1	1	EPSTEIN, INBAL S MD	10/26/2022	207P00000X	NA	Other	026	PHYSICIANS	181287	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
25494	Fee-for-Service	1467537480	1467537480	1	1	EHSAN, REZA R MD	7/4/2019	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	50372	40	Pediatrics	0	In state provider	None	15424 NORDHOFF ST	None	NORTH HILLS	CA	91343	6951	19	06037	34.23550347	-118.468656	Los Angeles County
25497	Fee-for-Service	1770670341	1770670341	1	1	ESTARIS, RAUL B. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3321 FLORIDA AVE	None	KENNER	LA	70065	3680	00	None	30.016903	-90.2406875	Jefferson Parish
25552	Fee-for-Service	1053482935	1053482935	1	1	ENG, CHOR W MD	8/24/2004	207L00000X	NA	Other	026	PHYSICIANS	47718	05	Anesthesiology	0	In state provider	SCRIPPS MEMORIAL HSPTL	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
25555	Fee-for-Service	1215901871	1215901871	1	1	EIDUS, ROBERT MD	7/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148291	01	General Practice	0	In state provider	None	1450 TREAT BLVD	STE 320	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
25568	Fee-for-Service	1265411730	1265411730	1	1	ENDO, CRAIG Y MD	10/28/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67492	08	Family Practice	0	In state provider	None	920 N GAREY AVE	None	POMONA	CA	91767	4618	19	06037	34.06666631	-117.7515392	Los Angeles County
25600	Fee-for-Service	1821418559	1821418559	1	1	ENCE, THOMAS C MD	5/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137679	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER COURT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
25687	Fee-for-Service	1831388339	1831388339	1	1	EIDENMULLER, WILLIAM C	12/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98306	66	Emergency Medicine (Urgent Care)	0	In state provider	IV MD	520 W I ST	None	LOS BANOS	CA	93635	3419	24	06047	37.06346603	-120.8593647	Merced County
25751	Fee-for-Service	1568569424	1568569424	1	1	ELLIS, MARK H MD	2/28/1986	174400000X	NA	Other	026	PHYSICIANS	41445	03	Allergy	0	In state provider	None	725 W LA VETA AVE	STE 100	ORANGE	CA	92868	4445	30	06059	33.78063949	-117.8603285	Orange County
25757	Fee-for-Service	1992873905	1992873905	1	1	ERRICO, ANTHONY J DPM	2/8/2015	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	101 S SAN MATEO DR	STE 111	SAN MATEO	CA	94401	3840	41	06081	37.56590481	-122.325549	San Mateo County
25774	Fee-for-Service	1295734713	1295734713	1	1	ENSIGN PALM I, LLC	11/16/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	PREMIER CARE CTR PALM SP	2990 E RAMON RD	None	PALM SPRINGS	CA	92264	7931	33	06065	33.8160777	-116.5133592	Riverside County
25958	Fee-for-Service	1255385415	1255385415	1	1	EASY BAY REGIONAL CRITICAL	3/20/1987	193200000X	NA	Other	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	411 30TH STREET	STE 314	OAKLAND	CA	94609	3312	01	06001	37.81903474	-122.2649444	Alameda County
25961	Fee-for-Service	1548610439	1548610439	1	1	EVARISTO CAMACHO, GABRIEL J	7/29/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166927	09	Gynecology (D.O. only)	0	In state provider	MD	1100 N PALM CANYON DR	STE 212	PALM SPRINGS	CA	92262	4426	33	06065	33.838182	-116.546744	Riverside County
25990	Fee-for-Service	1942483409	1942483409	1	1	EHUM, JOHN J MD	7/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97838	08	Family Practice	0	In state provider	None	1801 W ROMNEYA DR	STE 606	ANAHEIM	CA	92801	1828	30	06059	33.8506615	-117.946413	Orange County
26021	Fee-for-Service	1609871227	1609871227	1	1	EMERUWA, IHEANACHO	11/26/1993	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	41038	None	None	0	In state provider	None	760 WASHBURN AVE	STE 21	CORONA	CA	92882	3303	33	06065	33.87374678	-117.5678721	Riverside County
26032	Fee-for-Service	1578713384	1578713384	1	1	EVANSON, HEATHER M MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116270	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	1937	19	06037	33.808185	-118.1850575	Los Angeles County
26042	Fee-for-Service	1497755144	1497755144	1	1	ENSIGN SAN DIMAS, LLC	2/1/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	ARBOR GLEN CARE CENTER	1033 E ARROW HWY	None	GLENDORA	CA	91740	6110	19	06037	34.10677149	-117.8429895	Los Angeles County
26172	Fee-for-Service	1518278621	1518278621	1	1	ESTRERA, MICHAEL A MD	11/20/2018	207L00000X	NA	Other	026	PHYSICIANS	119111	05	Anesthesiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
26180	Fee-for-Service	1508013681	1508013681	1	1	ESTRADA, ROSA NELY LMFT	2/7/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2522 CHAMBERS ROAD	125	TUSTIN	CA	92780	6962	30	06059	33.71785088	-117.8076329	Orange County
26200	Fee-for-Service	1982670626	1982670626	1	1	ERCOLINI-BHATIA LISA M MD	2/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54110	08	Family Practice	0	In state provider	None	136 N 3RD ST	None	LOMPOC	CA	93436	7002	42	06083	34.64013944	-120.4451768	Santa Barbara County
26226	Fee-for-Service	1710533864	1710533864	1	1	ELITE TRANSFORMATIONS, A PRO	1/1/2023	2086S0122X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	FISHER MD	327 SAN MATEO DR,	SUITE 4	SAN MATEO	CA	94401	2585	41	06081	37.57156972	-122.3318678	San Mateo County
26244	Fee-for-Service	1255385415	1255385415	1	1	EASY BAY REGIONAL CRITICAL	3/20/1987	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	411 30TH STREET	STE 314	OAKLAND	CA	94609	3312	01	06001	37.81903474	-122.2649444	Alameda County
26249	Fee-for-Service	1548610439	1548610439	1	1	EVARISTO CAMACHO, GABRIEL J	7/29/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166927	15	Obstetrics (D.O. only)	0	In state provider	MD	1100 N PALM CANYON DR	STE 212	PALM SPRINGS	CA	92262	4426	33	06065	33.838182	-116.546744	Riverside County
26396	Fee-for-Service	1477055390	1477055390	1	1	ELLIS, ALEX D LMFT	1/13/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	407 WEST LINE STREET	SUITE 5	BISHOP	CA	93514	3321	14	06027	37.36141153	-118.398555	Inyo County
26466	Fee-for-Service	1285712091	1285712091	1	1	EMERY, YASMIN E MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84301	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1777 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735946	-121.2461325	San Joaquin County
26622	Fee-for-Service	1629580279	1629580279	1	1	EPLING, EDEN N CNM	5/24/2018	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
26631	Fee-for-Service	1194261495	1194261495	1	1	EVANS, MATTHEW LCSW	8/26/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11835 WEST OLYMPIC BLVD	SUITE 815E	LOS ANGELES	CA	90064	5056	19	06037	34.03273663	-118.4516927	Los Angeles County
26704	Fee-for-Service	1871139543	1871139543	1	1	EYE LOVE, INC.	7/11/2020	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	8341 WESTMINSTER BLVD ST	None	WESTMINSTER	CA	92683	8339	30	06059	33.75934845	-117.983493	Orange County
26756	Fee-for-Service	1770910986	1770910986	1	1	EMERGENT CARE ASSOCIATES INC	10/11/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	18751 VENTURA BLVD	SUITE 100	TARZANA	CA	91356	3372	19	06037	34.17098024	-118.5414492	Los Angeles County
26767	Fee-for-Service	1699298539	1699298539	1	1	ELHIANI, ALBERT A DPM	4/7/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	13624 HAWTHORNE BLVD	STE 206	HAWTHORNE	CA	90250	5818	19	06037	33.9083784	-118.3523983	Los Angeles County
26808	Fee-for-Service	1407816259	1407816259	1	1	ESKILDSEN, MANUEL A MD	9/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137468	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365 420 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
26851	Fee-for-Service	1750401980	1750401980	1	1	ENGLE, LEA LMFT	3/31/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13400 RIVERSIDE DR	318	SHERMAN OAKS	CA	91423	2500	19	06037	34.1575865	-118.4247405	Los Angeles County
26860	Fee-for-Service	1720475296	1720475296	1	1	ELMUFTI, HUSSEIN MD	9/11/2023	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	188159	None	None	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
26926	Fee-for-Service	1326230426	1326230426	1	1	ELWOOD, ALLISON E LMFT	5/22/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8247 E STOCKTON BLVD	None	SACRAMENTO	CA	95828	8200	34	06067	38.459187	-121.4080245	Sacramento County
26977	Fee-for-Service	1508020819	1508020819	1	1	ESPINOSA, MARCELA S MD	2/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104674	41	Internal Medicine	0	In state provider	None	19015 TOWN CENTER DR	SUITE 101	APPLE VALLEY	CA	92308	8995	36	06071	34.46573792	-117.2485123	San Bernardino County
27042	Fee-for-Service	1730163601	1730163601	1	1	ERICKSON, MELISSA B OD	10/14/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
27043	Fee-for-Service	1770910986	1770910986	1	1	EMERGENT CARE ASSOCIATES INC	5/28/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	18751 VENTURA BLVD	SUITE 100	TARZANA	CA	91356	3372	19	06037	34.17098024	-118.5414492	Los Angeles County
27078	Fee-for-Service	1639954928	1639954928	1	1	EMPATHIC PATHWAYS PSYCHOLOGY	2/11/2025	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	INC.	2535 ALPINE BLVD	2	ALPINE	CA	91901	2395	37	06073	32.83490165	-116.7593275	San Diego County
27093	Fee-for-Service	1407816259	1407816259	1	1	ESKILDSEN, MANUEL A MD	9/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137468	38	Geriatrics	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365 420 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
27152	Fee-for-Service	1942081682	1942081682	1	1	ESSENCE HEALTH AND UROGYNECO	11/30/2023	261Q00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	LOGY	1560 E CHEVY CHASE DR	450	GLENDALE	CA	91206	4140	19	06037	34.15290734	-118.2302295	Los Angeles County
27273	Fee-for-Service	1376834481	1376834481	1	1	ENIASIVAM, ARCHNA MD	7/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136397	01	General Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
27340	Fee-for-Service	1316588825	1316588825	1	1	EFFORT HOSPICE INC	12/29/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	19531 VENTURA BLVD	STE 3	TARZANA	CA	91356	2957	19	06037	34.17281748	-118.5590745	Los Angeles County
27353	Fee-for-Service	1780702209	1780702209	1	4	ELITE PHYSICAL THERAPY AND W	7/8/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ELLNESS, INC.	79440 CORPORATE CENTER D	None	LA QUINTA	CA	92253	7243	33	06065	33.70937862	-116.2788139	Riverside County
27364	Fee-for-Service	1801345731	1801345731	1	1	EGB HOLDINGS	2/14/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4100 LATHAM ST	SUITE E	RIVERSIDE	CA	92501	1733	33	06065	34.00149667	-117.3721621	Riverside County
27389	Fee-for-Service	1548680887	1548680887	1	1	ERLIKH, EDWARD MD	1/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139129	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
27398	Fee-for-Service	1124580741	1124580741	1	1	EMAMI, REZA MD	2/20/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	180452	36	Psychiatry	0	In state provider	None	4045 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2021	15	06029	35.3540847	-119.0536548	Kern County
27487	Fee-for-Service	1427529288	1427529288	1	1	ELENA GORROW LICENSED CLINIC	2/23/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	AL SOCIAL WORKER, INC.	2551 SAN RAMON VALLEY BL	246	SAN RAMON	CA	94583	1664	07	06013	37.77143928	-121.9737192	Contra Costa County
27501	Fee-for-Service	1770905994	1770905994	1	1	ENLOE MEDICAL CENTER	2/28/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	SPECIALISTS	1600 ESPLANADE	STE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
27506	Fee-for-Service	1245529940	1245529940	1	1	EBINGER, JOSEPH E MD	10/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123198	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
27521	Fee-for-Service	1306254305	1306254305	1	1	EXCEL HOME HEALTHCARE, INC	3/31/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4944 WINDPLAY DR	SUITE 115	EL DORADO HILLS	CA	95762	9688	09	06017	38.63760395	-121.0711269	El Dorado County
27536	Fee-for-Service	1780702209	1780702209	1	5	ELITE PHYSICAL THERAPY AND W	2/3/2020	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ELLNESS, INC.	13313 PALM DR	B	DESERT HOT SPRING	CA	92240	5980	33	06065	33.951663	-116.501339	Riverside County
27543	Fee-for-Service	1578818696	1578818696	1	1	EXPRESS MEDICINE URGENT CARE	5/5/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	5700 STONERIDGE MALL RD	STE 100	PLEASANTON	CA	94588	2872	01	06001	37.69233636	-121.9298813	Alameda County
27544	Fee-for-Service	1649463191	1649463191	1	1	ELLINGSON, DAVID LMFT	3/21/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	90183	-	NOT APPLICABLE	0	In state provider	None	406 SUNRISE AVE	100	ROSEVILLE	CA	95661	4106	31	06061	38.73944898	-121.2720559	Placer County
27628	Fee-for-Service	1316588825	1316588825	1	1	EFFORT HOSPICE INC	12/29/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	19531 VENTURA BLVD	STE 3	TARZANA	CA	91356	2957	19	06037	34.17281748	-118.5590745	Los Angeles County
27631	Fee-for-Service	1780702209	1780702209	1	4	ELITE PHYSICAL THERAPY AND W	2/3/2020	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ELLNESS, INC.	79440 CORPORATE CENTER D	None	LA QUINTA	CA	92253	7243	33	06065	33.70937862	-116.2788139	Riverside County
27654	Fee-for-Service	1801345731	1801345731	1	1	EGB HOLDINGS	2/14/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4100 LATHAM ST	SUITE E	RIVERSIDE	CA	92501	1733	33	06065	34.00149667	-117.3721621	Riverside County
27809	Fee-for-Service	1033260559	1033260559	1	1	EMENEY, PAMELA L MD	6/5/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	103067	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	445 SOUTH CEDAR AVENUE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
27825	Fee-for-Service	1780702209	1780702209	1	5	ELITE PHYSICAL THERAPY AND W	2/3/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ELLNESS, INC.	13313 PALM DR	B	DESERT HOT SPRING	CA	92240	5980	33	06065	33.951663	-116.501339	Riverside County
27858	Fee-for-Service	1619499845	1619499845	1	1	EDWARDS, LEAH S LMFT	10/8/2021	101YP2500X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6089 N 1ST ST	104	FRESNO	CA	93710	5464	10	06019	36.82574354	-119.7724848	Fresno County
27960	Fee-for-Service	1710293709	1710293709	1	1	EDGERTON, ANDREA N	9/29/2010	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
28065	Fee-for-Service	1952480527	1952480527	2	1	ETHERIDGE, SUSAN P MD	5/18/2024	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
28148	Fee-for-Service	1043284706	1043284706	1	1	ENCOMPASS HEALTH	6/6/1996	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION HOSPICE	15120 KENSINGTON PARK DR	None	TUSTIN	CA	92782	1801	30	06059	33.71335852	-117.8170952	Orange County
28185	Fee-for-Service	1245341817	1245341817	1	1	ELLIS-JAMMAL, MARYANN MD	1/1/1993	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	37659	01	General Practice	0	In state provider	None	2525 STOCKTON BLVD	# A2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
28199	Fee-for-Service	1992168058	1992168058	1	1	EELKEMA, MELISSA MD	9/3/2020	390200000X	NA	Other	026	PHYSICIANS	169541	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
28223	Fee-for-Service	1295198091	1295198091	1	1	EICHENFIELD, DAWN Z MD	7/8/2021	207N00000X	NA	Dermatology	026	PHYSICIANS	150792	None	None	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
28294	Fee-for-Service	1821300518	1821300518	1	1	EVANS, DARCI E DO	6/14/2018	2080P0203X	NA	Other	026	PHYSICIANS	11889	40	Pediatrics	0	In state provider	None	1000 W CARSON ST	DEPARTMENT OF PEDIATRICS	TORRANCE	CA	90509	2004	19	06037	33.83155851	-118.2920625	Los Angeles County
28316	Fee-for-Service	1508029133	1508029133	1	1	EMILY-ANNE CENTER INC	7/10/2008	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	8679 CANTERBURY AVE	None	PANORAMA CITY	CA	91402	4063	19	06037	34.22741817	-118.4223004	Los Angeles County
28356	Fee-for-Service	1952480527	1952480527	2	1	ETHERIDGE, SUSAN P MD	5/18/2024	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
28450	Fee-for-Service	1770556938	1770556938	1	1	EDDE, EDITH LYNN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
28473	Fee-for-Service	1245341817	1245341817	1	1	ELLIS-JAMMAL, MARYANN MD	1/1/1993	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	37659	40	Pediatrics	0	In state provider	None	2525 STOCKTON BLVD	# A2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
28528	Fee-for-Service	1528826286	1528826286	1	1	ENJOYING THE PRESENT MARRIAG	7/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	E AND FAMILY COUNSELIN	1369 FOOTHILL BLVD	None	LA CANADA FLINTRI	CA	91011	2121	19	06037	34.20818414	-118.2083131	Los Angeles County
28573	Fee-for-Service	1518431279	1518431279	1	1	ESTORCO, CELESTE MARIE M RCP	7/19/2021	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
28585	Fee-for-Service	1174744510	1174744510	1	1	EL CAMINO ADHC, INC.	8/15/2006	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	15429 CRENSHAW BLVD	SUITE D	GARDENA	CA	90249	4510	19	06037	33.8902707	-118.3266105	Los Angeles County
28744	Fee-for-Service	1568096436	1568096436	1	2	ELITE HEARING AID GROUP INC	10/7/2022	332S00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	16742 GOTHARD STREET	SUITE 102	HUNTINGTON BEACH	CA	92647	4562	30	06059	33.71950456	-118.0000737	Orange County
28914	Fee-for-Service	1295883171	1295883171	1	1	EFFRON, HARRIS G MD	9/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38131	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
28961	Fee-for-Service	1881835296	1881835296	1	1	EUBANKS, CAITLIN E LCSW	7/10/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7171 ALVARADO RD	100A	LA MESA	CA	91942	8258	37	06073	32.77267798	-117.0445155	San Diego County
29042	Fee-for-Service	1982955399	1982955399	1	1	ERIC MOWATT-LARSSEN, MD, INC	7/19/2021	202K00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	AND SALINAS	977 PACIFIC STREET	SUITE B	MONTEREY	CA	93940	4400	27	06053	36.59105417	-121.898995	Monterey County
29044	Fee-for-Service	1699851469	1699851469	1	1	ELMORE, JOANN G MD	5/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155516	77	Infectious Disease	0	In state provider	None	200 MED PLAZA	365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
29075	Fee-for-Service	1720259575	1720259575	1	1	EARLY, SEAN D MD INC	7/1/2004	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	1919 STATE ST	STE 301	SANTA BARBARA	CA	93101	8443	42	06083	34.4306401	-119.7144766	Santa Barbara County
29082	Fee-for-Service	1720161649	1720161649	1	2	EUBANKS, AUBREY L MD	12/24/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	97276	-	NOT APPLICABLE	0	In state provider	None	500 CROWN POINT CIRCLE	SUITE 120	GRASS VALLEY	CA	95945	9561	29	06057	39.22028885	-121.0316663	Nevada County
29146	Fee-for-Service	1336978923	1336978923	1	1	ESPINOZA, BRENDA	11/6/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	5100 N SIXTH ST	STE 120	FRESNO	CA	93710	7506	10	06019	36.810666	-119.763204	Fresno County
29196	Fee-for-Service	1992827794	1992827794	1	1	ESTRADA, ANNA G MD	12/29/2017	207L00000X	NA	Other	026	PHYSICIANS	47342	05	Anesthesiology	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
29263	Fee-for-Service	1932107331	1932107331	1	17	EAST BAY MEDICAL ONCOLOGY	8/31/2015	193400000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	365 HAWTHORNE AVENUE	SUITE 101	OAKLAND	CA	94609	3117	01	06001	37.82079728	-122.2633226	Alameda County
29331	Fee-for-Service	1699851469	1699851469	1	1	ELMORE, JOANN G MD	5/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155516	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
29332	Fee-for-Service	1285347294	1285347294	1	1	EDWARDS, KARA	2/8/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	50	06099	0	0	None
29336	Fee-for-Service	1235507724	1235507724	1	1	EVANS, JUSTIN C DO	8/1/2018	207P00000X	NA	Other	026	PHYSICIANS	16081	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
29363	Fee-for-Service	1720259575	1720259575	1	1	EARLY, SEAN D MD INC	8/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	60507	05	Anesthesiology	0	In state provider	None	1919 STATE ST	STE 301	SANTA BARBARA	CA	93101	8443	42	06083	34.4306401	-119.7144766	Santa Barbara County
29442	Fee-for-Service	1538243506	1538243506	1	1	ENGLISH, THOMAS P MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	55838	41	Internal Medicine	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
29456	Fee-for-Service	1023616752	1023616752	1	1	EASYCARE INC	10/20/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12509 OXNARD ST	207	NORTH HOLLYWOOD	CA	91605	4440	19	06037	34.17943548	-118.405683	Los Angeles County
29582	Fee-for-Service	1700169570	1700169570	1	1	EDWARDS, WILLIAM A MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	124110	05	Anesthesiology	0	In state provider	None	200 MEDICAL PLAZA	STE 214	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
29647	Fee-for-Service	1720259575	1720259575	1	1	EARLY, SEAN D MD INC	8/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	60507	40	Pediatrics	0	In state provider	None	1919 STATE ST	STE 301	SANTA BARBARA	CA	93101	8443	42	06083	34.4306401	-119.7144766	Santa Barbara County
29710	Fee-for-Service	1386828085	1386828085	1	1	EDDY, JULIA G LCSW	3/21/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
29727	Fee-for-Service	1528312444	1528312444	3	1	EVANS, ROBIN M LCSW	2/20/2019	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	383 W 6TH STREET	SUITE 9	SAN PEDRO	CA	90731	3301	19	06037	33.73873874	-118.2852814	Los Angeles County
29732	Fee-for-Service	1538243506	1538243506	1	1	ENGLISH, THOMAS P MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	55838	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
29743	Fee-for-Service	1023616752	1023616752	1	1	EASYCARE INC	10/20/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12509 OXNARD ST	207	NORTH HOLLYWOOD	CA	91605	4440	19	06037	34.17943548	-118.405683	Los Angeles County
29756	Fee-for-Service	1750915591	1750915591	1	1	ELEGANT LEGACY HOME CARE	1/14/2021	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	AND REHAB LLC	2667 CAMINO DEL RIO SOUT	SUITE 100C	SAN DIEGO	CA	92108	3771	37	06073	32.76979794	-117.1355701	San Diego County
29908	Fee-for-Service	1083132518	1083132518	1	1	EDEN MEDICAL TRANSPORTATION	5/29/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC.	1070 A ST	8	HAYWARD	CA	94541	4106	01	06001	37.67466758	-122.0827974	Alameda County
29942	Fee-for-Service	1942616859	1942616859	1	1	EGUIGUREN JIMENEZ, MARIA DE	1/20/2024	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	150268	None	None	0	In state provider	LOURDES MD	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
30007	Fee-for-Service	1376903336	1376903336	1	1	ESTRELLA, HUMBERTO J PT	4/13/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
30041	Fee-for-Service	1881122778	1881122778	1	1	EKE, UCHECHUKWU R MD	8/3/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	166757	40	Pediatrics	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
30050	Fee-for-Service	1518424449	1518424449	1	1	ESGUERRA, BEN PT	3/4/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4960 VERDUGO	None	CAMARILLO	CA	93012	8632	56	06111	34.21547303	-119.0040356	Ventura County
30104	Fee-for-Service	1215185293	1215185293	1	1	EYESTONE, ANTHONY J LMFT	4/20/2021	104100000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	748 N MARKET ST	None	REDDING	CA	96003	3606	45	06089	40.5960907	-122.38781	Shasta County
30146	Fee-for-Service	1952607426	1952607426	1	1	ELIAS, THOMAS CO	1/10/2006	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	2211 MOORPARK AVE	STE 230	SAN JOSE	CA	95128	2632	43	06085	37.31613943	-121.9326665	Santa Clara County
30156	Fee-for-Service	1366820870	1366820870	1	1	ELITE MEDICAL LABORATORY SOL	3/1/2021	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	UTIONS LLC	1101 ALMA ST	STE 100	TOMBALL	TX	77375	4554	00	None	30.09044534	-95.62636014	Harris County
30365	Fee-for-Service	1154402444	1154402444	1	1	ERIC BRAVO	2/26/2024	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	None	LITTLE ROCK	AR	72205	6321	00	None	34.744437	-92.3813595	Pulaski County
30534	Fee-for-Service	1902870215	1902870215	1	1	ELSHIWICK, ENAS PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	721 NEVADA ST	STE 203	REDLANDS	CA	92373	8051	36	06071	34.061715	-117.2174795	San Bernardino County
30552	Fee-for-Service	1235181652	1235181652	1	1	EGBERT, PETER R MD	1/1/1982	207W00000X	NA	Ophthalmology	026	PHYSICIANS	24518	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
30582	Fee-for-Service	1740377332	1740377332	1	1	ELGUESSAB,ELMOSTAFA MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69507	05	Anesthesiology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
30623	Fee-for-Service	1528316874	1528316874	1	2	ESCOBAR, LIDIA M LCSW	1/6/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15683 PONDEROSA LN	None	CHINO HILLS	CA	91709	3342	36	06071	33.96840057	-117.7186069	San Bernardino County
30663	Fee-for-Service	1285605212	1285605212	1	1	EJADI, SAMUEL MD	10/22/2017	207RX0202X	NA	Oncology	026	PHYSICIANS	55259	41	Internal Medicine	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
30716	Fee-for-Service	1184296931	1184296931	1	1	EXPERT CARE	11/8/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	18344 OXNARD ST	UNIT 212	TARZANA	CA	91356	6780	19	06037	34.18005817	-118.5324607	Los Angeles County
30750	Fee-for-Service	1558314237	1558314237	1	1	EMAD ABU-KHIERAN MD	2/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3810 PLAZA WAY	None	KENNEWICK	WA	99338	2722	00	None	46.17644625	-119.1911845	Benton County
30906	Fee-for-Service	1639598758	1639598758	1	1	ELITE HOSPITALIST MEDICAL	7/18/2014	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP INC	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
31222	Fee-for-Service	1336230689	1336230689	1	1	EXCEL HOME HEALTH	1/13/1995	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5575 LAKE PARK WAY	STE 220	LA MESA	CA	91942	1684	37	06073	32.78203256	-117.0342041	San Diego County
31246	Fee-for-Service	1740852979	1740852979	1	1	ENRIQUEZ, RICHARD CRNA	3/2/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
31353	Fee-for-Service	1558430587	1558430587	1	1	ERTL, JAN P MD	10/1/1988	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	39304	20	Orthopedic Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
31662	Fee-for-Service	1790158350	1790158350	1	1	EMERALD HEALTHCARE PHARMACY	1/12/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CORP	3414 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	1539	19	06037	34.02480443	-118.1411438	Los Angeles County
31678	Fee-for-Service	1780651893	1780651893	1	1	EHRREICH, STEVEN T MD	3/10/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85628	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
31690	Fee-for-Service	1083948137	1083948137	1	1	EURIPIDES, AVIVA LMFT	10/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
31756	Fee-for-Service	1124554399	1124554399	1	1	EGERTER, ALEXANDER DO	2/22/2025	207P00000X	NA	Other	026	PHYSICIANS	23302	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
31784	Fee-for-Service	1447215975	1447215975	1	1	ENVISION EYE APMC	11/27/2007	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	ASSOC EYE SUR MED GRP	9834 GENESEE AVENUE	SUITE 406	LA JOLLA	CA	92037	1207	37	06073	32.884074	-117.225855	San Diego County
31884	Fee-for-Service	1033470190	1033470190	1	1	ESPINOSA, JULIO M MD	5/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129783	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
31885	Fee-for-Service	1013308428	1013308428	1	1	EASTER, WILLIAM A CRNA	2/12/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
31898	Fee-for-Service	1356767545	1356767545	2	1	ENDEAVOR MEDICAL SUPPLY INC	2/26/2019	332BC3200X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	5552 CERRITOS AVE	STE C	CYPRESS	CA	90630	4725	30	06059	33.81021457	-118.0350969	Orange County
31930	Fee-for-Service	1457013807	1457013807	1	1	ESTRELLA, BRITTNEY L CCC-SLP	9/13/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	27393 YNEZ RD STE 153	None	TEMECULA	CA	92591	4605	33	06065	33.50698549	-117.1502918	Riverside County
31934	Fee-for-Service	1124458906	1124458906	1	1	EYE MEDICAL CLINIC OF FRESNO	5/21/2014	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1122 S ST	STE 101	FRESNO	CA	93721	1430	10	06019	36.74185388	-119.7823667	Fresno County
31964	Fee-for-Service	1780651893	1780651893	1	1	EHRREICH, STEVEN T MD	3/10/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85628	79	Neurology-Child	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
32010	Fee-for-Service	1518227651	1518227651	1	1	ERANDI LIYANAARACHCHI MD	10/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1460 G ST	None	SPRINGFIELD	OR	97477	4112	00	None	44.0524395	-123.0035985	Lane County
32012	Fee-for-Service	1841225612	1841225612	1	1	EYSMANN, SUSAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	30 SHELBURNE RD	None	STAMFORD	CT	06902	3628	00	None	41.054958	-73.55391404	Western Connecticut Planning Region
32043	Fee-for-Service	1700820677	1700820677	1	1	EBRAHIM,ALI M MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	73780	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18300 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
32113	Fee-for-Service	1699145169	1699145169	1	1	EZ COMFORT INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	24868 APPLE ST	STE 202	SANTA CLARITA	CA	91321	5043	19	06037	34.37883973	-118.5423667	Los Angeles County
32147	Fee-for-Service	1720510761	1720510761	1	1	EVAN TRINIDAD	11/18/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 S POTOMAC ST	None	AURORA	CO	80012	5411	00	None	39.689343	-104.832198	Arapahoe County
32190	Fee-for-Service	1548575061	1548575061	1	3	ECO OPTOMETRY, INC	8/22/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	VALLEY INC	10702 WESTMINSTER AVE	None	GARDEN GROVE	CA	92843	4928	30	06059	33.7595405	-117.942318	Orange County
32227	Fee-for-Service	1821467705	1821467705	1	1	EDWARDS, CLINT A LCSW	11/4/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	58811 SANTA BARBARA DR	None	YUCCA VALLEY	CA	92284	6459	36	06071	34.08355638	-116.3810874	San Bernardino County
32273	Fee-for-Service	1063488757	1063488757	1	1	EIDEL, JAMES M MD	5/16/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	152 PIONEER LANE	A-H	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
32354	Fee-for-Service	1093915480	1093915480	1	1	ENGEL, DELPHINE MD	6/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	97052	02	General Surgery	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
32405	Fee-for-Service	1699145169	1699145169	1	1	EZ COMFORT INC	2/28/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	24868 APPLE ST	STE 202	SANTA CLARITA	CA	91321	5043	19	06037	34.37883973	-118.5423667	Los Angeles County
32496	Fee-for-Service	1437169224	1437169224	1	1	ENGLISH, JOHN R MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	63984	08	Family Practice	0	In state provider	None	401 PARADISE RD	STE E	MODESTO	CA	95351	3104	50	06099	37.62692973	-121.0131742	Stanislaus County
32500	Fee-for-Service	1407349558	1407349558	1	1	ELLIS, KAELAN PT	8/4/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	275 W HOSPITALITY LN	103	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
32680	Fee-for-Service	1649875857	1649875857	1	1	EXPRESSABLE SPEECH-LANGUAGE	5/11/2022	193400000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	PATHOLOGY, P.C.	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
32763	Fee-for-Service	1275670036	1275670036	1	1	EXECUTIVE MENTAL HEALTH INC	1/6/2022	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
33052	Fee-for-Service	1275670036	1275670036	1	1	EXECUTIVE MENTAL HEALTH INC	9/1/2013	193400000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
33356	Fee-for-Service	1275513038	1275513038	1	1	ERIC P SIPOS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	WESTERN NEUROSURGERY	350 N WILMOT	None	TUCSON	AZ	85711	0000	00	None	32.227209	-110.8556595	Pima County
33387	Fee-for-Service	1417061557	1417061557	1	1	EL-MAGHARBEL, IBRAHIM MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	51567	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
33399	Fee-for-Service	1023459302	1023459302	1	1	ELIHU, KOOROSH J MD	9/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	133689	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
33420	Fee-for-Service	1144286162	1144286162	1	1	ELIASHIV, DAWN S MD	4/30/1993	174400000X	NA	Other	026	PHYSICIANS	52594	None	None	0	In state provider	None	300 UCLA PLAZA DR B200	None	LOS ANGELES	CA	90024	0000	19	06037	34.06465655	-118.4461	Los Angeles County
33435	Fee-for-Service	1902869860	1902869860	1	1	ESCOBAR, MARTHA V D MD	1/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	93506	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
33592	Fee-for-Service	1528027174	1528027174	1	1	EKNOYAN, DONALD P MD	3/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	54990	36	Psychiatry	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
33621	Fee-for-Service	1154513125	1154513125	1	1	ERLICHMAN, OREN MD	7/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103025	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93612	6800	10	06019	36.83745149	-119.6604315	Fresno County
33635	Fee-for-Service	1295715712	1295715712	1	1	ELIZARES, JACK M OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3610 OLD HIGHWAY 53	None	CLEARLAKE	CA	95422	9253	17	06033	38.96016333	-122.6309706	Lake County
33648	Fee-for-Service	1295993087	1295993087	1	1	EFFINGER, KAREN E MD	9/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	109535	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
33842	Fee-for-Service	1205387461	1205387461	1	1	EMPIRE FOOT AND ANKLE CENTER	6/19/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	INC.	299 W FOOTHILL BLVD	124	UPLAND	CA	91786	3854	36	06071	34.10706753	-117.6550335	San Bernardino County
33886	Fee-for-Service	1699725069	1699725069	1	2	EMERGENCY SERVICES MEDICAL C	2/18/2020	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ORPORATION	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
33954	Fee-for-Service	1184861684	1184861684	1	1	EVITMOV, STOIMEN S MD	12/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106441	41	Internal Medicine	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
33975	Fee-for-Service	1275511420	1275511420	1	1	EISMAN, SCOTT A MD	5/13/1985	207RP1001X	NA	Pulmonology	026	PHYSICIANS	54742	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
33983	Fee-for-Service	1952947665	1952947665	1	1	ELLIS, SANCIA NP	3/10/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
33991	Fee-for-Service	1225106602	1225106602	1	1	EKSTRUM, DALE E MD	11/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	69286	01	General Practice	0	In state provider	None	217 W CENTRAL AVE	STE G	LOMPOC	CA	93436	2830	42	06083	34.66084049	-120.460302	Santa Barbara County
34035	Fee-for-Service	1700874161	1700874161	1	1	ESTRADA-LINDER, LILIAN	11/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77531	02	General Surgery	0	In state provider	None	411 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.8531521	-117.8160824	Orange County
34042	Fee-for-Service	1629549225	1629549225	1	1	ERLEWINE, STACY L RCP	10/20/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
34138	Fee-for-Service	1700853728	1700853728	1	1	ELLIOTT, CANDACE A NP	10/4/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43112 N 15TH STREET WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
34150	Fee-for-Service	1235308883	1235308883	1	1	ESPIL, FLINT M PHD	11/28/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
34151	Fee-for-Service	1720115934	1720115934	1	1	EPIPHANY CARE HOMES INC	8/1/2003	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	JADE HOME ICF/DD-H	750 KENTWOOD DR	None	OXNARD	CA	93030	3451	56	06111	34.21746048	-119.1862395	Ventura County
34222	Fee-for-Service	1922056589	1922056589	1	1	ELLIS, LAMONT E MD	5/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
34270	Fee-for-Service	1720036569	1720036569	1	1	EIDAL, BRYAN D OD	7/24/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1630 11TH ST	None	REEDLEY	CA	93654	2902	10	06019	36.59686247	-119.4501247	Fresno County
34285	Fee-for-Service	1598840258	1598840258	1	1	EL CENTRO REG MED CTR	4/24/1996	261QR1300X	NA	Rural Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	495 BIRCH ST	STE A	CALEXICO	CA	92231	9632	13	06025	32.6794317	-115.4928454	Imperial County
34317	Fee-for-Service	1700874161	1700874161	1	1	ESTRADA-LINDER, LILIAN	11/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77531	01	General Practice	0	In state provider	None	411 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.8531521	-117.8160824	Orange County
34328	Fee-for-Service	1144272170	1144272170	1	1	EAST BAY PERINATAL MED	9/29/1990	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ASSOC	350 30TH ST	STE 208	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
34383	Fee-for-Service	1093192080	1093192080	1	1	ESCALANTE, CHRISTINE CRNA	10/19/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
34422	Fee-for-Service	1811623671	1811623671	1	1	ESPARZA, ANA	1/24/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
34486	Fee-for-Service	1831253509	1831253509	1	1	EICHHORN-MULLIGAN, KNUT	7/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103971	18	Ophthalmology	0	In state provider	MD	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2721	38	06075	37.76386986	-122.4568084	San Francisco County
34531	Fee-for-Service	1194967000	1194967000	1	1	ERIKSEN, CALVIN M MD	8/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131491	01	General Practice	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
34573	Fee-for-Service	1598840258	1598840258	1	1	EL CENTRO REG MED CTR	4/24/1996	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	495 BIRCH ST	STE A	CALEXICO	CA	92231	9632	13	06025	32.6794317	-115.4928454	Imperial County
34613	Fee-for-Service	1952555336	1952555336	1	1	ELLIOTT, JENNIFER K	10/20/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5400 W HILLSDALE AVE	SUITE 150	VISALIA	CA	93291	8222	54	06107	36.330327	-119.351943	Tulare County
34630	Fee-for-Service	1801989280	1801989280	1	2	EIGNER, DANIELLE A DO	4/14/2017	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	10329	-	NOT APPLICABLE	0	In state provider	None	190 MILL ST	DINING ROOM	SAN RAFAEL	CA	94901	4021	21	06041	37.96645291	-122.5124679	Marin County
34702	Fee-for-Service	1679661409	1679661409	1	1	EIKENBERRY, DAVID J MD	11/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	83597	01	General Practice	0	In state provider	None	23625 WR HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
34751	Fee-for-Service	1457488538	1457488538	1	1	EPIPHANY CARE HOMES, INC	12/16/2005	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WAVECREST HOME ICF/DD-H	2929 TEXAS AVE	None	SIMI VALLEY	CA	93063	1954	56	06111	34.28856532	-118.6975079	Ventura County
34788	Fee-for-Service	1942061361	1942061361	1	1	ESPINOZA, CORTEZ D PT	5/23/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
34796	Fee-for-Service	1982023719	1982023719	1	1	ELSWICK, BENJAMIN N MD	2/23/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	154748	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
34801	Fee-for-Service	1467004101	1467004101	1	1	EXPRESS HOMESERVICE INC	9/18/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7220 WOODMAN AVE	SUITE 205	VAN NUYS	CA	91405	2648	19	06037	34.20189	-118.431221	Los Angeles County
34935	Fee-for-Service	1750558805	1750558805	1	1	ESSAYYAD, THAMIR M MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105587	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
35006	Fee-for-Service	1073520029	1073520029	1	1	ELAINE THOMAS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
35086	Fee-for-Service	1861504854	1861504854	1	1	EL MIRADR MED PLAZA PHRM	11/19/2003	332B00000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	DESERT HOSP OUTPAT PHARM	1180 N INDIAN CANYON DR	STE E140	PALM SPRINGS	CA	92262	4883	33	06065	33.839505	-116.5455735	Riverside County
35091	Fee-for-Service	1053303560	1053303560	1	1	EHRMAN, WALTER J MD	9/1/2002	208G00000X	NA	General Surgery	026	PHYSICIANS	69981	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1180 N INDIAN CANYON DR	SUITE E218	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
35152	Fee-for-Service	1366429680	1366429680	1	1	EHRICH, MARC MD	11/30/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	52293	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2070 CENTURY PARK E	None	LOS ANGELES	CA	90067	1907	19	06037	34.05887194	-118.4122914	Los Angeles County
35267	Fee-for-Service	1427121417	1427121417	1	1	EVERITT-KRAUSE, LOIS K LMFT	5/11/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
35325	Fee-for-Service	1518478643	1518478643	1	1	EB PSYCH SOLUTION, INC.	6/19/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	1125 E 17TH ST	SUITE N153	SANTA ANA	CA	92701	2201	30	06059	33.76004145	-117.854838	Orange County
35425	Fee-for-Service	1386734887	1386734887	1	1	EUDICE E. FONTENOT, M.D.	5/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 CHILDRENS WAY	# 653	LITTLE ROCK	AR	72202	3500	00	None	34.742745	-92.2927905	Pulaski County
35438	Fee-for-Service	1710547609	1710547609	1	1	EVANS, STEPHANIE D NP	6/13/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
35459	Fee-for-Service	1932233673	1932233673	1	1	ESSENMACHER, KIRK R MD	6/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	60417	41	Internal Medicine	0	In state provider	None	375 LAGUNA HONDA BLVD	None	SAN FRANCISCO	CA	94116	1411	38	06075	37.74791027	-122.4587116	San Francisco County
35491	Fee-for-Service	1801120035	1801120035	1	1	EMERGENCY NEUROSURGERY	4/14/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	SERVICES MED GRP INC	ONE MEDICAL PLAZA	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
35521	Fee-for-Service	1588986855	1588986855	1	1	ESLINGER, LILA M LMFT	12/22/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	52737	-	NOT APPLICABLE	0	In state provider	None	40 W G STREET	SUITE A-E	LOS BANOS	CA	93635	3657	24	06047	37.06661683	-120.8545413	Merced County
35526	Fee-for-Service	1376305755	1376305755	1	2	EM ALLIANCE CALIFORNIA, APC	3/1/2024	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
35554	Fee-for-Service	1194721308	1194721308	1	1	ETEBAR, SHAHIN MD INC	2/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	72753	20	Orthopedic Surgery	0	In state provider	DESERT SPINE & NEUROSURG	39000 BOB HOPE DR	STE W410	RANCHO MIRAGE	CA	92270	7087	33	06065	33.763572	-116.4056895	Riverside County
35567	Fee-for-Service	1386235265	1386235265	1	1	ESQUEDA, LAUREN M NP	9/5/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	30	06059	33.74496	-117.818857	Orange County
35587	Fee-for-Service	1295129492	1295129492	1	1	EYVAZIAN, VAUGHN A MD	5/14/2020	207R00000X	NA	Other	026	PHYSICIANS	146289	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
35601	Fee-for-Service	1255574885	1255574885	1	1	ESTLIN, KATHERINE A T MD	1/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143957	01	General Practice	0	In state provider	None	3300 RENNER DRIVE	None	FORTUNA	CA	95540	3120	12	06023	40.58243651	-124.135992	Humboldt County
35735	Fee-for-Service	1659597805	1659597805	1	1	EBERLE, ROBERT J	12/26/2012	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	341 WESTLAKE CENTER	STE 331	DALY CITY	CA	94015	1443	41	06081	37.70045364	-122.4828512	San Mateo County
35830	Fee-for-Service	1548049299	1548049299	1	1	EVERETT, LASHAAN D CNM	10/4/2023	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	3630 ENTERPRISE STREET	None	SAN DIEGO	CA	92110	3212	37	06073	32.74601586	-117.1985439	San Diego County
35842	Fee-for-Service	1194721308	1194721308	1	1	ETEBAR, SHAHIN MD INC	2/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	72753	14	Neurological Surgery	0	In state provider	DESERT SPINE & NEUROSURG	39000 BOB HOPE DR	STE W410	RANCHO MIRAGE	CA	92270	7087	33	06065	33.763572	-116.4056895	Riverside County
36003	Fee-for-Service	1538402813	1538402813	1	1	ERIC G. LEVY MEDICAL CORPORA	8/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	70946	None	None	0	In state provider	TION	1505 SHEPARD DR	106	SANTA MARIA	CA	93454	7020	42	06083	34.93433773	-120.4213014	Santa Barbara County
36021	Fee-for-Service	1962599118	1962599118	1	1	ELK GROVE FAMILY PHYS	5/31/2000	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP, INC	9727 ELK GROVE FLORIN RD	STE 140	ELK GROVE	CA	95624	2291	34	06067	38.404503	-121.370994	Sacramento County
36049	Fee-for-Service	1831638444	1831638444	1	1	EVANS, CATHERINE CRNA	3/28/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
36051	Fee-for-Service	1134538697	1134538697	1	1	ECHEVERRIA, JESSICA LCSW	2/24/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
36100	Fee-for-Service	1093993263	1093993263	1	1	ERICKSON, CHRISTOPHER P MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109927	07	Dermatology	0	In state provider	None	7300 GIRARD AVENUE	SUITE 104	LA JOLLA	CA	92037	5138	37	06073	32.83772948	-117.2716382	San Diego County
36128	Fee-for-Service	1194721308	1194721308	1	1	ETEBAR, SHAHIN MD INC	2/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	72753	01	General Practice	0	In state provider	DESERT SPINE & NEUROSURG	39000 BOB HOPE DR	STE W410	RANCHO MIRAGE	CA	92270	7087	33	06065	33.763572	-116.4056895	Riverside County
36132	Fee-for-Service	1649740424	1649740424	1	1	EVANS, ROBIN J MD	5/13/2020	2086S0122X	NA	General Surgery	026	PHYSICIANS	159756	24	Plastic Surgery	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
36146	Fee-for-Service	1588664049	1588664049	1	1	EVES, WILLIAM C MD INC	10/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65653	20	Orthopedic Surgery	0	In state provider	None	450 4TH AVE	STE 311	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
36198	Fee-for-Service	1144782681	1144782681	1	1	ERLENDSON, MATTHEW J MD	7/20/2023	207L00000X	NA	Other	026	PHYSICIANS	181698	None	None	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
36268	Fee-for-Service	1033323118	1033323118	1	1	EICHENBERG, BRIAN J MD	7/13/2023	2086S0122X	NA	General Surgery	026	PHYSICIANS	55426	None	None	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
36389	Fee-for-Service	1093993263	1093993263	1	1	ERICKSON, CHRISTOPHER P MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109927	22	Pathology (M.D. only)	0	In state provider	None	7300 GIRARD AVENUE	SUITE 104	LA JOLLA	CA	92037	5138	37	06073	32.83772948	-117.2716382	San Diego County
36532	Fee-for-Service	1023319407	1023319407	1	1	ESOTERIX GENETIC LABORATORY	8/4/2011	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	LLC	2440 S SEPULVEDA BLVD	STE 100	LOS ANGELES	CA	90064	1744	19	06037	34.036488	-118.4323635	Los Angeles County
36566	Fee-for-Service	1740051069	1740051069	1	1	EDWARDS, ALEXANDER CCC-SLP	2/2/2025	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1650 LOS GAMOS DR	None	SAN RAFAEL	CA	94903	1850	21	06041	38.02105246	-122.5420674	Marin County
36580	Fee-for-Service	1487706842	1487706842	1	1	ETRATA JR, RENATO V MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	62771	05	Anesthesiology	0	In state provider	ATTN MGA OFFICE	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
36686	Fee-for-Service	1821015843	1821015843	1	1	EYER, AUBREY G MD	6/30/1992	207L00000X	NA	Other	026	PHYSICIANS	22526	02	General Surgery	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
36800	Fee-for-Service	1225685902	1225685902	1	1	ENWOROM, OZIOMA A CNP	11/4/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8090 PARKWAY DR	None	LA MESA	CA	91942	2105	37	06073	32.77549578	-117.0233009	San Diego County
36807	Fee-for-Service	1033446448	1033446448	1	2	EL DORADO PHYSICAL THERAPY,	10/12/2023	225XH1200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8135 SARATOGA WAY	STE 200	EL DORADO HILLS	CA	95762	4590	09	06017	38.65291812	-121.0731598	El Dorado County
36840	Fee-for-Service	1649440470	1649440470	1	1	EBERHARD VEIRA, CAROLINA LC	3/5/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	1310 STEWART DR	508	ORANGE	CA	92868	3854	30	06059	33.78236048	-117.8664975	Orange County
36852	Fee-for-Service	1922394493	1922394493	1	1	ERIN HEMPHILL MD	3/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2220 CANTERBURY DR	None	HAYS	KS	67601	2370	00	None	38.880486	-99.2961225	Ellis County
36973	Fee-for-Service	1821015843	1821015843	1	1	EYER, AUBREY G MD	6/30/1992	207L00000X	NA	Other	026	PHYSICIANS	22526	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
36991	Fee-for-Service	1487472577	1487472577	1	1	EDWARDS, ROSS-ANDRE CRNA	1/7/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
37152	Fee-for-Service	1265412993	1265412993	1	1	ELLIS, SELENA W	2/1/2011	2084N0400X	NA	Neurology	026	PHYSICIANS	71337	14	Neurological Surgery	0	In state provider	None	2999 REGENT ST	STE 627	BERKELEY	CA	94705	2058	01	06001	37.85592021	-122.2566436	Alameda County
37227	Fee-for-Service	1912053752	1912053752	1	1	EMERGENCY PHYSICIANS SOUTHWE	4/22/2025	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	1	Border provider	ST, PC	5330 S HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
37260	Fee-for-Service	1821015843	1821015843	1	1	EYER, AUBREY G MD	6/30/1992	207L00000X	NA	Other	026	PHYSICIANS	22526	08	Family Practice	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
37404	Fee-for-Service	1003833856	1003833856	1	1	EYE SPECIALISTS MEDICAL GROU	3/30/2022	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	P OF NAPA VALLEY INC	800 TRANCAS ST	SUITE A	NAPA	CA	94558	3044	28	06055	38.32419306	-122.2923825	Napa County
37430	Fee-for-Service	1659080547	1659080547	1	1	EMERGENCY PHYSICIANS URGENT	10/30/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	32860 PACIFIC COAST HWY	2	DANA POINT	CA	92629	3475	30	06059	33.48540757	-117.7253996	Orange County
37439	Fee-for-Service	1922379965	1922379965	1	1	EISENBERG, EVANN E MD	7/28/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	125493	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	625 S FAIR OAKS AVE	STE 215	PASADENA	CA	91105	2613	19	06037	34.134894	-118.1504155	Los Angeles County
37441	Fee-for-Service	1811321557	1811321557	1	1	EKPO, ELIZABETH I MD	11/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	129817	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
37471	Fee-for-Service	1790753408	1790753408	2	1	ELAHI, RASHID S MD	1/15/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54268	45	Nephrology (Renal-Kidney)	0	In state provider	None	200 JOSE FIGUERES AVENUE	SUITE 270	SAN JOSE	CA	95116	1555	43	06085	37.36122014	-121.8505998	Santa Clara County
37491	Fee-for-Service	1063568293	1063568293	1	1	ESCUDERO, KIM L MD	3/17/2004	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	61421	40	Pediatrics	0	In state provider	None	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.64575895	-118.9638914	Mono County
37516	Fee-for-Service	1912053752	1912053752	1	1	EMERGENCY PHYSICIANS SOUTHWE	11/24/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	ST, PC	5330 S HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
37590	Fee-for-Service	1104429323	1104429323	1	1	ESPINOZA, CRYSTAL A LMFT	6/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
37609	Fee-for-Service	1871783308	1871783308	1	1	EAST BAY OPHTHALMOLOGY	11/5/2007	207W00000X	NA	Ophthalmology	026	PHYSICIANS	87505	None	None	0	In state provider	None	1420 TARA HILLS DRIVE	SUITE D	PINOLE	CA	94564	2530	07	06013	37.99573909	-122.304492	Contra Costa County
37612	Fee-for-Service	1750414447	1750414447	1	1	EMILY PETERSEN	12/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 KOOTENAI HEALTH WAY	None	COEUR D ALENE	ID	83814	6051	00	None	47.695635	-116.792906	Kootenai County
37615	Fee-for-Service	1881684355	1881684355	1	1	EASTER-BRYAN, DORIA M DO	2/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9249	08	Family Practice	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
37622	Fee-for-Service	1447771548	1447771548	1	1	EVANS, MATTHEW S LMFT	10/19/2020	1041C0700X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
37693	Fee-for-Service	1003833856	1003833856	1	1	EYE SPECIALISTS MEDICAL GROU	9/6/2023	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	P OF NAPA VALLEY INC	800 TRANCAS ST	SUITE A	NAPA	CA	94558	3044	28	06055	38.32419306	-122.2923825	Napa County
37705	Fee-for-Service	1487386702	1487386702	1	1	EAGLES DIALYSIS LLC	11/7/2023	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2195 IRON POINT ROAD	None	FOLSOM	CA	95630	8707	34	06067	38.64321	-121.134771	Sacramento County
37760	Fee-for-Service	1790753408	1790753408	2	1	ELAHI, RASHID S MD	1/15/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54268	41	Internal Medicine	0	In state provider	None	200 JOSE FIGUERES AVENUE	SUITE 270	SAN JOSE	CA	95116	1555	43	06085	37.36122014	-121.8505998	Santa Clara County
37917	Fee-for-Service	1700823630	1700823630	1	1	EHRITT, DONELLE	8/15/1981	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	AUDIOLOGIST	1051 41ST AVE	None	SANTA CRUZ	CA	95062	4400	44	06087	36.967176	-121.964949	Santa Cruz County
37941	Fee-for-Service	1780702209	1780702209	1	2	ELITE PHYSICAL THERAPY AND W	2/3/2020	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ELLNESS, INC.	72-780 COUNTRY CLUB DR.,	None	RANCHO MIRAGE	CA	92270	0000	33	06065	33.68689976	-116.4073828	Riverside County
38033	Fee-for-Service	1568426211	1568426211	1	1	EINSTEIN, DAVID M MD	8/28/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	46940	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
38091	Fee-for-Service	1174878714	1174878714	1	1	ELAM, HEATHER CCC-SLP	2/16/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	800 SOUTH HARBOR BLVD	100	ANAHEIM	CA	92805	5188	30	06059	33.82512725	-117.9165556	Orange County
38105	Fee-for-Service	1487073441	1487073441	1	1	ELLIS, SARAH MD	10/21/2021	207L00000X	NA	Other	026	PHYSICIANS	163174	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
38124	Fee-for-Service	1174836373	1174836373	1	1	EVANS, JADYN J OD	3/18/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	24400 JACKSON AVE	STE A	MURRIETA	CA	92562	1987	33	06065	33.57240222	-117.2050098	Riverside County
38140	Fee-for-Service	1649690108	1649690108	1	1	ESPINDOLA, CHRISSIE A MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129094	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
38225	Fee-for-Service	1780702209	1780702209	1	2	ELITE PHYSICAL THERAPY AND W	5/15/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ELLNESS, INC.	72-780 COUNTRY CLUB DR.,	None	RANCHO MIRAGE	CA	92270	0000	33	06065	33.68689976	-116.4073828	Riverside County
38226	Fee-for-Service	1568096436	1568096436	1	1	ELITE HEARING AID GROUP INC	8/24/2022	332S00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	4085 ATLANTIC AVE	STE D	LONG BEACH	CA	90807	2904	19	06037	33.83153944	-118.1851023	Los Angeles County
38236	Fee-for-Service	1720161649	1720161649	1	1	EUBANKS, AUBREY L MD	2/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97276	36	Psychiatry	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
38331	Fee-for-Service	1720748692	1720748692	1	1	ENCORE SURGERY CENTER INC.	2/24/2025	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	300 W BADILLO ST	None	COVINA	CA	91723	1827	19	06037	34.0862745	-117.894699	Los Angeles County
38335	Fee-for-Service	1326815796	1326815796	1	1	EARLY BIRD HEARING	12/12/2023	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1141 N BRAND BLVD	201	GLENDALE	CA	91202	3647	19	06037	34.162983	-118.2550855	Los Angeles County
38357	Fee-for-Service	1346204385	1346204385	1	1	EAGLE RIVER MEMORIAL	2/21/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	201 HOSPITAL ROAD	None	EAGLE RIVER	WI	54521	8835	00	None	45.92836513	-89.25099204	Vilas County
38378	Fee-for-Service	1912610106	1912610106	1	1	ECONO PHARMACY INC	7/31/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15435 S WESTERN AVE	SUITE #100C	GARDENA	CA	90249	4323	19	06037	33.89088955	-118.3091776	Los Angeles County
38423	Fee-for-Service	1528387222	1528387222	1	1	ENGEL, WILLIAM J CRNA	9/4/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	43112 N 15TH ST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
38564	Fee-for-Service	1770542490	1770542490	1	1	ESCH, JAMES C MD	10/16/1973	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	29486	20	Orthopedic Surgery	0	In state provider	None	1940 S FREEMAN ST	None	OCEANSIDE	CA	92054	6431	37	06073	33.17274658	-117.358903	San Diego County
38647	Fee-for-Service	1255726576	1255726576	1	1	ECHEVARRIA, DINA M	3/28/2018	390200000X	NA	Other	026	PHYSICIANS	149012	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
38650	Fee-for-Service	1346204385	1346204385	1	1	EAGLE RIVER MEMORIAL	2/21/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	201 HOSPITAL ROAD	None	EAGLE RIVER	WI	54521	8835	00	None	45.92836513	-89.25099204	Vilas County
38653	Fee-for-Service	1871996843	1871996843	1	1	ELLCH, LINDSAY C PSY	1/12/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
38725	Fee-for-Service	1003327636	1003327636	1	1	ESTEN, JOHN L LCSW	1/18/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
38736	Fee-for-Service	1184603441	1184603441	1	1	EVANS, ROBERT S MD	12/27/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36975	01	General Practice	0	In state provider	None	426 17TH ST	STE 400	OAKLAND	CA	94612	2817	01	06001	37.80642889	-122.269093	Alameda County
38894	Fee-for-Service	1235516147	1235516147	1	1	EBRAHIMZADEH, PAYMON DO	8/9/2019	390200000X	NA	Other	026	PHYSICIANS	15639	41	Internal Medicine	0	In state provider	None	6733 N WILLOW AVE	SUITE 107	FRESNO	CA	93710	5953	10	06019	36.83464076	-119.7311553	Fresno County
38961	Fee-for-Service	1396107017	1396107017	1	1	EDGCOMB, JULIET B MD	10/25/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	153003	None	None	0	In state provider	None	300 UCLA MEDICAL PLAZA	3300	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
38969	Fee-for-Service	1871896118	1871896118	1	1	ELSHELIKH, SAM MD INC	4/8/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41651	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5565 GROSSMONT CENTER DR	SUITE 227	LA MESA	CA	91942	3026	37	06073	32.77978322	-117.0094766	San Diego County
38989	Fee-for-Service	1417206186	1417206186	1	1	EVANS, MICHELE A NP	5/11/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
39025	Fee-for-Service	1811193246	1811193246	1	1	EARL, CONSTANCE J DO	3/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10553	41	Internal Medicine	0	In state provider	None	3883 AIRWAY DR	#202	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
39094	Fee-for-Service	1861956575	1861956575	1	1	E C LILLY PALLIATIVE CARE AN	12/12/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	AND HOSPICE AGENCY, INC	1942 DEL PASO ROAD	STE 130-100	SACRAMENTO	CA	95834	7719	34	06067	38.655288	-121.50549	Sacramento County
39191	Fee-for-Service	1194702548	1194702548	1	1	EARON, SHIRL G RN	8/24/2004	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	None	SACRAMENTO	CA	95820	1532	34	06067	38.546091	-121.447305	Sacramento County
39259	Fee-for-Service	1871896118	1871896118	1	1	ELSHELIKH, SAM MD INC	4/8/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41651	10	Gastroenterology (M.D. only)	0	In state provider	None	5565 GROSSMONT CENTER DR	SUITE 227	LA MESA	CA	91942	3026	37	06073	32.77978322	-117.0094766	San Diego County
39292	Fee-for-Service	1932107331	1932107331	1	1	EAST BAY MEDICAL ONCOLOGY	7/7/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	13847 E 14TH ST	STE 217	SAN LEANDRO	CA	94578	2626	01	06001	37.71457844	-122.1418551	Alameda County
39381	Fee-for-Service	1861956575	1861956575	1	1	E C LILLY PALLIATIVE CARE AN	12/12/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	AND HOSPICE AGENCY, INC	1942 DEL PASO ROAD	STE 130-100	SACRAMENTO	CA	95834	7719	34	06067	38.655288	-121.50549	Sacramento County
39452	Fee-for-Service	1134575988	1134575988	1	1	ERIN MAIN	1/21/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5200 DTC PKWY	STE 400	GREENWOOD VLG	CO	80111	2719	00	None	39.621636	-104.8992545	Arapahoe County
39488	Fee-for-Service	1235373622	1235373622	1	1	ESAKI, ROY K MD	4/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113437	05	Anesthesiology	0	In state provider	None	751 S BASCOM AVENUE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
39551	Fee-for-Service	1164876157	1164876157	1	1	ELNAN, MIRA R MD	2/24/2020	207R00000X	NA	Other	026	PHYSICIANS	152302	41	Internal Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
39552	Fee-for-Service	1619519246	1619519246	1	1	ERICK MADRIGAL MD MBA INC	1/20/2023	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	833 SEQUOIA AVE	None	LINDSAY	CA	93247	1424	54	06107	36.212967	-119.0961185	Tulare County
39573	Fee-for-Service	1053876284	1053876284	1	1	EVANGALINA E MARTINEZ MD INC	7/17/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	2 UPPER RAGSDALE DR	STE B200	MONTEREY	CA	93940	7844	27	06053	36.57940327	-121.8142876	Monterey County
39578	Fee-for-Service	1932107331	1932107331	1	1	EAST BAY MEDICAL ONCOLOGY	7/7/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	13847 E 14TH ST	STE 217	SAN LEANDRO	CA	94578	2626	01	06001	37.71457844	-122.1418551	Alameda County
39584	Fee-for-Service	1235883802	1235883802	1	1	ELIANA CARRILLO S RAMIREZ	2/17/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6641 W CELESTE AVE	None	FRESNO	CA	93723	8113	10	06019	36.8211255	-119.9098485	Fresno County
39616	Fee-for-Service	1619933371	1619933371	1	1	ESCAJEDA, MARK S MD	6/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76960	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
39748	Fee-for-Service	1205012762	1205012762	1	1	ECKLE, TOBIAS MD	10/2/2020	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
39755	Fee-for-Service	1639178809	1639178809	1	1	ENSIGN WILLITS LLC	11/16/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	64 NORTHBROOK WAY	None	WILLITS	CA	95490	3019	23	06045	39.41519672	-123.3613603	Mendocino County
39761	Fee-for-Service	1942845300	1942845300	1	1	E&E HOSPICE INC	11/12/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2369 COLORADO BLVD	STE 201	LOS ANGELES	CA	90041	1185	19	06037	34.13985099	-118.2180331	Los Angeles County
39839	Fee-for-Service	1619519246	1619519246	1	1	ERICK MADRIGAL MD MBA INC	12/29/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	833 SEQUOIA AVE	None	LINDSAY	CA	93247	1424	54	06107	36.212967	-119.0961185	Tulare County
39866	Fee-for-Service	1932107331	1932107331	1	1	EAST BAY MEDICAL ONCOLOGY	7/7/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	13847 E 14TH ST	STE 217	SAN LEANDRO	CA	94578	2626	01	06001	37.71457844	-122.1418551	Alameda County
39869	Fee-for-Service	1194804237	1194804237	1	1	ESCOBAR, GABRIEL MD	4/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	51659	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1580 VALENCIA ST	None	SAN FRANCISCO	CA	94110	4423	38	06075	37.74746923	-122.4202583	San Francisco County
39872	Fee-for-Service	1235883802	1235883802	1	1	ELIANA CARRILLO S RAMIREZ	2/17/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6641 W CELESTE AVE	None	FRESNO	CA	93723	8113	10	06019	36.8211255	-119.9098485	Fresno County
39906	Fee-for-Service	1619933371	1619933371	1	1	ESCAJEDA, MARK S MD	6/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76960	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
40047	Fee-for-Service	1265534234	1265534234	1	1	EDWARDS, CHARLES F MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30356	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	15525 POMERADO RD	STE A	POWAY	CA	92064	2435	37	06073	32.99479918	-117.0579468	San Diego County
40049	Fee-for-Service	1942845300	1942845300	1	1	E&E HOSPICE INC	11/12/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2369 COLORADO BLVD	STE 201	LOS ANGELES	CA	90041	1185	19	06037	34.13985099	-118.2180331	Los Angeles County
40089	Fee-for-Service	1417515636	1417515636	1	1	EDDINGTON, KYLE C DO	2/17/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	20367	None	None	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
40095	Fee-for-Service	1497487185	1497487185	1	1	EGAN, KATHERINE V CRNA	3/16/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
40109	Fee-for-Service	1073045613	1073045613	1	1	EBREO, CHRISELLE MAE N MD	9/18/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	158832	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
40127	Fee-for-Service	1619519246	1619519246	1	1	ERICK MADRIGAL MD MBA INC	12/29/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	833 SEQUOIA AVE	None	LINDSAY	CA	93247	1424	54	06107	36.212967	-119.0961185	Tulare County
40176	Fee-for-Service	1619050119	1619050119	1	1	ENGSTROM, JENNIFER	6/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85755	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
40241	Fee-for-Service	1316184856	1316184856	1	1	ESSENMACHER, JOAN I	6/28/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8250 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5427	19	06037	34.22078654	-118.4326211	Los Angeles County
40274	Fee-for-Service	1871811034	1871811034	1	1	ENG, CHESDA MD	10/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126904	41	Internal Medicine	0	In state provider	None	2501 E CHAPMAN AVE	STE 301	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
40377	Fee-for-Service	1275631145	1275631145	1	1	EMIL SILBERMAN, M.D.	4/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8900 VAN WYCK EXPWY	None	JAMAICA	NY	11418	0000	00	None	40.700268	-73.8157905	Queens County
40439	Fee-for-Service	1861184665	1861184665	1	1	EL MIRADOR MEDICAL PLAZA PHA	2/1/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
40472	Fee-for-Service	1750627196	1750627196	1	1	EVAZYAN, TANDIK MD	9/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111262	05	Anesthesiology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
40525	Fee-for-Service	1477547008	1477547008	1	1	ELLSWORTH, EDWARD L MD	1/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	21796	22	Pathology (M.D. only)	0	In state provider	None	675 E SANTA CLARA ST	None	SAN JOSE	CA	95112	1932	43	06085	37.34275712	-121.8768207	Santa Clara County
40579	Fee-for-Service	1225783228	1225783228	1	1	EMPATHY HOME CARE SOLUTIONS	10/20/2022	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	720 S RAMONA AVE	202	CORONA	CA	92879	2147	33	06065	33.87364876	-117.5654939	Riverside County
40610	Fee-for-Service	1023196938	1023196938	1	1	ELAM, MOSES D MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	85512	07	Dermatology	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
40717	Fee-for-Service	1801384896	1801384896	1	1	EBY-MCDERMOTT, ALICIA	1/11/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
40781	Fee-for-Service	1316787054	1316787054	1	1	EASTMAN, NOAH LMFT	7/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
40783	Fee-for-Service	1588660310	1588660310	1	1	EASTERN PLUMAS DIST HOSP	7/2/1983	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	500 1ST AVE	None	PORTOLA	CA	96122	9406	32	06063	39.80595392	-120.4626723	Plumas County
40878	Fee-for-Service	1376305755	1376305755	1	1	EM ALLIANCE CALIFORNIA, APC	3/1/2024	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	36485 INLAND VALLEY DR	None	WILDOMAR	CA	92595	9681	33	06065	33.591699	-117.2368285	Riverside County
40906	Fee-for-Service	1164629424	1164629424	1	1	ESQUIBEL, ABRAN JR LCSW	6/12/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
40950	Fee-for-Service	1619983533	1619983533	1	1	ELAHI, ALI MD	10/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86267	13	Neurology (M.D. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
40975	Fee-for-Service	1043409022	1043409022	1	2	ENT AND SINUS CENTER, INC	9/16/2019	207YX0905X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	84	Surgery-Head and Neck	0	In state provider	None	8241 ROCHESTER AVE	SUITE 130	RANCHO CUCAMONGA	CA	91730	0713	36	06071	34.103979	-117.542898	San Bernardino County
41035	Fee-for-Service	1215056569	1215056569	1	1	ERIKSSON, NANCY C	6/15/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10992 SAN DIEGO MISSION	None	SAN DIEGO	CA	92108	2417	37	06073	32.78503881	-117.1020911	San Diego County
41057	Fee-for-Service	1568494649	1568494649	1	1	EYECARE SPECIALISTS MEDICAL	10/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	ATLANTIS EYECARE	8311 FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
41077	Fee-for-Service	1508914813	1508914813	1	1	ESCALANTE, MARGARITA LCSW	1/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
41229	Fee-for-Service	1942734892	1942734892	1	1	ELLER, ALEXANDER C MD	2/19/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157562	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
41432	Fee-for-Service	1013148568	1013148568	1	1	ESPEJO, MARIA KAREENA P MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119763	08	Family Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
41446	Fee-for-Service	1073573168	1073573168	1	1	ELLISON, GREGG A MD	12/31/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33338	41	Internal Medicine	0	In state provider	None	1105 LAS TABLAS RD	STE F	TEMPLETON	CA	93465	9731	40	06079	35.55437047	-120.7191105	San Luis Obispo County
41452	Fee-for-Service	1184078164	1184078164	1	1	EVERYDAY FREINDLY TRANSPORT	6/28/2019	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	SERVICE LLC	1240 MARKET STREET	SUITE # 1	YUBA CITY	CA	95991	3498	51	06101	39.14893056	-121.6146138	Sutter County
41464	Fee-for-Service	1790781409	1790781409	1	3	EYE CARE CENTER OF NAPA	5/31/2016	193200000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	VALLEY AMC	1287 INGLEWOOD AVE	None	ST HELENA	CA	94574	2215	28	06055	38.48718795	-122.4500971	Napa County
41552	Fee-for-Service	1609476472	1609476472	1	1	ENSEGUIDA HOSPICE CARE INC	8/20/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	20945 DEVONSHIRE ST	SUITE 105	CHATSWORTH	CA	91311	2370	19	06037	34.25727552	-118.5901965	Los Angeles County
41616	Fee-for-Service	1871665604	1871665604	1	1	EWAYS, LISA F MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86212	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
41750	Fee-for-Service	1134235450	1134235450	1	1	EISENBERG, BARRY K MD	2/1/1991	207R00000X	NA	Other	026	PHYSICIANS	71657	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1111 E STANLEY BLVD	None	LIVERMORE	CA	94550	4115	01	06001	37.67881307	-121.7823992	Alameda County
41755	Fee-for-Service	1790781409	1790781409	1	3	EYE CARE CENTER OF NAPA	5/31/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	VALLEY AMC	1287 INGLEWOOD AVE	None	ST HELENA	CA	94574	2215	28	06055	38.48718795	-122.4500971	Napa County
41814	Fee-for-Service	1013675925	1013675925	1	1	ERIN VIRAY THERAPY PRACTICE	2/11/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	INC	2810 E DEL MAR BLVD	STE 7	PASADENA	CA	91007	4321	19	06037	34.14212984	-118.092328	Los Angeles County
41817	Fee-for-Service	1669511689	1669511689	1	1	ERIC STONE MD	7/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	500 W BROADWAY ST	None	MISSOULA	MT	59802	4008	00	None	46.87419951	-114.0007525	Missoula County
41826	Fee-for-Service	1780702209	1780702209	1	1	ELITE PHYSICAL THERAPY AND W	1/31/2020	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ELLNESS, INC.	50-225 CESAR CHAVEZ ST.	SUITE 103	COACHELLA	CA	92253	7243	33	06065	33.67309459	-116.181558	Riverside County
41836	Fee-for-Service	1609476472	1609476472	1	1	ENSEGUIDA HOSPICE CARE INC	8/20/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	20945 DEVONSHIRE ST	SUITE 105	CHATSWORTH	CA	91311	2370	19	06037	34.25727552	-118.5901965	Los Angeles County
41956	Fee-for-Service	1154681609	1154681609	1	1	EDELSTEIN, AARON G MD	9/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129314	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
42081	Fee-for-Service	1477687051	1477687051	1	1	ESGUERRA, CHRIS E M MD	7/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96869	36	Psychiatry	0	In state provider	None	222 W 39TH AVENUE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
42119	Fee-for-Service	1780702209	1780702209	1	1	ELITE PHYSICAL THERAPY AND W	5/15/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ELLNESS, INC.	50-225 CESAR CHAVEZ ST.	SUITE 103	COACHELLA	CA	92253	7243	33	06065	33.67309459	-116.181558	Riverside County
42125	Fee-for-Service	1710101811	1710101811	1	2	E NADJMABADI INC	8/17/2022	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	EDICINE	300 OLD RIVER	150	BAKERSFIELD	CA	93311	9512	15	06029	35.352648	-119.1122505	Kern County
42144	Fee-for-Service	1205448750	1205448750	1	1	ELITE SURGERY CENTER OF SOUT	12/29/2023	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	H BAY LLC	20528 HAWTHORNE BLVD	STE 301	TORRANCE	CA	90503	3271	19	06037	33.844149	-118.3536225	Los Angeles County
42162	Fee-for-Service	1932107331	1932107331	1	8	EAST BAY MEDICAL ONCOLOGY	9/5/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	HEMATOLOGY MEDICAL ASSOC	3300 WEBSTER ST	STE 212	OAKLAND	CA	94609	3117	01	06001	37.82132826	-122.2621843	Alameda County
42180	Fee-for-Service	1225186158	1225186158	1	1	EVERETT, KEITH H DPM	7/7/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	400 CRAVEN ROAD	None	SAN MARCOS	CA	92078	4201	37	06073	33.12746646	-117.17028	San Diego County
42208	Fee-for-Service	1952726713	1952726713	1	1	EVANS, LINDSAY LCSW	7/29/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	409 13TH	STE 1900	OAKLAND	CA	94612	2605	01	06001	37.80326679	-122.2707988	Alameda County
42246	Fee-for-Service	1568556801	1568556801	1	1	EXCELLENCE HOME HEALTH CARE	11/29/2004	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE AGENCY, INC	11780 CENTRAL AVE	STE 220	CHINO	CA	91710	6499	36	06071	34.03900422	-117.6896581	San Bernardino County
42265	Fee-for-Service	1992884522	1992884522	1	1	ESTRADA, JOSEPH JESS APOC	12/27/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	311 PAJARO ST	None	SALINAS	CA	93901	3421	27	06053	36.67356122	-121.6524134	Monterey County
42271	Fee-for-Service	1952634230	1952634230	1	1	ERION, MEGAN K PSYD	5/20/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
42451	Fee-for-Service	1932107331	1932107331	1	8	EAST BAY MEDICAL ONCOLOGY	9/5/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	HEMATOLOGY MEDICAL ASSOC	3300 WEBSTER ST	STE 212	OAKLAND	CA	94609	3117	01	06001	37.82132826	-122.2621843	Alameda County
42520	Fee-for-Service	1790562551	1790562551	1	1	ENLOE HEALTH AND WELLNESS	11/4/2024	193400000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	IOLOGY- CHICO	198 COHASSET RD	None	CHICO	CA	95926	2202	04	06007	39.75140931	-121.8541188	Butte County
42531	Fee-for-Service	1285016683	1285016683	1	1	ESPARZA, MARDENE LCSW	4/16/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
42654	Fee-for-Service	1659711786	1659711786	1	1	ESPIRITU, CHIARA I MD	7/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127519	40	Pediatrics	0	In state provider	None	3200 KEARNEY STREET	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
42727	Fee-for-Service	1891842720	1891842720	1	1	ENCINITAS UNION SCHOOL	3/16/2000	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	101 S RANCHO SANTA FE RD	None	ENCINITAS	CA	92024	4349	37	06073	33.03695478	-117.2382864	San Diego County
42738	Fee-for-Service	1932107331	1932107331	1	8	EAST BAY MEDICAL ONCOLOGY	9/5/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	HEMATOLOGY MEDICAL ASSOC	3300 WEBSTER ST	STE 212	OAKLAND	CA	94609	3117	01	06001	37.82132826	-122.2621843	Alameda County
42806	Fee-for-Service	1790562551	1790562551	1	1	ENLOE HEALTH AND WELLNESS	11/4/2024	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	IOLOGY- CHICO	198 COHASSET RD	None	CHICO	CA	95926	2202	04	06007	39.75140931	-121.8541188	Butte County
42818	Fee-for-Service	1922772862	1922772862	1	2	ELITE PRIMARY PHYSICIANS INC	7/5/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	200 N. HARBOR BLVD	100	ANAHEIM	CA	92805	2510	30	06059	33.83572835	-117.9199135	Orange County
42893	Fee-for-Service	1952326118	1952326118	1	1	EISENMAN,DAVID MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85597	41	Internal Medicine	0	In state provider	None	200 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
43133	Fee-for-Service	1861889925	1861889925	1	1	ENG, KEVIN MD	8/2/2018	208M00000X	NA	Other	026	PHYSICIANS	145436	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
43280	Fee-for-Service	1659525459	1659525459	1	1	EPSTEIN, OLGA M MD	12/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111123	08	Family Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
43290	Fee-for-Service	1205341336	1205341336	1	2	ELICA HEALTH CENTERS	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	155 15TH STREET	SUITE A	WEST SACRAMENTO	CA	95691	3737	57	06113	38.57104661	-121.5260133	Yolo County
43375	Fee-for-Service	1760670228	1760670228	1	1	ELLIOTT, TIMOTHY A	9/1/1996	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	1477 LINCOLN ST	None	REDDING	CA	96001	2641	45	06089	40.57851566	-122.3895308	Shasta County
43429	Fee-for-Service	1538686738	1538686738	1	1	EVERCARE HOME HEALTH INC	7/29/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	315 W VERDUGO AVE	STE 100	BURBANK	CA	91502	2469	19	06037	34.17082135	-118.314366	Los Angeles County
43463	Fee-for-Service	1366474819	1366474819	1	1	ENTE, PHILIP MD	8/20/1985	207T00000X	NA	General Surgery	026	PHYSICIANS	42029	13	Neurology (M.D. only)	0	In state provider	None	1111 E OCEAN AVE	STE 4A	LOMPOC	CA	93436	2500	42	06083	34.63889719	-120.4447732	Santa Barbara County
43518	Fee-for-Service	1912067521	1912067521	1	1	ERICSON, SHASTA F LAC	8/17/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	940 SARATOGA AVE	SUITE 104	SAN JOSE	CA	95129	3409	43	06085	37.30938002	-121.9773594	Santa Clara County
43539	Fee-for-Service	1649603978	1649603978	1	1	EARLE, SHARON LMFT	11/2/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23822 VALENCIA BLVD	207	VALENCIA	CA	91355	5302	19	06037	34.41372708	-118.5513626	Los Angeles County
43553	Fee-for-Service	1619531258	1619531258	1	1	ENGLISH CHANNEL HOLDINGS	6/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	321 W TURNER RD	None	LODI	CA	95240	0517	39	06077	38.14571389	-121.2776835	San Joaquin County
43556	Fee-for-Service	1114160991	1114160991	1	1	ENGORN, BRANDEN M MD	9/11/2017	207LP3000X	NA	Other	026	PHYSICIANS	147411	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
43576	Fee-for-Service	1205341336	1205341336	1	2	ELICA HEALTH CENTERS	2/23/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	155 15TH STREET	SUITE A	WEST SACRAMENTO	CA	95691	3737	57	06113	38.57104661	-121.5260133	Yolo County
43580	Fee-for-Service	1629012778	1629012778	1	1	EBERSTEIN, STEPHANIE R AU	1/13/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
43609	Fee-for-Service	1699842583	1699842583	1	1	EDENS, BRUCE L MD	12/31/1983	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	40544	04	Otology, Laryngology, Rhinology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
43708	Fee-for-Service	1871349175	1871349175	1	1	EMERGENCY FOOD BANK	8/29/2024	251V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	7 W SCOTTS AVE	None	STOCKTON	CA	95203	3431	39	06077	37.94520808	-121.2897881	San Joaquin County
43776	Fee-for-Service	1912964495	1912964495	1	1	ELLERTSON, DAVID G MD	11/10/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	17987	33	Thoracic Surgery	0	In state provider	None	1850 SULLIVAN AVE	STE 210	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
43779	Fee-for-Service	1265469878	1265469878	1	1	ENGSTROM, JOHN W MD	10/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	52739	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	# 4M	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
43804	Fee-for-Service	1588190227	1588190227	1	1	ELWAN, DEENA MD	9/15/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	173134	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	210 PALISADE DR	STE 101	SANTA MARIA	CA	93454	8901	42	06083	34.95169604	-120.4120907	Santa Barbara County
43821	Fee-for-Service	1437479300	1437479300	1	1	EATON, PATRICIA F PSYD	7/21/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY STREET	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
43867	Fee-for-Service	1205341336	1205341336	1	2	ELICA HEALTH CENTERS	9/24/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	155 15TH STREET	SUITE A	WEST SACRAMENTO	CA	95691	3737	57	06113	38.57104661	-121.5260133	Yolo County
43871	Fee-for-Service	1497803290	1497803290	1	1	EGGOLD, ROBERT J MD	1/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67182	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
43967	Fee-for-Service	1366831653	1366831653	1	1	EFENDY, YOGGIE NP	5/13/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15272 SUMMIT AVE	None	FONTANA	CA	92336	0231	36	06071	34.152624	-117.4724415	San Bernardino County
44012	Fee-for-Service	1134747306	1134747306	1	1	ENGEMAN, POLINE C NP	9/27/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
44043	Fee-for-Service	1396706438	1396706438	1	1	ESSIEN, EKERETTE J PHD	3/1/2002	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CA STRESS CONTROL MGT	375 S MAIN ST	STE 107	POMONA	CA	91766	1639	19	06037	34.05623489	-117.7523117	Los Angeles County
44063	Fee-for-Service	1912964495	1912964495	1	1	ELLERTSON, DAVID G MD	11/10/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	17987	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1850 SULLIVAN AVE	STE 210	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
44066	Fee-for-Service	1265469878	1265469878	1	1	ENGSTROM, JOHN W MD	10/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	52739	13	Neurology (M.D. only)	0	In state provider	None	1001 POTRERO AVE	# 4M	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
44120	Fee-for-Service	1013929215	1013929215	1	1	EWY, GORDON MD.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N. CAMPBELL	None	TUCSON	AZ	85724	0000	00	None	32.240493	-110.9460825	Pima County
44138	Fee-for-Service	1629234554	1629234554	1	1	EROGBOGBO, ALISSA R MD	4/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138885	None	None	0	In state provider	None	2500 GRANT ROAD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
44157	Fee-for-Service	1205341336	1205341336	1	2	ELICA HEALTH CENTERS	5/15/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	155 15TH STREET	SUITE A	WEST SACRAMENTO	CA	95691	3737	57	06113	38.57104661	-121.5260133	Yolo County
44160	Fee-for-Service	1497803290	1497803290	1	1	EGGOLD, ROBERT J MD	1/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67182	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
44196	Fee-for-Service	1962582007	1962582007	1	1	EVANS, GREGORY R MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	57437	24	Plastic Surgery	0	In state provider	None	101 CITY DR S	# B10	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
44283	Fee-for-Service	1417055948	1417055948	1	3	EAST COUNTY URGENT CARE	7/31/1991	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8802 CUYAMACA ST	STE A	SANTEE	CA	92071	4283	37	06073	32.8360803	-116.9839492	San Diego County
44310	Fee-for-Service	1619941267	1619941267	1	1	EMANUEL KANAL, MD	11/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 LOTHROP ST	None	PITTSBURGH	PA	15213	2536	00	None	40.44188737	-79.96079711	Allegheny County
44314	Fee-for-Service	1649885468	1649885468	1	1	EAGLES WINGS HOSPICE LLC	9/10/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	27290 MADISON AVE	SUITE 103	TEMECULA	CA	92590	5672	33	06065	33.52503675	-117.1665539	Riverside County
44341	Fee-for-Service	1518029636	1518029636	1	1	EILERS, JULIE K CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
44394	Fee-for-Service	1245246032	1245246032	1	1	EITOKU COMPANY INC	9/15/1998	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	18 4TH STREET	None	GONZALES	CA	93926	0808	27	06053	36.50698522	-121.4443339	Monterey County
44569	Fee-for-Service	1417055948	1417055948	1	3	EAST COUNTY URGENT CARE	7/31/1991	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	8802 CUYAMACA ST	STE A	SANTEE	CA	92071	4283	37	06073	32.8360803	-116.9839492	San Diego County
44603	Fee-for-Service	1649885468	1649885468	1	1	EAGLES WINGS HOSPICE LLC	9/10/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	27290 MADISON AVE	SUITE 103	TEMECULA	CA	92590	5672	33	06065	33.52503675	-117.1665539	Riverside County
44637	Fee-for-Service	1710964432	1710964432	1	1	EL-SOKKARY, SHERIF MD	4/30/1996	207R00000X	NA	Other	026	PHYSICIANS	49317	41	Internal Medicine	0	In state provider	None	23340 MOULTON PKWY	None	LAGUNA HILLS	CA	92653	1211	30	06059	33.62338392	-117.7309615	Orange County
44734	Fee-for-Service	1104875475	1104875475	1	1	EVANS, CHARLES E MD	3/7/1988	207P00000X	NA	Other	026	PHYSICIANS	51002	08	Family Practice	0	In state provider	None	3325 CHANATE RD	None	SANTA ROSA	CA	95404	1707	49	06097	38.469537	-122.707314	Sonoma County
44750	Fee-for-Service	1700475183	1700475183	1	1	ERIKA BEHNKE, MARRIAGE & FAM	1/12/2021	261QM0850X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ILY THERAPY INC.	28605 TAMARACK LN	None	SANTA CLARITA	CA	91390	4217	19	06037	34.46889039	-118.529566	Los Angeles County
44789	Fee-for-Service	1295929255	1295929255	1	1	EMAD M DODIN MD	3/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 3RD AVE SW	None	MINOT	ND	58701	3880	00	None	48.23336909	-101.2951165	Ward County
44835	Fee-for-Service	1124290036	1124290036	1	1	ESMAIL, ZAHRA	8/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9333	None	None	0	In state provider	None	4311 THIRD STREET	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
44976	Fee-for-Service	1801381736	1801381736	1	1	ESSIEN, FRANCIS MD DO	3/28/2022	207R00000X	NA	Other	026	PHYSICIANS	19227	None	None	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
45021	Fee-for-Service	1104875475	1104875475	1	1	EVANS, CHARLES E MD	3/7/1988	207P00000X	NA	Other	026	PHYSICIANS	51002	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3325 CHANATE RD	None	SANTA ROSA	CA	95404	1707	49	06097	38.469537	-122.707314	Sonoma County
45054	Fee-for-Service	1992716393	1992716393	1	1	ERIN L NELSON MD	5/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4493	00	None	29.508012	-98.578683	Bexar County
45063	Fee-for-Service	1184729352	1184729352	1	1	EHRENSAFT, DANIEL V MD	6/15/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	22676	41	Internal Medicine	0	In state provider	A PROFESSIONAL CORP	3831 HUGHES AVE	STE 603	CULVER CITY	CA	90232	6846	19	06037	34.02243278	-118.3981492	Los Angeles County
45116	Fee-for-Service	1164509006	1164509006	1	1	ESMAIL, SHAHINOOR MD	6/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74507	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
45193	Fee-for-Service	1720214125	1720214125	1	1	EAST BAY HAND & PLASTIC	8/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	60104	46	Hand Surgery	0	In state provider	SURGERY CENTER INC	39141 CIVIC CENTER DRIVE	STE 110	FREMONT	CA	94538	5831	01	06001	37.55436307	-121.9764708	Alameda County
45223	Fee-for-Service	1346055514	1346055514	1	1	EL-KARA, INSAF B DC	3/5/2025	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	4380 FELTON ST	None	SAN DIEGO	CA	92104	1421	37	06073	32.756778	-117.1211455	San Diego County
45307	Fee-for-Service	1467409763	1467409763	1	1	ENGEL, GREGORY MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66069	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
45350	Fee-for-Service	1184729352	1184729352	1	1	EHRENSAFT, DANIEL V MD	6/15/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	22676	77	Infectious Disease	0	In state provider	A PROFESSIONAL CORP	3831 HUGHES AVE	STE 603	CULVER CITY	CA	90232	6846	19	06037	34.02243278	-118.3981492	Los Angeles County
45356	Fee-for-Service	1083922066	1083922066	1	1	EYE FACE & BODY SURGERY CENT	11/5/2021	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	ER LLC	4906 EL CAMINO REAL	SUITE C	LOS ALTOS	CA	94022	1449	43	06085	37.39825624	-122.1078327	Santa Clara County
45469	Fee-for-Service	1346274537	1346274537	1	1	EPISCOPAL HEALTH SERVICES	1/23/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INC	327 BEACH 19TH ST	None	FAR ROCKAWAY	NY	11691	4423	00	None	40.598658	-73.753002	Queens County
45479	Fee-for-Service	1801137195	1801137195	1	1	EZ PHARMACY INC	8/21/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	625 E VALLEY BLVD	STE J	SAN GABRIEL	CA	91776	3591	19	06037	34.0801262	-118.0919781	Los Angeles County
45481	Fee-for-Service	1720214125	1720214125	1	1	EAST BAY HAND & PLASTIC	8/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	60104	24	Plastic Surgery	0	In state provider	SURGERY CENTER INC	39141 CIVIC CENTER DRIVE	STE 110	FREMONT	CA	94538	5831	01	06001	37.55436307	-121.9764708	Alameda County
45501	Fee-for-Service	1982224291	1982224291	1	1	EKAI, JACKLINE CHELIMO	6/9/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6749 RICO CT	None	EASTVALE	CA	92880	8993	33	06065	33.965262	-117.564799	Riverside County
45513	Fee-for-Service	1265976021	1265976021	1	1	ESTRELLA, SOL CNP	5/6/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1045 N TUSTIN ST	None	ORANGE	CA	92867	5904	30	06059	33.80481643	-117.8356481	Orange County
45758	Fee-for-Service	1346274537	1346274537	1	1	EPISCOPAL HEALTH SERVICES	1/23/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INC	327 BEACH 19TH ST	None	FAR ROCKAWAY	NY	11691	4423	00	None	40.598658	-73.753002	Queens County
45772	Fee-for-Service	1881724961	1881724961	1	1	ELMORE, RAYMOND G MD	3/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102209	None	None	0	In state provider	None	200 MEDICAL PLAZA	STE 430	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
45790	Fee-for-Service	1982224291	1982224291	1	1	EKAI, JACKLINE CHELIMO	6/9/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6749 RICO CT	None	EASTVALE	CA	92880	8993	33	06065	33.965262	-117.564799	Riverside County
45866	Fee-for-Service	1265481923	1265481923	1	1	ERNEY, TRENT P MD	7/17/1991	207P00000X	NA	Other	026	PHYSICIANS	71919	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1225 15TH ST	None	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
46039	Fee-for-Service	1144810771	1144810771	1	2	ENRIQUEZ, MICHELLE S	2/17/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	100 N BRAND BLVD	STE 223	GLENDALE	CA	91203	2641	19	06037	34.14652066	-118.2549229	Los Angeles County
46192	Fee-for-Service	1174569453	1174569453	1	1	ETTELSON, RICHARD PHD	10/23/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
46224	Fee-for-Service	1104083781	1104083781	1	1	ESHETU, TADESSE MD	11/16/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	132088	None	None	0	In state provider	None	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2302	19	06037	34.02980528	-118.4786605	Los Angeles County
46446	Fee-for-Service	1073588646	1073588646	1	1	ESCONDIDO CA ENDOSCOPY	9/30/2004	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	ASC LP	488 E VALLEY PKWY	STE 110	ESCONDIDO	CA	92025	3366	37	06073	33.12523814	-117.0769715	San Diego County
46624	Fee-for-Service	1689775892	1689775892	1	1	EMERT, SEMYON MD	8/31/1980	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	37223	01	General Practice	0	In state provider	None	7549 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90046	6406	19	06037	34.09081953	-118.354563	Los Angeles County
46709	Fee-for-Service	1295178689	1295178689	1	1	EPIC MEDICAL GROUP INC	9/21/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	4955 VAN NUYS BLVD	SUITE 308	SHERMAN OAKS	CA	91403	1811	19	06037	34.160805	-118.4487295	Los Angeles County
46797	Fee-for-Service	1144716598	1144716598	1	1	ERIC SULLIVAN	3/28/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1001 TOWSON AVE	None	FORT SMITH	AR	72901	4921	00	None	35.374455	-94.42107	Sebastian County
46810	Fee-for-Service	1922090372	1922090372	1	1	ENTRUST MEDICAL CORP	10/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1140 W LA VETA AVE	STE 520	ORANGE	CA	92868	4227	30	06059	33.7802984	-117.8651669	Orange County
46844	Fee-for-Service	1487913851	1487913851	1	1	ENGLE, CHRISTINA M LMFT	6/1/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	96362	-	NOT APPLICABLE	0	In state provider	None	2000 W BRIGGSMORE AVE	STE I	MODESTO	CA	95350	3839	50	06099	37.67139252	-121.0281273	Stanislaus County
46913	Fee-for-Service	1689775892	1689775892	1	1	EMERT, SEMYON MD	8/31/1980	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	37223	08	Family Practice	0	In state provider	None	7549 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90046	6406	19	06037	34.09081953	-118.354563	Los Angeles County
46982	Fee-for-Service	1114453107	1114453107	1	1	ELITE HEALTH CARE SERVICES	4/17/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	LLC	9267 GREENBACK LN	SUITE B-1	ORANGEVALE	CA	95662	4864	34	06067	38.678733	-121.208598	Sacramento County
47080	Fee-for-Service	1255743779	1255743779	1	1	ERIN KLOOS	6/22/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	16601 N 40TH ST	STE 204	PHOENIX	AZ	85032	3356	00	None	33.637356	-111.995514	Maricopa County
47273	Fee-for-Service	1982251609	1982251609	1	1	EZADJIAN, RITA A LCSW	10/8/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
47298	Fee-for-Service	1801181961	1801181961	1	1	EXECUTIVE URGENT CARE OF IND	6/17/2019	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	IAN WELLS	74785 HIGHWAY 111	SUITE 100	INDIAN WELLS	CA	92210	7129	33	06065	33.72131925	-116.360116	Riverside County
47306	Fee-for-Service	1750657565	1750657565	1	1	ESPINDOLA, MARIO MD	7/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	128570	08	Family Practice	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
47382	Fee-for-Service	1770108771	1770108771	1	1	ERIC L GIANG DO INC A PROFES	12/17/2020	207X00000X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1701 COFFEE RD	1	CITY IS NOT LISTE	CA	95355	2817	50	06099	37.668897	-120.9757285	Stanislaus County
47701	Fee-for-Service	1134654163	1134654163	1	1	EICHELBERGER, HILLARY MD	11/22/2024	2080S0012X	NA	Other	026	PHYSICIANS	191767	79	Neurology-Child	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
47712	Fee-for-Service	1689842288	1689842288	1	1	EMANY, SARADA MD	11/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102277	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
47721	Fee-for-Service	1780670059	1780670059	1	1	EVAN,GUZ MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	520 MADISON OAK DRIVE	None	SAN ANTONIO	TX	78258	0000	00	None	29.62127927	-98.49119067	Bexar County
47759	Fee-for-Service	1891748034	1891748034	1	1	ELICKER, MICHAEL B MD	7/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91048	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
47760	Fee-for-Service	1841290798	1841290798	1	1	EVANS, BRIAN D MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67869	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 MINERS TRL	None	GRASS VALLEY	CA	95945	7320	29	06057	39.21015325	-121.0572838	Nevada County
47781	Fee-for-Service	1932107331	1932107331	1	5	EAST BAY MEDICAL ONCOLOGY	9/5/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	HEMATOLOGY MEDICAL ASSOC	2400 BALFOUR RD	STE 230	BRENTWOOD	CA	94513	4957	07	06013	37.92519383	-121.734461	Contra Costa County
47791	Fee-for-Service	1396800231	1396800231	1	2	ESPINOSA, JAMES C OD	7/31/1996	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4210 HIGHLAND AVE	None	HIGHLAND	CA	92346	2742	36	06071	34.137684	-117.1947915	San Bernardino County
47805	Fee-for-Service	1093798977	1093798977	1	1	ETHICAL HOME HEALTH CARE INC	2/19/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	550 N EUCLID AVE	None	UPLAND	CA	91786	4734	36	06071	34.10033216	-117.6509893	San Bernardino County
47856	Fee-for-Service	1033596507	1033596507	1	1	ELSIDDIG, YOMNA	7/15/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
48061	Fee-for-Service	1205341336	1205341336	1	4	ELICA HEALTH CENTERS	4/28/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE 3	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95691	3412	57	06113	38.573118	-121.5501275	Yolo County
48065	Fee-for-Service	1427046549	1427046549	1	1	EVE, KATHLEEN L MD	1/1/1998	208600000X	NA	General Surgery	026	PHYSICIANS	54095	02	General Surgery	0	In state provider	None	1541 FLORIDA AVE	STE 200	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
48069	Fee-for-Service	1932107331	1932107331	1	5	EAST BAY MEDICAL ONCOLOGY	9/5/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	HEMATOLOGY MEDICAL ASSOC	2400 BALFOUR RD	STE 230	BRENTWOOD	CA	94513	4957	07	06013	37.92519383	-121.734461	Contra Costa County
48136	Fee-for-Service	1396117982	1396117982	1	1	ELEGANCE HEALTHCARE INC	6/15/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6345 BALBOA BLVD	SUITE 155	ENCINO	CA	91316	1511	19	06037	34.18620241	-118.5011527	Los Angeles County
48236	Fee-for-Service	1144425166	1144425166	1	1	EBRAHIMI, HALEH MD	2/8/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	105903	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3003 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2700	37	06073	32.79785552	-117.1563475	San Diego County
48347	Fee-for-Service	1205341336	1205341336	1	4	ELICA HEALTH CENTERS	4/28/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE 3	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95691	3412	57	06113	38.573118	-121.5501275	Yolo County
48358	Fee-for-Service	1932107331	1932107331	1	5	EAST BAY MEDICAL ONCOLOGY	9/5/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	HEMATOLOGY MEDICAL ASSOC	2400 BALFOUR RD	STE 230	BRENTWOOD	CA	94513	4957	07	06013	37.92519383	-121.734461	Contra Costa County
48391	Fee-for-Service	1215914767	1215914767	1	1	EISON, ROBERT C MD	11/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83528	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
48401	Fee-for-Service	1699725069	1699725069	1	1	EMERGENCY SERVICES MEDICAL C	2/28/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
48415	Fee-for-Service	1114550886	1114550886	1	1	ENCOMPASS HEALTH REHABILITAT	2/23/2022	283X00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	TWORK REHABILITATION HOS	2450 CORAL COURT	None	CORALVILLE	IA	52241	2975	00	None	41.706693	-91.611153	Johnson County
48457	Fee-for-Service	1831162627	1831162627	1	1	EISENBERG, STEVEN G DO	6/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	8293	78	Neoplastic Diseases/Oncology	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
48502	Fee-for-Service	1063918183	1063918183	2	1	ESP HEALTHCARE GROUP, LLC	1/9/2019	332BX2000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1269 POMONA RD	UNIT # 109	CORONA	CA	92882	7158	33	06065	33.88284937	-117.5871947	Riverside County
48644	Fee-for-Service	1184614968	1184614968	1	1	ETHAN WIENER, MD	8/18/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 1ST AVE	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
48686	Fee-for-Service	1508158783	1508158783	1	1	ETEMADIAN, ASHKAN MD INC	5/31/2011	207R00000X	NA	Other	026	PHYSICIANS	105385	41	Internal Medicine	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
48703	Fee-for-Service	1114550886	1114550886	1	1	ENCOMPASS HEALTH REHABILITAT	2/23/2022	283X00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	TWORK REHABILITATION HOS	2450 CORAL COURT	None	CORALVILLE	IA	52241	2975	00	None	41.706693	-91.611153	Johnson County
48737	Fee-for-Service	1184490385	1184490385	1	1	EAST CAMPUS HOSPITALIST MEDI	12/13/2023	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CAL GROUP, INC.	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
48744	Fee-for-Service	1831162627	1831162627	1	1	EISENBERG, STEVEN G DO	6/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	8293	66	Emergency Medicine (Urgent Care)	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
48761	Fee-for-Service	1033724372	1033724372	1	1	ENNIS, KELSEY CNM	8/9/2024	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	14500 ROSCOE BLVD	FLOOR 4 OFFICE 58	PANORAMA CITY	CA	91402	4194	19	06037	34.2215055	-118.44918	Los Angeles County
48885	Fee-for-Service	1255434999	1255434999	1	1	EDELBROCK, MARIAN R PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1816 PORTOFINO DR	None	OCEANSIDE	CA	92054	6130	37	06073	33.19123426	-117.333992	San Diego County
48912	Fee-for-Service	1447092788	1447092788	1	1	EDMONDS, JADEA	6/8/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	48	06095	0	0	None
48913	Fee-for-Service	1609372606	1609372606	1	1	ELLIOTT, THOMAS R MD	1/3/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	174780	None	None	0	In state provider	None	1245 16TH STREET	SUITE 125, 204, 307	SANTA MONICA	CA	90404	1240	19	06037	34.02726451	-118.4857138	Los Angeles County
49028	Fee-for-Service	1386912202	1386912202	1	1	EAST VALLEY COMMUNITY HEALTH	11/26/2012	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	17840 VILLA CORTA STREET	None	LA PUENTE	CA	91744	5342	19	06037	34.01804501	-117.9119303	Los Angeles County
49070	Fee-for-Service	1609097807	1609097807	1	1	EDPAO, WEBSTER M MD	11/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115603	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
49113	Fee-for-Service	1457947616	1457947616	1	1	ESSENTIAL HOSPICE INC	8/30/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	17050 CHATSWORTH STREET	UNIT #121	GRANADA HILLS	CA	91344	5978	19	06037	34.26477251	-118.5039945	Los Angeles County
49121	Fee-for-Service	1821033424	1821033424	1	1	ELSAYED, MOHAMMED K MD	1/13/2009	207P00000X	NA	Other	026	PHYSICIANS	100765	08	Family Practice	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
49314	Fee-for-Service	1386912202	1386912202	1	1	EAST VALLEY COMMUNITY HEALTH	11/26/2012	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	17840 VILLA CORTA STREET	None	LA PUENTE	CA	91744	5342	19	06037	34.01804501	-117.9119303	Los Angeles County
49332	Fee-for-Service	1659594570	1659594570	1	1	EL-HARAZI, SHERIF MD INC	10/26/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	801 S CHEVY CHASE DR	STE 103	GLENDALE	CA	91205	4437	19	06037	34.136757	-118.2396195	Los Angeles County
49345	Fee-for-Service	1235136177	1235136177	1	2	EPIC HOMECARE	2/8/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6404 WILSHIRE BLVD	STE 550	LOS ANGELES	CA	90048	5516	19	06037	34.06373411	-118.3685394	Los Angeles County
49396	Fee-for-Service	1457947616	1457947616	1	1	ESSENTIAL HOSPICE INC	8/30/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	17050 CHATSWORTH STREET	UNIT #121	GRANADA HILLS	CA	91344	5978	19	06037	34.26477251	-118.5039945	Los Angeles County
49403	Fee-for-Service	1790819258	1790819258	1	1	EBERLY, JANELL C LMFT	6/9/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
49427	Fee-for-Service	1316094253	1316094253	1	1	ESCONDIDO UNION ELEM SD	9/16/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	2310 ALDERGROVE AVE	None	ESCONDIDO	CA	92029	1935	37	06073	33.11810947	-117.1147557	San Diego County
49603	Fee-for-Service	1386912202	1386912202	1	1	EAST VALLEY COMMUNITY HEALTH	8/20/2013	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	17840 VILLA CORTA STREET	None	LA PUENTE	CA	91744	5342	19	06037	34.01804501	-117.9119303	Los Angeles County
49619	Fee-for-Service	1659594570	1659594570	1	1	EL-HARAZI, SHERIF MD INC	10/26/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	801 S CHEVY CHASE DR	STE 103	GLENDALE	CA	91205	4437	19	06037	34.136757	-118.2396195	Los Angeles County
49688	Fee-for-Service	1225301898	1225301898	1	1	EYE 2 EYE FAMILY OPTOMETRY	5/15/2012	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PC	4633 WHITNEY AVENUE	SUITE A	SACRAMENTO	CA	95821	4100	34	06067	38.628873	-121.356198	Sacramento County
49702	Fee-for-Service	1619306628	1619306628	2	1	EPYC DIAGNOSTICS LLC	10/3/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	21117 OSBORNE ST	None	CANOGA PARK	CA	91304	1622	19	06037	34.2327073	-118.593936	Los Angeles County
49748	Fee-for-Service	1235598749	1235598749	1	1	ESTRADA, MARINA CNP	1/21/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1900 19TH AVE	None	SAN FRANCISCO	CA	94116	1250	38	06075	37.75211157	-122.4762664	San Francisco County
49772	Fee-for-Service	1336336502	1336336502	1	1	EACRET, WES E CO	1/21/2022	222Z00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	3125 COFFEE RD	SUITE 2	MODESTO	CA	95355	1768	50	06099	37.68354805	-120.9760392	Stanislaus County
49815	Fee-for-Service	1316966815	1316966815	1	1	EISENBERG, ELYSE R MD	1/4/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	64542	-	NOT APPLICABLE	0	In state provider	None	1466 LINCOLN AVE	None	SAN RAFAEL	CA	94901	2021	21	06041	37.98004532	-122.5221262	Marin County
49867	Fee-for-Service	1447970058	1447970058	1	1	ESPERANZA FAMILY COUNSELING	5/31/2024	101Y00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	410 W FALLBROOK AVE	STE 105	FRESNO	CA	93711	6191	10	06019	36.84938752	-119.7995445	Fresno County
49878	Fee-for-Service	1073671814	1073671814	1	1	ENRILE, FERNANDO T MD	5/8/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	29539	08	Family Practice	0	In state provider	None	900 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	4716	19	06037	34.049623	-118.1388014	Los Angeles County
49889	Fee-for-Service	1386912202	1386912202	1	1	EAST VALLEY COMMUNITY HEALTH	11/26/2012	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	17840 VILLA CORTA STREET	None	LA PUENTE	CA	91744	5342	19	06037	34.01804501	-117.9119303	Los Angeles County
49941	Fee-for-Service	1972641736	1972641736	1	1	EVERGREEN PEDIATRICS INC	11/9/2007	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	4205 SAN FELIPE RD	STE 110	SAN JOSE	CA	95135	1549	43	06085	37.30453446	-121.7766135	Santa Clara County
49972	Fee-for-Service	1245253582	1245253582	1	2	EVANS, JOHN R MD	10/31/1990	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	50624	10	Gastroenterology (M.D. only)	0	In state provider	None	355 E 21ST ST	STE H	SAN BERNARDINO	CA	92404	3842	36	06071	34.13404548	-117.2779515	San Bernardino County
49991	Fee-for-Service	1093009375	1093009375	1	1	ENO, MICHELE L MD	1/24/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	115845	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
50019	Fee-for-Service	1689602773	1689602773	1	1	EWENS, MARK P MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71440	08	Family Practice	0	In state provider	None	2330 W COVELL BLVD	None	DAVIS	CA	95616	5058	57	06113	38.56097929	-121.7800614	Yolo County
50035	Fee-for-Service	1255337028	1255337028	1	1	ERLBAUM, ALAN I MD	4/24/1987	207RN0300X	NA	Nephrology	026	PHYSICIANS	25643	41	Internal Medicine	0	In state provider	None	3440 LOMITA BLVD	STE 138	TORRANCE	CA	90505	4812	19	06037	33.81328127	-118.3452927	Los Angeles County
50156	Fee-for-Service	1447970058	1447970058	1	1	ESPERANZA FAMILY COUNSELING	5/31/2024	101Y00000X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	410 W FALLBROOK AVE	STE 105	FRESNO	CA	93711	6191	10	06019	36.84938752	-119.7995445	Fresno County
50160	Fee-for-Service	1073671814	1073671814	1	1	ENRILE, FERNANDO T MD	5/8/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	29539	22	Pathology (M.D. only)	0	In state provider	None	900 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	4716	19	06037	34.049623	-118.1388014	Los Angeles County
50193	Fee-for-Service	1750337200	1750337200	1	1	EMERICK, THOMAS H MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74836	66	Emergency Medicine (Urgent Care)	0	In state provider	None	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2751	41	06081	37.48093988	-122.2531826	San Mateo County
50199	Fee-for-Service	1720437908	1720437908	1	1	EDWARDS, JOHN M DO	9/20/2021	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
50268	Fee-for-Service	1992723803	1992723803	1	1	EMERGENCY MEDICAL OFFICE, IN	2/15/1995	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	264 N. HIGHLAND SPRINGS	#4	BANNING	CA	92220	3083	33	06065	33.93063	-116.946864	Riverside County
50397	Fee-for-Service	1942426986	1942426986	1	2	ENCOMPASS COMMUNITY SERVICES	3/14/2017	261QR0405X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	380 ENCINAL ST	200, ROOM A	SANTA CRUZ	CA	95060	2178	44	06087	36.98747083	-122.0380148	Santa Cruz County
50438	Fee-for-Service	1629374020	1629374020	1	1	ETESAMI, KAMBIZ MD	8/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150383	02	General Surgery	0	In state provider	None	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
50445	Fee-for-Service	1073671814	1073671814	1	1	ENRILE, FERNANDO T MD	5/8/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	29539	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	4716	19	06037	34.049623	-118.1388014	Los Angeles County
50482	Fee-for-Service	1750337200	1750337200	1	1	EMERICK, THOMAS H MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74836	05	Anesthesiology	0	In state provider	None	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2751	41	06081	37.48093988	-122.2531826	San Mateo County
50492	Fee-for-Service	1235197500	1235197500	1	1	ENDENO-GALIMA ELIZABETH	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	76162	40	Pediatrics	0	In state provider	M MD	501 N BRIDGE ST	None	VISALIA	CA	93291	5014	54	06107	36.334107	-119.289186	Tulare County
50512	Fee-for-Service	1427134485	1427134485	1	1	ELSTROM, REBECCA L MD	4/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56125	68	Hematology	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
50574	Fee-for-Service	1265851182	1265851182	1	1	EDQUILANG, JOANNE K MD	7/8/2019	208600000X	NA	General Surgery	026	PHYSICIANS	141509	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
50594	Fee-for-Service	1538579586	1538579586	1	1	ESSILFIE, JULIET O MD	6/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	141118	18	Ophthalmology	0	In state provider	None	850 S ATLANTIC BLVD	STE 301	MONTEREY PARK	CA	91754	6710	19	06037	34.05097684	-118.1379979	Los Angeles County
50670	Fee-for-Service	1831362300	1831362300	1	1	ERNESTO RUIZ-RODRIGUEZ, MD	12/13/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	None	LITTLE ROCK	AR	72205	6321	00	None	34.744437	-92.3813595	Pulaski County
50675	Fee-for-Service	1962612432	1962612432	1	1	EISENBERG VLG OF THE LA	7/8/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	18855 VICTORY BLVD	None	RESEDA	CA	91335	6445	19	06037	34.18660752	-118.5441525	Los Angeles County
50683	Fee-for-Service	1942426986	1942426986	1	2	ENCOMPASS COMMUNITY SERVICES	3/14/2017	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	380 ENCINAL ST	200, ROOM A	SANTA CRUZ	CA	95060	2178	44	06087	36.98747083	-122.0380148	Santa Cruz County
50713	Fee-for-Service	1265460893	1265460893	1	1	EVANS, SHAWN D MD	11/1/1995	207P00000X	NA	Other	026	PHYSICIANS	80419	None	None	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
50716	Fee-for-Service	1053726810	1053726810	1	1	ELNEMA, GITOUF E MD	8/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156331	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
50732	Fee-for-Service	1275788853	1275788853	1	1	EMANUEL, BENJAMIN A DO	6/4/2008	207T00000X	NA	General Surgery	026	PHYSICIANS	10407	14	Neurological Surgery	0	In state provider	None	300 MEDICAL PLAZA	#200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
50735	Fee-for-Service	1689178808	1689178808	1	1	ELBULUK, AMEER M MD	7/3/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	185241	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
50800	Fee-for-Service	1427134485	1427134485	1	1	ELSTROM, REBECCA L MD	4/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56125	78	Neoplastic Diseases/Oncology	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
50814	Fee-for-Service	1730302134	1730302134	1	1	ENOS, MURIEL L PHD	11/15/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	20957	-	NOT APPLICABLE	0	In state provider	None	5 MAREBLU	STE 100, 200, 250	ALISO VIEJO	CA	92656	3014	30	06059	33.57250566	-117.7027366	Orange County
50822	Fee-for-Service	1508841370	1508841370	1	1	ECKLAND, KRISTIN L NP	6/4/2020	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
51083	Fee-for-Service	1841578333	1841578333	1	2	EA HEALTH PHYSICIANS MEDICAL	3/21/2023	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1150 INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
51147	Fee-for-Service	1376838177	1376838177	1	1	ESRAELIAN, FLORA LCSW	2/7/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SRAELIAN	1702 E. BULLARD AVE	103	FRESNO	CA	93710	7510	10	06019	36.82318447	-119.7563985	Fresno County
51185	Fee-for-Service	1871083881	1871083881	1	1	EASY MEDICAL TRANSPORTATION	12/17/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC	1533 BAKER	11	COSTA MESA	CA	92626	3711	30	06059	33.68015047	-117.9209582	Orange County
51219	Fee-for-Service	1811159569	1811159569	1	1	EDEN, MYRA S PT	12/6/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12411 SLAUSON AVE	STE H	WHITTIER	CA	90606	2835	19	06037	33.96028839	-118.0529975	Los Angeles County
51300	Fee-for-Service	1225007560	1225007560	1	1	ELYSSA PETERS ROSENTHAL M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9201 W THOMAS RD	None	PHOENIX	AZ	85037	3332	00	None	33.47892	-112.2579	Maricopa County
51369	Fee-for-Service	1841578333	1841578333	1	2	EA HEALTH PHYSICIANS MEDICAL	10/18/2022	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1150 INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
51381	Fee-for-Service	1033675905	1033675905	1	1	ESTRADA, ALEKA PT	3/16/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	29650 BRADLEY RD	None	MENIFEE	CA	92586	6521	33	06065	33.6899672	-117.1885767	Riverside County
51490	Fee-for-Service	1922596501	1922596501	1	1	EVRON, EVYATAR MD	9/30/2021	207R00000X	NA	Other	026	PHYSICIANS	173472	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
51543	Fee-for-Service	1457118705	1457118705	1	1	ELEVATE EMERGENCY MEDICINE	6/1/2024	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	41870 GARSTIN DR	None	BIG BEAR LAKE	CA	92315	2088	36	06071	34.24602097	-116.8885243	San Bernardino County
51630	Fee-for-Service	1427218940	1427218940	1	1	ELLIOTT, JAMES C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1701 N SENATE BLVD	None	INDIANAPOLIS	IN	46202	1239	00	None	39.78959047	-86.16551711	Marion County
51697	Fee-for-Service	1205341336	1205341336	1	5	ELICA HEALTH CENTERS	10/13/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE 4	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95961	3412	57	06113	38.573118	-121.5501275	Yolo County
51746	Fee-for-Service	1295050441	1295050441	1	1	EMERSON, DOMINIC A C MD	7/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	141972	33	Thoracic Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
51762	Fee-for-Service	1689748998	1689748998	1	1	ENGMAN, ELAINE MD	7/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	54301	22	Pathology (M.D. only)	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
51787	Fee-for-Service	1902905961	1902905961	1	1	ERDREICH-EPSTEIN, ANAT M	8/18/1997	2080P0207X	NA	Hematology	026	PHYSICIANS	45491	78	Neoplastic Diseases/Oncology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
51791	Fee-for-Service	1013786565	1013786565	1	1	ENCINO CENTER PHARMACY INC	3/7/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16740 VENTURA BLVD	None	ENCINO	CA	91436	1702	19	06037	34.15861103	-118.4985518	Los Angeles County
51806	Fee-for-Service	1033360995	1033360995	1	1	ESPARZA, LUIS M MD	7/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110384	08	Family Practice	0	In state provider	None	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	0000	19	06037	34.2206967	-118.5342638	Los Angeles County
51839	Fee-for-Service	1689815946	1689815946	1	1	EXCEPTIONAL CHILDREN FND	1/28/2009	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	10918 BARMAN AVENUE	None	CULVER CITY	CA	90230	4205	19	06037	34.00816519	-118.4038221	Los Angeles County
51928	Fee-for-Service	1164798120	1164798120	1	1	ESSA, NADIA MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120328	40	Pediatrics	0	In state provider	None	1515 NEWELL AVENUE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
51977	Fee-for-Service	1831133321	1831133321	1	1	EINCK, JOHN P MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	81776	78	Neoplastic Diseases/Oncology	0	In state provider	None	555 E VALLEY PKWY	None	ESCONDIDO	CA	92025	3048	37	06073	33.12542915	-117.0764725	San Diego County
51982	Fee-for-Service	1205341336	1205341336	1	5	ELICA HEALTH CENTERS	10/13/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE 4	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95961	3412	57	06113	38.573118	-121.5501275	Yolo County
52010	Fee-for-Service	1114401437	1114401437	1	1	EWERS, ALEXANDRA H NP	12/19/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
52048	Fee-for-Service	1811057771	1811057771	1	1	ELLIOTT, RYAN	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
52056	Fee-for-Service	1215983093	1215983093	1	1	EVENSEN, ERIK P DO	11/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LN	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
52074	Fee-for-Service	1902905961	1902905961	1	1	ERDREICH-EPSTEIN, ANAT M	8/18/1997	2080P0207X	NA	Hematology	026	PHYSICIANS	45491	68	Hematology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
52079	Fee-for-Service	1144648841	1144648841	1	1	ENDO, BRANDON P MD	5/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	143004	66	Emergency Medicine (Urgent Care)	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	7402	19	06037	34.06633051	-118.4452686	Los Angeles County
52090	Fee-for-Service	1528011392	1528011392	1	1	EMMANUEL, GERRY F MD INC	11/23/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
52178	Fee-for-Service	1669589214	1669589214	1	1	EDWARDS, SARA L MD	5/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96922	20	Orthopedic Surgery	0	In state provider	None	80 GRAND AVE	5TH FLOOR AVE	OAKLAND	CA	94619	3725	01	06001	37.81147674	-122.2656076	Alameda County
52222	Fee-for-Service	1073259735	1073259735	1	1	ESSENTIAL HEALTHCARE GROUP	12/27/2022	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9850 GENESEE AVENUE	SUITE 820	LA JOLLA	CA	92037	1219	37	06073	32.882913	-117.226341	San Diego County
52299	Fee-for-Service	1568690527	1568690527	1	1	ELMADHUN, NASSRENE Y MD	8/3/2020	208G00000X	NA	General Surgery	026	PHYSICIANS	163803	33	Thoracic Surgery	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
52349	Fee-for-Service	1710456447	1710456447	1	1	ELLIOTT, HANNAH L NP	2/27/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
52363	Fee-for-Service	1902905961	1902905961	1	1	ERDREICH-EPSTEIN, ANAT M	8/18/1997	2080P0207X	NA	Hematology	026	PHYSICIANS	45491	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
52431	Fee-for-Service	1013271337	1013271337	1	1	EFROS, KEVIN A MD	2/19/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	129011	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
52458	Fee-for-Service	1164960639	1164960639	1	1	ESCAMILLA, DANIEL MD	7/13/2023	390200000X	NA	Other	026	PHYSICIANS	185160	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
52488	Fee-for-Service	1891721098	1891721098	1	1	ENGMAN, DAVID M MD	2/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139739	22	Pathology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
52514	Fee-for-Service	1497864664	1497864664	1	1	EQUI, ROBERT A MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78901	18	Ophthalmology	0	In state provider	None	960 E GREEN ST	STE 254	PASADENA	CA	91106	2418	19	06037	34.14451994	-118.1301695	Los Angeles County
52521	Fee-for-Service	1568671196	1568671196	1	1	ELLEN ELIZABETH KITCHELL, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
52585	Fee-for-Service	1568690527	1568690527	1	1	ELMADHUN, NASSRENE Y MD	8/3/2020	208G00000X	NA	General Surgery	026	PHYSICIANS	163803	02	General Surgery	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
52631	Fee-for-Service	1578850194	1578850194	1	1	ELCHICO, MELANIE C MD	6/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	124726	30	Radiology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
52639	Fee-for-Service	1073853800	1073853800	1	1	EGGEN, ALICIA LMFT	7/10/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
52665	Fee-for-Service	1073369963	1073369963	1	1	ESPINOSA, IVETTE	1/20/2025	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	9901 PARAMOUNT BLVD	STE #236	DOWNEY	CA	90240	3853	19	06037	33.95539219	-118.128812	Los Angeles County
52770	Fee-for-Service	1740289982	1740289982	1	1	ENSIGN WHITTIER WEST LLC	7/31/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	ROYAL COURT HEALTH CARE	12385 WASHINGTON BLVD	None	WHITTIER	CA	90606	2502	19	06037	33.96718678	-118.0497585	Los Angeles County
52832	Fee-for-Service	1487186409	1487186409	1	1	EVERETT, JO MD	4/1/2019	390200000X	NA	Other	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
52860	Fee-for-Service	1053003087	1053003087	1	3	ELITE FAMILY MEDICINE	4/26/2024	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2140 CHAPMAN AVENUE	SUITE 109	ORANGE	CA	92868	2331	30	06059	33.78787403	-117.8757819	Orange County
52868	Fee-for-Service	1972990760	1972990760	1	1	ESKATON FOUNTAINWOOD LODGE	5/13/2015	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	8773 OAK AVE	None	ORANGEVALE	CA	95662	2410	34	06067	38.701377	-121.231917	Sacramento County
52875	Fee-for-Service	1770905994	1770905994	1	2	ENLOE MEDICAL CENTER	2/12/2021	207X00000X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	CLINIC	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
52879	Fee-for-Service	1295813913	1295813913	1	1	ENRIQUEZ, ERWIN G MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71585	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
52911	Fee-for-Service	1912414707	1912414707	1	1	EL ZUWAY, SALEM A MD	1/30/2023	207T00000X	NA	General Surgery	026	PHYSICIANS	175351	None	None	0	In state provider	None	7257 FRESNO	FIRST FLOOR	FRESNO	CA	93720	2950	10	06019	36.84225164	-119.7833937	Fresno County
52971	Fee-for-Service	1922772862	1922772862	1	1	ELITE PRIMARY PHYSICIANS INC	9/10/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	1781 W ROMNEYA DR	SUITE B	ANAHEIM	CA	92801	1818	30	06059	33.85067272	-117.9447342	Orange County
53095	Fee-for-Service	1639577109	1639577109	1	1	ESCOBEDO, SANDRA LCSW	2/6/2024	106H00000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
53144	Fee-for-Service	1841578333	1841578333	1	1	EA HEALTH PHYSICIANS MEDICAL	12/15/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
53197	Fee-for-Service	1811956469	1811956469	1	1	EICHEL, JAMES E MD	10/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74264	08	Family Practice	0	In state provider	None	2915 TELEGRAPH AVE	STE 101	BERKELEY	CA	94705	2069	01	06001	37.85719633	-122.2595246	Alameda County
53222	Fee-for-Service	1467856948	1467856948	1	1	ENGELBERG, KATHLEEN LMFT	2/4/2015	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	925 THE ALAMEDA	None	BERKELEY	CA	94707	2310	01	06001	37.89072074	-122.2769176	Alameda County
53485	Fee-for-Service	1811956469	1811956469	1	1	EICHEL, JAMES E MD	10/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74264	01	General Practice	0	In state provider	None	2915 TELEGRAPH AVE	STE 101	BERKELEY	CA	94705	2069	01	06001	37.85719633	-122.2595246	Alameda County
53802	Fee-for-Service	1295729382	1295729382	1	1	EYE ASSOC OF SEBASTOPOL	9/1/1998	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	MEDICAL GROUP	6880 PALM AVE	None	SEBASTOPOL	CA	95472	4270	49	06097	38.39599965	-122.8192479	Sonoma County
53821	Fee-for-Service	1588765127	1588765127	1	1	ELKO COUNTY AMBULANCE	12/12/2007	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	569 COURT ST	None	ELKO	NV	89801	3573	00	None	40.83398384	-115.763081	Elko County
53850	Fee-for-Service	1285932749	1285932749	1	1	ESHAGHIAN, SHERVIN MD INC	4/8/2011	207R00000X	NA	Other	026	PHYSICIANS	97729	41	Internal Medicine	0	In state provider	None	2080 CENTURY PARK E	STE 1405	LOS ANGELES	CA	90067	2017	19	06037	34.05887194	-118.4122914	Los Angeles County
53891	Fee-for-Service	1548002678	1548002678	1	1	ELYYAN, RENA LCSW	8/7/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4199 CAMPUS DR	SUITE 550, OFFICE 57	IRVINE	CA	92612	4684	30	06059	33.650775	-117.838296	Orange County
53899	Fee-for-Service	1902860554	1902860554	1	1	EAKIN, ELIANE F MD	3/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145488	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
53931	Fee-for-Service	1932109642	1932109642	1	1	EMDUR, LARRY I DO INC	12/24/1989	174400000X	NA	Other	026	PHYSICIANS	4940	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
54045	Fee-for-Service	1467980136	1467980136	1	1	ENDERS, ALLEN F	2/3/2023	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1467 WANDA RD	STE 135	ORANGE	CA	92867	5344	30	06059	33.81173472	-117.8219635	Orange County
54093	Fee-for-Service	1457594087	1457594087	1	1	EL CAMINO HOSP	3/18/1993	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4378	43	06085	37.36893518	-122.0779448	Santa Clara County
54095	Fee-for-Service	1730447715	1730447715	1	1	EXETER HEALTH MEDICAL GROUP	5/21/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
54108	Fee-for-Service	1316070048	1316070048	1	1	ELYASSNIA, DINO MD	1/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	90659	24	Plastic Surgery	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
54130	Fee-for-Service	1457963415	1457963415	1	1	EXCELLENT QUALITY HOSPICE	10/6/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	6308 WOODMAN AVE	STE 103	VAN NUYS	CA	91401	2369	19	06037	34.185123	-118.4312405	Los Angeles County
54148	Fee-for-Service	1457781957	1457781957	1	1	ETESAMI, MICHELLE D NP	9/26/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	95205	3045	33	06065	33.904782	-117.469323	Riverside County
54219	Fee-for-Service	1932109642	1932109642	1	1	EMDUR, LARRY I DO INC	12/24/1989	174400000X	NA	Other	026	PHYSICIANS	4940	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
54226	Fee-for-Service	1205341336	1205341336	1	3	ELICA HEALTH CENTERS	5/5/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE 2	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95691	3412	57	06113	38.573118	-121.5501275	Yolo County
54273	Fee-for-Service	1093968570	1093968570	1	1	ELLGASS, KATIE A MD	8/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130372	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5548	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
54348	Fee-for-Service	1992934970	1992934970	1	1	EXPERT SURGEONS OF	11/16/2010	208600000X	NA	General Surgery	026	PHYSICIANS	10547	02	General Surgery	0	In state provider	CALIFORNIA INC	3601 VISTA WAY	STE 203	OCEANSIDE	CA	92053	4559	37	06073	33.18140858	-117.3093221	San Diego County
54394	Fee-for-Service	1063903003	1063903003	1	1	ENGELHARD, STEPHANIE B MD	7/6/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	177825	None	None	0	In state provider	None	1450 SAN PABLO ST	STE 2505	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
54401	Fee-for-Service	1366513327	1366513327	1	1	ENGELBERG, LON P MD	7/20/1970	No Taxonomy Provided	NA	None	026	PHYSICIANS	23863	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
54408	Fee-for-Service	1063890093	1063890093	1	1	EKE, CHIBUZO U DO	10/4/2018	208M00000X	NA	Other	026	PHYSICIANS	15106	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
54418	Fee-for-Service	1457963415	1457963415	1	1	EXCELLENT QUALITY HOSPICE	10/6/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	6308 WOODMAN AVE	STE 103	VAN NUYS	CA	91401	2369	19	06037	34.185123	-118.4312405	Los Angeles County
54460	Fee-for-Service	1437656410	1437656410	1	1	EWBANK, JORDYN E DO	2/3/2022	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	101 CIVIC CTR LN	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
54496	Fee-for-Service	1346254000	1346254000	1	1	EAST COUNTY DERMATOLOGY	7/21/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	MEDICAL GROUP INC	514 S MAGNOLIA AVE	None	EL CAJON	CA	92020	6011	37	06073	32.79028005	-116.962414	San Diego County
54506	Fee-for-Service	1932109642	1932109642	1	1	EMDUR, LARRY I DO INC	12/24/1989	174400000X	NA	Other	026	PHYSICIANS	4940	41	Internal Medicine	0	In state provider	None	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
54513	Fee-for-Service	1205341336	1205341336	1	3	ELICA HEALTH CENTERS	5/5/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE 2	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95691	3412	57	06113	38.573118	-121.5501275	Yolo County
54533	Fee-for-Service	1215042866	1215042866	1	1	EL-ZAYAT, SAID L MD	2/8/2005	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	37201	01	General Practice	0	In state provider	None	12901 HARBOR BLVD	STE A6	GARDEN GROVE	CA	92840	5830	30	06059	33.77553773	-117.9183416	Orange County
54574	Fee-for-Service	1013969153	1013969153	1	1	EMERGENCY PHYSICIAN	7/1/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
54689	Fee-for-Service	1366513327	1366513327	1	1	ENGELBERG, LON P MD	7/20/1970	No Taxonomy Provided	NA	None	026	PHYSICIANS	23863	36	Psychiatry	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
54714	Fee-for-Service	1124319959	1124319959	1	1	EAST BAY RETINA CONSULTANTS	9/15/2011	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL GROUP INC	1401 WILLOW PASS RD	#120	CONCORD	CA	94520	7966	07	06013	37.96988498	-122.0504278	Contra Costa County
54890	Fee-for-Service	1588029045	1588029045	1	1	ENHANCED PSYCHOLOGICAL HEALT	8/11/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	H CARE, INC	6645 ALVARADO RD	SUITE 255	SAN DIEGO	CA	92120	5208	37	06073	32.7772577	-117.0575222	San Diego County
54896	Fee-for-Service	1568494649	1568494649	1	2	EYECARE SPECIALISTS MEDICAL	10/3/2018	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	GROUP INC	8311 E FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
54908	Fee-for-Service	1245556406	1245556406	1	1	ENG, OLIVER S MD	12/20/2021	2086X0206X	NA	General Surgery	026	PHYSICIANS	140751	None	None	0	In state provider	None	101 CITY DR S	# B10	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
54925	Fee-for-Service	1881798189	1881798189	1	1	ENG, STEVEN L MD	3/15/2019	207RE0101X	NA	Endocrinology	026	PHYSICIANS	74358	67	Endocrinology	0	In state provider	None	3300 EAST SOUTH STREET	STE. #103	LONG BEACH	CA	90805	4549	19	06037	33.86018093	-118.1537163	Los Angeles County
54939	Fee-for-Service	1023087558	1023087558	1	1	ELLIS, DONNA JILL MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	55338	05	Anesthesiology	0	In state provider	None	320 SANTA FE DR	STE 100	ENCINITAS	CA	92024	5139	37	06073	33.038847	-117.285579	San Diego County
54969	Fee-for-Service	1629061940	1629061940	1	1	ETTNER, MICHAEL L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	KOOTENAI MEDICAL CENTER	2003 LINCOLN WAY	None	COEUR D ALENE	ID	83814	2611	00	None	47.69465937	-116.7917936	Kootenai County
55003	Fee-for-Service	1689356818	1689356818	1	1	ELIZABETH STROUT A LICENSED	2/28/2024	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	11230 SORRENTO VALLEY RD	STE 220	SAN DIEGO	CA	92121	1300	37	06073	32.90734306	-117.2281918	San Diego County
55013	Fee-for-Service	1043348378	1043348378	1	1	ENGELMANN, GUY R MD	12/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	81777	01	General Practice	0	In state provider	None	1429 WEST FREMONT ST	None	STOCKTON	CA	95023	2627	39	06077	37.95439432	-121.3112101	San Joaquin County
55118	Fee-for-Service	1871245373	1871245373	1	1	EXPLICIT COMFORT HOME	2/18/2025	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE INC.	539 N GLENOAKS BLVD	STE 305	BURBANK	CA	91502	3213	19	06037	34.18652984	-118.310858	Los Angeles County
55125	Fee-for-Service	1982953303	1982953303	1	1	ENCINAS, TIMOTHY LCSW	2/6/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
55157	Fee-for-Service	1316239775	1316239775	1	1	EAKIN, JOHN MD	8/1/2023	390200000X	NA	Other	026	PHYSICIANS	185784	None	None	0	In state provider	None	1139 THIRD STREET	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
55186	Fee-for-Service	1568494649	1568494649	1	2	EYECARE SPECIALISTS MEDICAL	10/3/2018	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	8311 E FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
55193	Fee-for-Service	1417996869	1417996869	1	1	EMILE N EL-SHAMMAA	4/18/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
55265	Fee-for-Service	1437196219	1437196219	1	1	ESTREMERA, CATHERINE P CRNA	6/30/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
55288	Fee-for-Service	1689356818	1689356818	1	1	ELIZABETH STROUT A LICENSED	5/29/2024	1041C0700X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	11230 SORRENTO VALLEY RD	STE 220	SAN DIEGO	CA	92121	1300	37	06073	32.90734306	-117.2281918	San Diego County
55291	Fee-for-Service	1619496080	1619496080	1	1	ELITE CARE HOME HEALTH	1/31/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	225 E BROADWAY	STE B114	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
55301	Fee-for-Service	1528074044	1528074044	1	1	ELDESSOUKY, AMANI A MD	2/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	56426	None	None	0	In state provider	INC	1704 W MANCHESTER AVE	# 109	LOS ANGELES	CA	90047	3034	19	06037	33.9599425	-118.307079	Los Angeles County
55314	Fee-for-Service	1417141292	1417141292	1	1	EL-TOM, BASSEM MD	8/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	27924 SECO CANYON ROAD	None	SANTA CLARITA	CA	91350	3870	19	06037	34.4588501	-118.5343405	Los Angeles County
55318	Fee-for-Service	1689296238	1689296238	1	1	ELDERLY HOSPICE AND	3/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	12444 VICTORY BLVD	SUITE 504	N HOLLYWOOD	CA	91606	3113	19	06037	34.18663951	-118.4043555	Los Angeles County
55430	Fee-for-Service	1548550510	1548550510	1	1	EDWARDS, SARA B MD	8/7/2017	208600000X	NA	General Surgery	026	PHYSICIANS	140928	02	General Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
55451	Fee-for-Service	1790084978	1790084978	1	1	EPSTEIN, DAVID J MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	122144	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
55454	Fee-for-Service	1871794016	1871794016	1	1	EVURI, VISHNU D MD	7/21/2009	207R00000X	NA	Other	026	PHYSICIANS	106281	41	Internal Medicine	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
55473	Fee-for-Service	1568494649	1568494649	1	2	EYECARE SPECIALISTS MEDICAL	10/3/2018	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	GROUP INC	8311 E FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
55504	Fee-for-Service	1871980672	1871980672	1	1	EIVAZ, NATHAN A MD	11/12/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	168644	None	None	0	In state provider	None	1700 E CESAR E CHAVEZ AV	SUITE 2500	LOS ANGELES	CA	90033	2434	19	06037	34.05101259	-118.217259	Los Angeles County
55545	Fee-for-Service	1366991200	1366991200	1	1	ESKANDER, FLORA LMFT	7/21/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
55556	Fee-for-Service	1497891022	1497891022	1	1	EWUSI-MENSAH, THEODORA	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	31536	40	Pediatrics	0	In state provider	TEMS PEDIATRIC CARE INC	304 W F ST	None	ONTARIO	CA	91762	3206	36	06071	34.069563	-117.6538005	San Bernardino County
55569	Fee-for-Service	1801972328	1801972328	1	1	ENGELMAN, EPHRAIM P MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	26680	22	Pathology (M.D. only)	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
55575	Fee-for-Service	1801343249	1801343249	1	1	ECKHARDT, SARAH MD	7/14/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	144594	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
55577	Fee-for-Service	1689356818	1689356818	1	1	ELIZABETH STROUT A LICENSED	2/28/2024	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	11230 SORRENTO VALLEY RD	STE 220	SAN DIEGO	CA	92121	1300	37	06073	32.90734306	-117.2281918	San Diego County
55605	Fee-for-Service	1689296238	1689296238	1	1	ELDERLY HOSPICE AND	3/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	12444 VICTORY BLVD	SUITE 504	N HOLLYWOOD	CA	91606	3113	19	06037	34.18663951	-118.4043555	Los Angeles County
55608	Fee-for-Service	1497293674	1497293674	1	1	ENGLAND, KENNETH LMFT	7/31/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	31356 VIA COLINAS	114	WESTLAKE VILLAGE	CA	91362	6864	19	06037	34.15593339	-118.8063914	Los Angeles County
55643	Fee-for-Service	1801838933	1801838933	1	1	EDER, SUZANNE E NP	8/30/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
55644	Fee-for-Service	1235609348	1235609348	1	1	EBERHART, ROBERT N DO	3/10/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19252	None	None	0	In state provider	None	3000 Q ST	1ST FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
55739	Fee-for-Service	1790084978	1790084978	1	1	EPSTEIN, DAVID J MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	122144	77	Infectious Disease	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
55794	Fee-for-Service	1942523642	1942523642	1	1	EL-JAMMAL, HANI MD	8/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110034	41	Internal Medicine	0	In state provider	None	1180 EAST SHAW #125	None	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
55849	Fee-for-Service	1205914363	1205914363	1	1	ENNIS, MICHAEL E MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	70960	05	Anesthesiology	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
55867	Fee-for-Service	1689356818	1689356818	1	1	ELIZABETH STROUT A LICENSED	11/1/2024	1041C0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11230 SORRENTO VALLEY RD	STE 220	SAN DIEGO	CA	92121	1300	37	06073	32.90734306	-117.2281918	San Diego County
55911	Fee-for-Service	1659392785	1659392785	1	1	ELMAGHRABY, ZAKI MD	4/10/2023	207RC0200X	NA	Other	026	PHYSICIANS	77668	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
55923	Fee-for-Service	1902193956	1902193956	1	1	EL CENTRO DE LIBERTAD/THE	7/25/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	FREEDOM CENTER, INC	500 ALLERTON STREET	2ND AND 3RD FLOOR	REDWOOD CITY	CA	94063	1545	41	06081	37.48870447	-122.2316558	San Mateo County
56157	Fee-for-Service	1083904809	1083904809	1	1	ESSENTIAL MEDICAL SOLUTIONS,	4/6/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	INC.	3 NEBO YORKVILLE RD	None	YORKVILLE	TN	38389	0009	00	None	36.099342	-89.1196435	Gibson County
56380	Fee-for-Service	1043394513	1043394513	2	1	EMILYS RESIDENTIAL CARE	10/11/2018	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER LLC	8983 TELFAIR AVE	None	SUN VALLEY	CA	91352	2441	19	06037	34.23252473	-118.392714	Los Angeles County
56452	Fee-for-Service	1285694422	1285694422	1	1	EVANS, ALLEN MAURICE MD	5/24/1995	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	73994	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	1351 E SPRUCE AVE	None	FRESNO	CA	93720	3342	10	06019	36.84136088	-119.7588077	Fresno County
56537	Fee-for-Service	1508884941	1508884941	1	1	EVANS, ELIZABETH D MD	6/30/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	68987	40	Pediatrics	0	In state provider	None	18460 RESEDA	None	NORTHRIDGE	CA	91324	0000	19	06037	34.23900541	-118.5360841	Los Angeles County
56538	Fee-for-Service	1295770642	1295770642	1	1	ERLIEN, RICHARD A LMFT	5/4/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	121 S PALM CANYON DR	SUITE 217	PALM SPRINGS	CA	92262	6378	33	06065	33.822774	-116.5468275	Riverside County
56621	Fee-for-Service	1619542784	1619542784	1	1	ETERNITY HOME HEALTH CARE	12/6/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	1480 COLORADO BLVD	SUITE 125	LOS ANGELES	CA	90041	2373	19	06037	34.13925431	-118.1972852	Los Angeles County
56644	Fee-for-Service	1598083990	1598083990	1	1	ERWTEMAN, ANDREW S MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134839	20	Orthopedic Surgery	0	In state provider	None	6719 ALVARADO RD	STE 200	SAN DIEGO	CA	92120	5256	37	06073	32.77684978	-117.055137	San Diego County
56688	Fee-for-Service	1831955822	1831955822	1	1	EMODI, ANGEL BIRTH DOULA	2/27/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
56716	Fee-for-Service	1922485366	1922485366	1	1	EKASUMARA, NYDIA F MD	8/4/2020	390200000X	NA	Other	026	PHYSICIANS	162188	05	Anesthesiology	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
56810	Fee-for-Service	1588198055	1588198055	1	1	EAST LA EMERGENCY PHYSICIANS	5/1/2017	282N00000X	NA	Hospitals	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
56959	Fee-for-Service	1093774168	1093774168	1	1	ESKENAZI, ABRAHAM MD	1/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76892	41	Internal Medicine	0	In state provider	None	3229 ERIE ST	None	SAN DIEGO	CA	92117	6151	37	06073	32.79711788	-117.2010607	San Diego County
57060	Fee-for-Service	1912190430	1912190430	1	1	ENOCH SANDERS	3/19/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13135 LEE JACKSON	HWY STE 305	FAIRFAX	VA	22033	1907	00	None	38.88178955	-77.39983515	Fairfax County
57062	Fee-for-Service	1477055390	1477055390	1	2	ELLIS, ALEX D LMFT	9/1/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	217 SIERRA MANOR	None	MAMMOTH LAKES	CA	93546	6037	26	06051	37.64145885	-118.9648281	Mono County
57076	Fee-for-Service	1326200999	1326200999	1	1	ERNSTER, ERIC M MD	2/14/2011	390200000X	NA	Other	026	PHYSICIANS	109416	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
57088	Fee-for-Service	1023000502	1023000502	1	1	ELLIOTT, L EDWARD OD	6/1/1983	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1555 VIKING ST	None	ESCALON	CA	95320	1742	39	06077	37.7963989	-120.9937447	San Joaquin County
57091	Fee-for-Service	1962429886	1962429886	1	1	ERLENDSON, LEE WAYNE MD	1/19/1988	207L00000X	NA	Other	026	PHYSICIANS	50577	05	Anesthesiology	0	In state provider	None	69844 HIGHWAY 111	STE E	RANCHO MIRAGE	CA	92270	2849	33	06065	33.76988393	-116.4463473	Riverside County
57248	Fee-for-Service	1093774168	1093774168	1	1	ESKENAZI, ABRAHAM MD	1/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76892	77	Infectious Disease	0	In state provider	None	3229 ERIE ST	None	SAN DIEGO	CA	92117	6151	37	06073	32.79711788	-117.2010607	San Diego County
57309	Fee-for-Service	1750459202	1750459202	1	1	ELIAZAR, FELICIA	6/5/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1132 MCKENDRIE ST	None	SAN JOSE	CA	95126	2220	43	06085	37.34121241	-121.9246913	Santa Clara County
57327	Fee-for-Service	1164837035	1164837035	1	1	ESPEJO, GEMMA D MD	10/4/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	180296	None	None	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
57353	Fee-for-Service	1184698631	1184698631	1	1	ELITE MEDICAL DISTRIBUTORS	7/20/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ELITE MEDICAL DISTRIBUTO	4549 W ROSECRANS AVE	None	HAWTHORNE	CA	90250	6935	19	06037	33.9019593	-118.3567571	Los Angeles County
57358	Fee-for-Service	1144519422	1144519422	1	1	ECHOLS, LEESA MD	3/1/2024	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	9300 W SUNSET RD	None	LAS VEGAS	NV	89148	4844	00	None	36.072729	-115.295094	Clark County
57368	Fee-for-Service	1215170097	1215170097	1	1	EAST COUNTY NEUROLOGY	12/10/2009	2084N0400X	NA	Neurology	026	PHYSICIANS	98831	13	Neurology (M.D. only)	0	In state provider	ASSOCIATES, INC	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
57384	Fee-for-Service	1073914255	1073914255	1	1	ESTRADA, ORSINI Y LCSW	11/10/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
57406	Fee-for-Service	1528639481	1528639481	1	1	EMH PSYCHIATRY INC	9/27/2021	2084P0800X	NA	Psychiatry	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	11835 W OLYMPIC BLVD	1265E	LOS ANGELES	CA	90064	5814	19	06037	34.03273663	-118.4516927	Los Angeles County
57450	Fee-for-Service	1891984324	1891984324	1	1	EMERSON, SUSAN LCSW	3/27/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12440 FIRESTONE BLVD	3001	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
57452	Fee-for-Service	1700913977	1700913977	1	1	EPSTEIN OPTOMETRIC CORPO	5/7/2008	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	BELLA VISTA OPTOMETRIC G	1598 WASHINGTON AVE	None	SAN LEANDRO	CA	94577	4465	01	06001	37.72227514	-122.1546132	Alameda County
57454	Fee-for-Service	1710425376	1710425376	1	1	ESQUIVIAS, CINDY	2/28/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
57540	Fee-for-Service	1093774168	1093774168	1	1	ESKENAZI, ABRAHAM MD	1/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76892	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3229 ERIE ST	None	SAN DIEGO	CA	92117	6151	37	06073	32.79711788	-117.2010607	San Diego County
57659	Fee-for-Service	1659437978	1659437978	1	1	ESHERICK, JOSEPH S MD	4/30/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55216	None	None	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
57663	Fee-for-Service	1871882712	1871882712	1	1	EDGAR S. MACIAS, M.D., INC	2/27/2024	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	7115 N CHESTNUT AVE	STE 101	FRESNO	CA	93720	0361	10	06019	36.83977368	-119.7366985	Fresno County
57677	Fee-for-Service	1144272170	1144272170	1	2	EAST BAY PERINATAL MED	9/17/2007	193400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2648 INTERNATIONAL BLVD	FL 7	OAKLAND	CA	94601	1506	01	06001	37.78093454	-122.231728	Alameda County
57694	Fee-for-Service	1528639481	1528639481	1	1	EMH PSYCHIATRY INC	9/27/2021	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	11835 W OLYMPIC BLVD	1265E	LOS ANGELES	CA	90064	5814	19	06037	34.03273663	-118.4516927	Los Angeles County
57697	Fee-for-Service	1104073659	1104073659	1	1	ENCINO OPEN MRI INC	1/15/2016	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	17323 VENTURA BLVD	SUITE 101	ENCINO	CA	91316	3964	19	06037	34.16098968	-118.5105896	Los Angeles County
57871	Fee-for-Service	1750569133	1750569133	1	1	ELCHURI, SWATI V MD	9/28/2017	2080P0205X	NA	Endocrinology	026	PHYSICIANS	149522	67	Endocrinology	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
57885	Fee-for-Service	1922269083	1922269083	1	1	EL-SAWY, TAREK MD	8/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120920	18	Ophthalmology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
57916	Fee-for-Service	1073684056	1073684056	1	1	ELSAYEGH, ASHRAF M MD	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77236	41	Internal Medicine	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
57942	Fee-for-Service	1962651885	1962651885	1	1	ESKANDER, ASHRAF I MD	10/30/1990	208M00000X	NA	Other	026	PHYSICIANS	48837	41	Internal Medicine	0	In state provider	A PROFESSIONAL MED CORP	700 E REDLANDS BLVD	# U345	REDLANDS	CA	92373	6109	36	06071	34.04750423	-117.1691726	San Bernardino County
58044	Fee-for-Service	1639380215	1639380215	1	1	EAP-BRAJE, SOPAGNA PHD	1/21/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8775 AERO DRIVE	STE 238	SAN DIEGO	CA	92123	1756	37	06073	32.80965551	-117.1391563	San Diego County
58115	Fee-for-Service	1538646575	1538646575	1	1	ESCALERA, ALEXIS I LMFT	2/8/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
58262	Fee-for-Service	1841492006	1841492006	1	1	EDWARDS, ALLIE W PHD	9/29/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	18234	-	NOT APPLICABLE	0	In state provider	None	20094 MISSION BLVD	None	HAYWARD	CA	94541	1237	01	06001	37.68697869	-122.1024518	Alameda County
58296	Fee-for-Service	1326023359	1326023359	1	1	EATON, DOUGLAS OWEN W	10/10/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	66251	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	# 3600	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
58302	Fee-for-Service	1952464802	1952464802	1	1	ENDICOTT, PHILLIP D OD	5/1/1995	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	18194 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	2665	19	06037	33.98844506	-117.9074218	Los Angeles County
58329	Fee-for-Service	1245851625	1245851625	1	1	ESTRADA, AMBER LMFT	8/27/2024	390200000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1845 CHICAGO AVE	B	RIVERSIDE	CA	92507	2366	33	06065	33.994269	-117.3485375	Riverside County
58414	Fee-for-Service	1548847189	1548847189	1	1	ENAM, SYED FAAIZ MD	4/2/2025	2084N0400X	NA	Neurology	026	PHYSICIANS	None	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
58417	Fee-for-Service	1881729663	1881729663	1	1	EU, JAMES KIM-TZONG OD	1/31/1982	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1937 TULLY RD	None	SAN JOSE	CA	95122	1934	43	06085	37.32504239	-121.8221289	Santa Clara County
58455	Fee-for-Service	1710719281	1710719281	1	1	EMPOWER HEALTH ANTELOPE VALL	2/5/2025	251B00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	EY	43535 17TH ST	402	LANCASTER	CA	93534	5984	19	06037	34.67404436	-118.1612748	Los Angeles County
58509	Fee-for-Service	1356537039	1356537039	1	1	ETKIN, AMIT MD	6/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101289	36	Psychiatry	0	In state provider	None	300 PASTEUR DRIVE	MC: 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
58533	Fee-for-Service	1336126820	1336126820	1	1	ENT ASSOCIATES	5/1/2000	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	OF GLENDALE	1505 WILSON TER	STE 270	GLENDALE	CA	91206	4078	19	06037	34.14960934	-118.2313491	Los Angeles County
58605	Fee-for-Service	1265708416	1265708416	1	1	ERIK CONTRERAS MD	4/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1003 WILLOW CREEK RD	None	PRESCOTT	AZ	86301	1641	00	None	34.558992	-112.481901	Yavapai County
58632	Fee-for-Service	1295740991	1295740991	1	3	EYE CARE INSTITUTE, A MEDICA	5/4/2021	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	L CORPORATION	1383 N. MCDOWELL BLVD	100	PETALUMA	CA	94954	1187	49	06097	38.27485524	-122.6679772	Sonoma County
58710	Fee-for-Service	1457348039	1457348039	1	1	EVERTS, MEIGAN M MD	2/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	51004	40	Pediatrics	0	In state provider	None	27871 MEDICAL CENTER RD	SUITE 200	MISSION VIEJO	CA	92691	6406	30	06059	33.558534	-117.6641255	Orange County
58767	Fee-for-Service	1104644293	1104644293	1	1	ESHO, MARK CRNA	1/7/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
58859	Fee-for-Service	1497705495	1497705495	1	1	EVANS, BRIANA C	1/16/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
58883	Fee-for-Service	1629140454	1629140454	1	1	EASTMAN, ANN K MD	11/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	63786	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
58918	Fee-for-Service	1295740991	1295740991	1	3	EYE CARE INSTITUTE, A MEDICA	5/4/2021	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	L CORPORATION	1383 N. MCDOWELL BLVD	100	PETALUMA	CA	94954	1187	49	06097	38.27485524	-122.6679772	Sonoma County
58942	Fee-for-Service	1033446448	1033446448	1	1	EL DORADO PHYSICAL THERAPY,	10/4/2023	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	907 EMBARCADERO DR	None	EL DORADO HILLS	CA	95762	4087	09	06017	38.70864351	-121.0826115	El Dorado County
58974	Fee-for-Service	1275271918	1275271918	1	1	EASLEY, KRISTIN	9/21/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	9653 FOLSOM BLVD	STE A	SACRAMENTO	CA	95827	1212	34	06067	38.571822	-121.3386885	Sacramento County
59022	Fee-for-Service	1861122061	1861122061	1	1	ENCOMPASS PHARMACY, INC	6/24/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1110 N WESTERN AVE	STE 101	LOS ANGELES	CA	90029	1199	19	06037	34.091289	-118.3091505	Los Angeles County
59115	Fee-for-Service	1962501718	1962501718	2	1	ELDALY, MOHAMED E MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52285	78	Neoplastic Diseases/Oncology	0	In state provider	None	880 E TUOLUMNE RD	STE 103	TURLOCK	CA	95382	1547	50	06099	37.51459247	-120.837519	Stanislaus County
59231	Fee-for-Service	1033446448	1033446448	1	1	EL DORADO PHYSICAL THERAPY,	10/4/2023	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	INC	907 EMBARCADERO DR	None	EL DORADO HILLS	CA	95762	4087	09	06017	38.70864351	-121.0826115	El Dorado County
59263	Fee-for-Service	1275271918	1275271918	1	1	EASLEY, KRISTIN	9/21/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	9653 FOLSOM BLVD	STE A	SACRAMENTO	CA	95827	1212	34	06067	38.571822	-121.3386885	Sacramento County
59272	Fee-for-Service	1164666715	1164666715	1	1	ESTES, MICHAEL C MD	3/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113850	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
59402	Fee-for-Service	1962501718	1962501718	2	1	ELDALY, MOHAMED E MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52285	68	Hematology	0	In state provider	None	880 E TUOLUMNE RD	STE 103	TURLOCK	CA	95382	1547	50	06099	37.51459247	-120.837519	Stanislaus County
59444	Fee-for-Service	1316968977	1316968977	1	1	EAST PALMDALE DIALYSIS	5/8/2001	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER, LLC	2710 E PALMDALE BLVD	None	PALMDALE	CA	93550	4946	19	06037	34.58011781	-118.0808338	Los Angeles County
59469	Fee-for-Service	1942498522	1942498522	1	1	ENG, LILLIAN MD	8/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101963	08	Family Practice	0	In state provider	None	2300 7TH ST	None	WASCO	CA	93280	1585	15	06029	35.59431549	-119.3517135	Kern County
59519	Fee-for-Service	1164437620	1164437620	1	1	EDMONDS, ELAINE	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
59687	Fee-for-Service	1881610376	1881610376	1	1	EASTHAM, MARK EDWARD	11/22/2012	174400000X	NA	Other	026	PHYSICIANS	65379	14	Neurological Surgery	0	In state provider	None	2505 SAMARITAN DR	STE 605	SAN JOSE	CA	95124	4017	43	06085	37.25111447	-121.9483395	Santa Clara County
59716	Fee-for-Service	1992018436	1992018436	1	1	ERVIN, LYNN C LCSW	7/17/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	700 E STREET	SUITE 102	SAN RAFAEL	CA	94901	2753	21	06041	37.97112293	-122.533553	Marin County
59879	Fee-for-Service	1336696848	1336696848	1	1	EIGHT FIGURE HOLDINGS INC	5/4/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	201 COVINA AVE	STE 2	LONG BEACH	CA	90803	1843	19	06037	33.76007445	-118.1338046	Los Angeles County
59930	Fee-for-Service	1306981196	1306981196	1	1	ECHEVERRY-FRANKCK, DIANA MD	9/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	66198	67	Endocrinology	0	In state provider	None	641 S ATLANTIC BLVD	SUITE 101	MONTEREY PARK	CA	91754	4722	19	06037	34.05446341	-118.1360074	Los Angeles County
59954	Fee-for-Service	1780156356	1780156356	1	1	ESPARZA, ANGEL	12/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
60003	Fee-for-Service	1427081983	1427081983	1	1	EPPERSON, JOHN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1512 12TH AVE RD	None	NAMPA	ID	83686	0000	00	None	43.55346193	-116.5727785	Canyon County
60023	Fee-for-Service	1821036419	1821036419	1	1	EL-SAYED, IVAN H MD	5/17/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79136	04	Otology, Laryngology, Rhinology	0	In state provider	None	21-D	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.756044	-122.435658	San Francisco County
60194	Fee-for-Service	1386328300	1386328300	1	1	ELDER LOVE USA, INC.	11/18/2024	253Z00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	41550 ECLECTIC ST	None	PALM DESERT	CA	92260	1967	33	06065	33.74649422	-116.358184	Riverside County
60209	Fee-for-Service	1417055948	1417055948	1	2	EAST COUNTY URGENT CARE	2/9/1988	207P00000X	NA	Other	026	PHYSICIANS	29972	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1625 E MAIN ST	STE 100	EL CAJON	CA	92021	5240	37	06073	32.80969963	-116.9203429	San Diego County
60218	Fee-for-Service	1306981196	1306981196	1	1	ECHEVERRY-FRANKCK, DIANA MD	9/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	66198	41	Internal Medicine	0	In state provider	None	641 S ATLANTIC BLVD	SUITE 101	MONTEREY PARK	CA	91754	4722	19	06037	34.05446341	-118.1360074	Los Angeles County
60225	Fee-for-Service	1821897521	1821897521	1	1	EARTHSEED BIRTHWORK	3/14/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
60252	Fee-for-Service	1497485833	1497485833	1	1	EMW PHARMACY INC	10/28/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	19520 NORDHOFF ST	STE 2	NORTHRIDGE	CA	91324	2454	19	06037	34.23392022	-118.557451	Los Angeles County
60295	Fee-for-Service	1952431413	1952431413	1	1	EATCHEL, JESALYN LMSW	10/29/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1925 WINCHESTER BOULEVAR	SUITE 204	CAMPBELL	CA	95008	1038	43	06085	37.28904861	-121.9499866	Santa Clara County
60345	Fee-for-Service	1134483829	1134483829	1	1	EASLICK, ANDREA L CRNA	4/25/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	20940 BURBANK BLVD	None	WOODLAND HILLS	CA	91365	6701	19	06037	34.1719401	-118.5881418	Los Angeles County
60418	Fee-for-Service	1316416134	1316416134	1	1	EDWIN A LEE MD A MEDICAL COR	11/4/2020	261Q00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	PORATION	1300 VERMONT	STE 808	LOS ANGELES	CA	90027	6098	19	06037	34.0956033	-118.2916918	Los Angeles County
60491	Fee-for-Service	1154720522	1154720522	1	2	ELIM WELLCARE HOSPICE, LLC	12/1/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	690 WILSHIRE PLACE	SUITE 307	LOS ANGELES	CA	90005	3930	19	06037	34.06019204	-118.2877969	Los Angeles County
60530	Fee-for-Service	1194896852	1194896852	1	1	ETKIN, MARC L MD	6/15/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75092	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
60587	Fee-for-Service	1568687853	1568687853	2	1	EYESTHETICA	11/21/2019	174400000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	50 CENTRAL CT	None	PASADENA	CA	91105	2060	19	06037	34.1430245	-118.151559	Los Angeles County
60600	Fee-for-Service	1295740991	1295740991	1	1	EYE CARE INSTITUTE, A MEDICA	12/31/2024	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3035 CLEVELAND AVE	100	SANTA ROSA	CA	95403	2122	49	06097	38.468088	-122.729283	Sonoma County
60629	Fee-for-Service	1639116668	1639116668	1	1	ERIK MATTISON, M.D.	8/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	475 S DOBSON RD	None	CHANDLER	AZ	85224	5605	00	None	33.29768043	-111.8761089	Maricopa County
60676	Fee-for-Service	1073603791	1073603791	1	1	ESTEVES, DEBORAH MD	11/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
60744	Fee-for-Service	1285953133	1285953133	1	1	EBNER, BENJAMIN T MD	2/12/2020	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
60781	Fee-for-Service	1154720522	1154720522	1	2	ELIM WELLCARE HOSPICE, LLC	12/1/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	690 WILSHIRE PLACE	SUITE 307	LOS ANGELES	CA	90005	3930	19	06037	34.06019204	-118.2877969	Los Angeles County
60809	Fee-for-Service	1518423425	1518423425	1	1	EMPOWER HOME HEALTH CARE	9/16/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7065 HAYVENHURST AVE	STE 9	VAN NUYS	CA	91406	3827	19	06037	34.199262	-118.4924395	Los Angeles County
60863	Fee-for-Service	1326717521	1326717521	1	1	EMERGENCY PHYSICIANS URGENT	9/29/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	2251 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	0000	15	06029	35.38868165	-118.9673556	Kern County
60875	Fee-for-Service	1568687853	1568687853	2	1	EYESTHETICA	11/21/2019	174400000X	NA	Other	022	PHYSICIANS GROUP	-	24	Plastic Surgery	0	In state provider	None	50 CENTRAL CT	None	PASADENA	CA	91105	2060	19	06037	34.1430245	-118.151559	Los Angeles County
60893	Fee-for-Service	1295740991	1295740991	1	1	EYE CARE INSTITUTE, A MEDICA	1/1/1979	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	3035 CLEVELAND AVE	100	SANTA ROSA	CA	95403	2122	49	06097	38.468088	-122.729283	Sonoma County
60940	Fee-for-Service	1497203103	1497203103	1	1	EDELMAN, RACHEL C PHD	1/23/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	6968	19	06037	34.07067	-118.4432445	Los Angeles County
60998	Fee-for-Service	1841492006	1841492006	1	2	EDWARDS, ALLIE W PHD	10/17/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1970 BROADWAY	STE 835	OAKLAND	CA	94612	2299	01	06001	37.80880176	-122.2683539	Alameda County
61082	Fee-for-Service	1073527057	1073527057	1	1	EILBER, FREDERICK C MD	12/1/1997	2086S0129X	NA	General Surgery	026	PHYSICIANS	62408	02	General Surgery	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
61083	Fee-for-Service	1063875862	1063875862	1	1	ELSEVIER, HANNAH MD	7/20/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	172768	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
61141	Fee-for-Service	1902425465	1902425465	1	1	ELKAYAM, ISAK MD	8/24/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182109	None	None	0	In state provider	None	7301 MEDICAL CENTER DR	SUITE 500	WEST HILLS	CA	91307	4101	19	06037	34.20285756	-118.6294575	Los Angeles County
61283	Fee-for-Service	1376969139	1376969139	1	1	ESPINOSA, RONALD F MD	4/19/2024	390200000X	NA	Other	026	PHYSICIANS	13802	41	Internal Medicine	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
61311	Fee-for-Service	1710950217	1710950217	1	1	EDGARDO EMILIA	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1009 S 42ND ST SUITE 1	None	MT VERNON	IL	62864	0000	00	None	38.30424851	-88.94226996	Jefferson County
61431	Fee-for-Service	1326340308	1326340308	1	1	ELIST, MICHAEL DO	1/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	11440	83	Rheumatology	0	In state provider	None	12922 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	2924	19	06037	34.18665352	-118.414773	Los Angeles County
61498	Fee-for-Service	1265661953	1265661953	1	1	EBNESHAHIDI, HOSSEIN M MD	5/5/2014	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	107313	08	Family Practice	0	In state provider	None	420 HEFFERNAM AVE	SUITE D	CALEXICO	CA	92231	4718	13	06025	32.6691	-115.494863	Imperial County
61503	Fee-for-Service	1609815927	1609815927	1	1	ELLEN M BENDEL STENZEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MINNESOTA NEONATAL	2545 CHICAGO AVE	None	MINNEAPOLIS	MN	55404	4522	00	None	44.955792	-93.26257049	Hennepin County
61509	Fee-for-Service	1265753180	1265753180	1	1	ETESAMI, MARJAN MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127596	41	Internal Medicine	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
61531	Fee-for-Service	1154730828	1154730828	1	4	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	150 N AZUSA AVE	None	AZUSA	CA	91702	3521	19	06037	34.12348703	-117.9075659	Los Angeles County
61550	Fee-for-Service	1598198111	1598198111	1	1	ELUWOLE,AYOBAMI	6/13/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	760 BROADWAY	None	BROOKLYN	NY	11206	4922	00	None	40.700349	-73.9416015	Kings County
61566	Fee-for-Service	1811045602	1811045602	1	1	EMEL, ERIQUE E MD	7/6/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69047	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
61606	Fee-for-Service	1649237678	1649237678	1	1	EISENHART, ANITA W DO	8/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3269 STOCKTON HILL RD	None	KINGMAN	AZ	86409	3619	00	None	35.220006	-114.0380145	Mohave County
61640	Fee-for-Service	1518136043	1518136043	1	1	EVERGREEN EYECARE	5/10/2007	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRY INC	3005 SILVER CREEK RD	STE 104	SAN JOSE	CA	95121	1789	43	06085	37.30948255	-121.8129834	Santa Clara County
61677	Fee-for-Service	1407861917	1407861917	1	1	EDELMAN, ALISON B MD	2/8/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	2	Out of state provider	None	3181 SW SAM JACKSON PARK	None	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
61684	Fee-for-Service	1356815377	1356815377	1	1	EDA HOME HEALTH CARE INC	3/3/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	16 S OAKLAND AVE	STE 213	PASADENA	CA	91101	2042	19	06037	34.14549768	-118.139679	Los Angeles County
61719	Fee-for-Service	1326340308	1326340308	1	1	ELIST, MICHAEL DO	1/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	11440	41	Internal Medicine	0	In state provider	None	12922 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	2924	19	06037	34.18665352	-118.414773	Los Angeles County
61819	Fee-for-Service	1154730828	1154730828	1	4	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	150 N AZUSA AVE	None	AZUSA	CA	91702	3521	19	06037	34.12348703	-117.9075659	Los Angeles County
61855	Fee-for-Service	1811045602	1811045602	1	1	EMEL, ERIQUE E MD	7/6/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69047	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
61873	Fee-for-Service	1275766867	1275766867	1	1	ESLAMI, AFSHIN MD INC	9/16/2009	193400000X	NA	Other	026	PHYSICIANS	102804	02	General Surgery	0	In state provider	None	7501 HOSPITAL DRIVE	SUITE 305	SACRAMENTO	CA	95823	5405	34	06067	38.464776	-121.416912	Sacramento County
62051	Fee-for-Service	MSS00035F	None	1	1	EL DORADO COUNTY	3/1/1999	No Taxonomy Provided	NA	None	074	MULTIPURPOSE SENIOR SERVICES PROGRAM	-	-	NOT APPLICABLE	0	In state provider	COMMUNITY SERVICES DEPT	935 SPRING STREET	STE A	PLACERVILLE	CA	95667	4543	09	06017	38.73231685	-120.8018873	El Dorado County
62108	Fee-for-Service	1154730828	1154730828	1	4	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	150 N AZUSA AVE	None	AZUSA	CA	91702	3521	19	06037	34.12348703	-117.9075659	Los Angeles County
62128	Fee-for-Service	1073584470	1073584470	1	1	ERIC L THOMAS, M.D	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
62168	Fee-for-Service	1578904744	1578904744	1	1	ELLIS, LAURA NP	5/14/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
62214	Fee-for-Service	1245225010	1245225010	3	1	ELITE RX INC	3/9/2010	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	317 WEST NOBLE AVE	None	VISALIA	CA	93277	2668	54	06107	36.326223	-119.2957875	Tulare County
62216	Fee-for-Service	1043409022	1043409022	1	1	ENT AND SINUS CENTER, INC	2/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	83603	04	Otology, Laryngology, Rhinology	0	In state provider	None	8241 ROCHESTER AVE	SUITE 130	RANCHO CUCAMONGA	CA	91730	0700	36	06071	34.103979	-117.542898	San Bernardino County
62235	Fee-for-Service	1376790089	1376790089	1	1	ELRASHIDY, HANY R MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112631	20	Orthopedic Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
62247	Fee-for-Service	1962889311	1962889311	1	1	EGELSKI, JENNIFER	11/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
62254	Fee-for-Service	1841693827	1841693827	1	1	EAGLE CREST CARE CENTER	3/6/2015	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1733 E. ALLUVIAL AVENUE	None	FRESNO	CA	93720	2705	10	06019	36.84474461	-119.7520228	Fresno County
62266	Fee-for-Service	1245703958	1245703958	1	1	EXCELLENCY HOME HEALTH CARE	1/12/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	7502 FOOTHILL BLVD	SUITE 201	TUJUNGA	CA	91042	3814	19	06037	34.25295017	-118.2957018	Los Angeles County
62298	Fee-for-Service	1245664515	1245664515	1	1	ENG, JONATHAN K MD INC	9/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121799	05	Anesthesiology	0	In state provider	None	309 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	19	06037	34.01597577	-118.1003516	Los Angeles County
62309	Fee-for-Service	1194252916	1194252916	1	1	ELLEDGE, NATHAN R DO	11/1/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	18996	None	None	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
62408	Fee-for-Service	1366948796	1366948796	1	1	ERFE, BETTY M MD	9/2/2023	207L00000X	NA	Other	026	PHYSICIANS	186794	None	None	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
62436	Fee-for-Service	1619942216	1619942216	1	1	ESPLIN, CORDELL A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
62457	Fee-for-Service	1346379419	1346379419	1	1	ERICKSON, KATHERINE E LCSW	6/25/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2009 PALO VERDE AVE	SUITE A	LONG BEACH	CA	90815	3322	19	06037	33.792597	-118.1080155	Los Angeles County
62488	Fee-for-Service	1003580671	1003580671	1	1	ESCAMILLA, KELLEY LCSW	5/6/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4221 WILSHIRE BLVD	STE 230	LOS ANGELES	CA	90010	3519	19	06037	34.06177566	-118.320844	Los Angeles County
62675	Fee-for-Service	1730104266	1730104266	1	1	ENGEL JR, JEROME MD	5/31/1994	2084N0400X	NA	Neurology	026	PHYSICIANS	20331	13	Neurology (M.D. only)	0	In state provider	None	300 UCLA PLAZA DR	STE B200	LOS ANGELES	CA	90024	0000	19	06037	34.06465655	-118.4461	Los Angeles County
62783	Fee-for-Service	1821097569	1821097569	1	1	EGHBAL, AZAM A MD	1/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55958	30	Radiology	0	In state provider	None	1201 W LA VETA	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
62797	Fee-for-Service	1154930212	1154930212	1	1	EILAND, STEPHANIE M NP	12/19/2021	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	415 W ROUTE 66	SUITE 202	GLENDORA	CA	91740	4335	19	06037	34.12883848	-117.869958	Los Angeles County
62895	Fee-for-Service	1487658332	1487658332	1	1	ESKENAZI, ALLEN E MD	7/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55903	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
62902	Fee-for-Service	1174824114	1174824114	1	1	EMERGENCY MEDICINE PHYSICIAN	1/1/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	PARTNERS OF CALAVERAS	768 MOUNTAIN RANCH ROAD	None	SAN ANDREAS	CA	95249	9707	05	06009	38.19058212	-120.6709481	Calaveras County
62962	Fee-for-Service	1528415494	1528415494	1	1	ESSENCE HOME CARE LLC	4/23/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	32 EXECUTIVE PARK	SUITE 150	IRVINE	CA	92614	4722	30	06059	33.68515267	-117.860422	Orange County
63068	Fee-for-Service	1295740991	1295740991	1	2	EYE CARE INSTITUTE, A MEDICA	9/27/2019	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	L CORPORATION	720 4TH ST	None	SANTA ROSA	CA	95404	4421	49	06097	38.441403	-122.711562	Sonoma County
63126	Fee-for-Service	1710129986	1710129986	1	1	ESHRAGHI, YASHAR MD	8/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141197	05	Anesthesiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
63180	Fee-for-Service	1184777286	1184777286	2	1	EXPRESS RX INC	7/19/2007	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2503 BEVERLY BLVD	1ST FLOOR	LOS ANGELES	CA	90057	1024	19	06037	34.06880075	-118.2751986	Los Angeles County
63224	Fee-for-Service	1134940190	1134940190	1	1	ELITE BARIATRIC SURGERY & WE	1/17/2025	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	LLNESS PC	4234 RIVERWALK PKWY	STE 150	RIVERSIDE	CA	92505	3371	33	06065	33.90290859	-117.4941562	Riverside County
63250	Fee-for-Service	1508593617	1508593617	1	1	EDWARD SAMOURJIAN MEDICAL CO	2/2/2023	2086S0129X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	RPORATION, INC.	1030 S GLENDALE AVE	STE 402	GLENDALE	CA	91205	2866	19	06037	34.13381535	-118.2519184	Los Angeles County
63253	Fee-for-Service	1528415494	1528415494	1	1	ESSENCE HOME CARE LLC	4/23/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	32 EXECUTIVE PARK	SUITE 150	IRVINE	CA	92614	4722	30	06059	33.68515267	-117.860422	Orange County
63354	Fee-for-Service	1295740991	1295740991	1	2	EYE CARE INSTITUTE, A MEDICA	9/27/2019	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	L CORPORATION	720 4TH ST	None	SANTA ROSA	CA	95404	4421	49	06097	38.441403	-122.711562	Sonoma County
63409	Fee-for-Service	1821338617	1821338617	1	1	ELGAMMAL, IMAN A DO	2/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	15744	66	Emergency Medicine (Urgent Care)	0	In state provider	None	555 EAST HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
63478	Fee-for-Service	1174554182	1174554182	1	1	ESCARZA, SOTERO J MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	48879	05	Anesthesiology	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
63506	Fee-for-Service	1144319039	1144319039	1	1	EVANS, EDWARD T MD	1/8/1974	No Taxonomy Provided	NA	None	026	PHYSICIANS	22103	30	Radiology	0	In state provider	None	652 PETALUMA AVE	STE I	SEBASTOPOL	CA	95472	4266	49	06097	38.39662494	-122.8201368	Sonoma County
63552	Fee-for-Service	1487650313	1487650313	1	1	EASTERN PLUMAS HEALTH CARE	6/13/1994	261Q00000X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	7597 HWY 89	None	GRAEAGLE	CA	96103	0000	32	06063	39.76866912	-120.6195902	Plumas County
63567	Fee-for-Service	1154730828	1154730828	1	5	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8902 WOODMAN AVE	None	ARLETA	CA	91331	6401	19	06037	34.23141203	-118.4374526	Los Angeles County
63608	Fee-for-Service	1376305755	1376305755	1	3	EM ALLIANCE CALIFORNIA, APC	3/1/2024	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
63697	Fee-for-Service	1588427587	1588427587	1	1	ENHANCED CARE MANAGEMENT	7/8/2024	193400000X	NA	Other	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	1668 S GARFIELD AVE	FL 2	ALHAMBRA	CA	91801	5400	19	06037	34.07553674	-118.1229866	Los Angeles County
63715	Fee-for-Service	1396482303	1396482303	1	1	EASON, BRITTANY LCSW	7/15/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4241 JUTLAND DR	320	SAN DIEGO	CA	92117	3663	37	06073	32.82458459	-117.2275063	San Diego County
63779	Fee-for-Service	1245244664	1245244664	1	1	ECONOMOU, JAMES S MD	11/30/1987	2086X0206X	NA	General Surgery	026	PHYSICIANS	40192	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
63844	Fee-for-Service	1487650313	1487650313	1	1	EASTERN PLUMAS HEALTH CARE	6/13/1994	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	7597 HWY 89	None	GRAEAGLE	CA	96103	0000	32	06063	39.76866912	-120.6195902	Plumas County
63845	Fee-for-Service	1174710339	1174710339	1	1	EFIRD, THOMAS I MD	8/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92604	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
63858	Fee-for-Service	1154730828	1154730828	1	5	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8902 WOODMAN AVE	None	ARLETA	CA	91331	6401	19	06037	34.23141203	-118.4374526	Los Angeles County
63864	Fee-for-Service	1083925739	1083925739	1	1	ELANGOVAN, INITHA R MD	10/20/2017	207RP1001X	NA	Pulmonology	026	PHYSICIANS	144190	41	Internal Medicine	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
63949	Fee-for-Service	1316050107	1316050107	1	1	EL DORADO COUNTY COMM	9/10/2004	261QC1500X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	4212 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6269	09	06017	38.706228	-120.834891	El Dorado County
63991	Fee-for-Service	1952318289	1952318289	1	1	EDWARD ERIBE MD	11/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3255 LT MOSS RD	None	MISSOULA	MT	59804	7220	00	None	46.839843	-114.058935	Missoula County
64035	Fee-for-Service	1881965143	1881965143	1	1	ELKARRA, MANAL I MD	1/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127577	01	General Practice	0	In state provider	None	2200 O'FARRELL STREET	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
64099	Fee-for-Service	1063969509	1063969509	1	1	EYE SPECIALISTS OF CALIFORNI	12/7/2022	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1955 CITRACADO PARKWAY	#301	ESCONDIDO	CA	92029	4113	37	06073	33.11301099	-117.1202081	San Diego County
64106	Fee-for-Service	1558484519	1558484519	1	1	EGGLESTON, BEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4401 HARRISON BLVD	None	OGDEN	UT	84403	3195	00	None	41.18328	-111.9536955	Weber County
64146	Fee-for-Service	1154730828	1154730828	1	5	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8902 WOODMAN AVE	None	ARLETA	CA	91331	6401	19	06037	34.23141203	-118.4374526	Los Angeles County
64157	Fee-for-Service	1386750198	1386750198	1	1	EAST LOS ANGELES ENT MEDICAL	8/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	83484	None	None	0	In state provider	CENTER	533 W LAS TUNAS DR	202	SAN GABRIEL	CA	91776	1133	19	06037	34.10247828	-118.1075627	Los Angeles County
64197	Fee-for-Service	1669776191	1669776191	1	1	EXPRESS MEDICAL SUPPLIES	1/19/2012	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	8454 SUNLAND BLVD	None	SUN VALLEY	CA	91352	3436	19	06037	34.22405394	-118.3655745	Los Angeles County
64218	Fee-for-Service	1669608121	1669608121	1	1	EMORY, KIRAN A MD	11/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	100362	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
64237	Fee-for-Service	1316050107	1316050107	1	1	EL DORADO COUNTY COMM	9/10/2004	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	4212 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6269	09	06017	38.706228	-120.834891	El Dorado County
64249	Fee-for-Service	1013972785	1013972785	1	1	ENGELHARDT, ELIZABETH L	2/8/2015	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	2	Out of state provider	MD	2811 TIETON DRIVE	None	YAKIMA	WA	98902	3761	00	None	46.59274567	-120.54785	Yakima County
64266	Fee-for-Service	1083067995	1083067995	1	1	EVERGREEN SHOP PHARMACY INC	11/19/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	150 S GRAND AVE	UNIT K	GLENDORA	CA	91741	4715	19	06037	34.13462554	-117.8725267	Los Angeles County
64322	Fee-for-Service	1336180751	1336180751	1	1	ECKARD, VALERIE R MD	4/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	52585	30	Radiology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
64355	Fee-for-Service	1477997336	1477997336	1	1	EMDADI, ARAS DO	9/3/2020	208600000X	NA	General Surgery	026	PHYSICIANS	17463	02	General Surgery	0	In state provider	None	3660 PARK SIERRA DRIVE	SUITE 105	RIVERSIDE	CA	92505	3071	33	06065	33.90330693	-117.4707039	Riverside County
64404	Fee-for-Service	1720058415	1720058415	1	1	ENLOE-WHITAKER, SUZANNE	7/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	7535	41	Internal Medicine	0	In state provider	DO	1700 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	5115	36	06071	34.130214	-117.2788065	San Bernardino County
64461	Fee-for-Service	1346357696	1346357696	1	1	EGAN, JAMES V MD	4/30/1988	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	59413	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
64522	Fee-for-Service	1316134802	1316134802	1	1	ECKHARDT, SUZANNE CP	7/16/2007	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	637 LUCAS AVE	STE 609	LOS ANGELES	CA	90017	1912	19	06037	34.05351827	-118.2646017	Los Angeles County
64526	Fee-for-Service	1316050107	1316050107	1	1	EL DORADO COUNTY COMM	12/4/2007	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	4212 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6269	09	06017	38.706228	-120.834891	El Dorado County
64646	Fee-for-Service	1477997336	1477997336	1	1	EMDADI, ARAS DO	9/3/2020	208600000X	NA	General Surgery	026	PHYSICIANS	17463	28	Proctology (colon and rectal)	0	In state provider	None	3660 PARK SIERRA DRIVE	SUITE 105	RIVERSIDE	CA	92505	3071	33	06065	33.90330693	-117.4707039	Riverside County
64692	Fee-for-Service	1720058415	1720058415	1	1	ENLOE-WHITAKER, SUZANNE	7/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	7535	83	Rheumatology	0	In state provider	DO	1700 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	5115	36	06071	34.130214	-117.2788065	San Bernardino County
64757	Fee-for-Service	1427354299	1427354299	1	1	EGAN, BARBARA E LCSW	7/27/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	135 CARMEN LANE	None	SANTA MARIA	CA	93454	4607	42	06083	34.92484952	-120.4374645	Santa Barbara County
64845	Fee-for-Service	1548656713	1548656713	1	1	ELDREDGE, JOANNA B MD	10/19/2021	207R00000X	NA	Other	026	PHYSICIANS	155868	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
64849	Fee-for-Service	1407811128	1407811128	1	1	EDMISTON, WALTER A MD	10/17/1987	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	23064	06	Cardiovascular Disease (M.D. only)	0	In state provider	A MEDICAL CORPORATION	1720 BROOKLYN AVE	BLDG 1231	LOS ANGELES	CA	90033	2462	19	06037	34.040502	-118.191954	Los Angeles County
64870	Fee-for-Service	1487644993	1487644993	1	1	ELLIS HOSPITAL	9/19/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1101 NOTT STREET	None	SCHENECTADY	NY	12308	2425	00	None	42.819975	-73.9165185	Schenectady County
64907	Fee-for-Service	1730548249	1730548249	1	1	ELLIS, ANNE-MICHELLE LCSW	2/7/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2743, 2709, 2759 ORANGE	None	RIVERSIDE	CA	92501	2538	33	06065	33.99094851	-117.3667964	Riverside County
65158	Fee-for-Service	1487644993	1487644993	1	1	ELLIS HOSPITAL	9/19/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1101 NOTT STREET	None	SCHENECTADY	NY	12308	2425	00	None	42.819975	-73.9165185	Schenectady County
65172	Fee-for-Service	1619030194	1619030194	1	1	EL-SAID, HOWAIDA G MD	2/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93820	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
65280	Fee-for-Service	1336296862	1336296862	1	1	EHRLICH, MARTIN LEO, MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68564	None	None	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
65339	Fee-for-Service	1487324844	1487324844	1	1	EDITH KYEBASUUTA BROUGHTON	10/21/2021	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	13629 ERIN DRIVE	None	MORENO VALLEY	CA	92555	2524	33	06065	33.922647	-117.206199	Riverside County
65374	Fee-for-Service	1881923233	1881923233	1	1	EICHELBERGER, JON G MD	2/4/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	49685	08	Family Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
65428	Fee-for-Service	1972821213	1972821213	1	1	EDWARDS, ANDREA G MD INC	2/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	83742	68	Hematology	0	In state provider	None	1663 DOMINICAN WAY	SUITE 210	SANTA CRUZ	CA	95065	1527	44	06087	36.99029729	-121.9809324	Santa Cruz County
65458	Fee-for-Service	1619030194	1619030194	1	1	EL-SAID, HOWAIDA G MD	2/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93820	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
65534	Fee-for-Service	1336386853	1336386853	1	1	EHSANI, HAMID MD	9/20/2022	207P00000X	NA	Other	026	PHYSICIANS	179463	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
65574	Fee-for-Service	1134455348	1134455348	2	1	EPSTEIN, ALYSSA M PHD	11/2/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 SMITH RANCH RD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
65626	Fee-for-Service	1487324844	1487324844	1	1	EDITH KYEBASUUTA BROUGHTON	10/21/2021	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	13629 ERIN DRIVE	None	MORENO VALLEY	CA	92555	2524	33	06065	33.922647	-117.206199	Riverside County
65675	Fee-for-Service	1275760662	1275760662	1	1	ENG, LIANA L MD	2/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115741	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
65684	Fee-for-Service	1700368974	1700368974	1	1	ELLIS, LAUREN LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
65716	Fee-for-Service	1972821213	1972821213	1	1	EDWARDS, ANDREA G MD INC	2/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	83742	78	Neoplastic Diseases/Oncology	0	In state provider	None	1663 DOMINICAN WAY	SUITE 210	SANTA CRUZ	CA	95065	1527	44	06087	36.99029729	-121.9809324	Santa Cruz County
65824	Fee-for-Service	1972747350	1972747350	1	1	ETHAN MEZOFF	5/3/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
65839	Fee-for-Service	1073559514	1073559514	1	1	ESCARA, FELY T MD	6/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	31231	05	Anesthesiology	0	In state provider	None	1805 N CALIFORNIA ST	STE 101A	STOCKTON	CA	95204	6032	39	06077	37.9711691	-121.2894221	San Joaquin County
65950	Fee-for-Service	1043369416	1043369416	1	1	EWBANK, CLIFTON R MD	6/2/2022	208600000X	NA	General Surgery	026	PHYSICIANS	149659	None	None	0	In state provider	None	786 3RD AVE	STE B	CHULA VISTA	CA	91910	5826	37	06073	32.62477162	-117.0734615	San Diego County
66131	Fee-for-Service	1104818434	1104818434	1	1	EMERGENCY MEDICAL SERVICE	4/14/2013	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1213 E 20TH ST	None	OKMULGEE	OK	74447	6301	00	None	35.61002153	-95.95669196	Okmulgee County
66132	Fee-for-Service	1174118178	1174118178	1	1	EVERETT HOME HEALTH	8/5/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3318 W BURBANK BLVD	STE A	BURBANK	CA	91505	2230	19	06037	34.17573397	-118.3470279	Los Angeles County
66143	Fee-for-Service	1437355534	1437355534	1	1	ELQUZA, EMAD MD	5/22/2020	207RX0202X	NA	Oncology	026	PHYSICIANS	167835	41	Internal Medicine	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
66188	Fee-for-Service	1558402842	1558402842	1	1	EL CENTRO ELEM SD	7/1/1994	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1256 BROADWAY ST	None	EL CENTRO	CA	92243	2317	13	06025	32.79388767	-115.5662308	Imperial County
66293	Fee-for-Service	1386702140	1386702140	1	1	ELLIS, RICHARD A DO	10/28/2022	207QS0010X	NA	Adult Primary Care	026	PHYSICIANS	12609	None	None	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
66360	Fee-for-Service	1750682779	1750682779	2	1	EMERGENCY MEDICINE PHYS OF	12/31/2012	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	CLARK SAINT ROSE MCCOURT	3001 SAINT ROSE PKWY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
66436	Fee-for-Service	1992954465	1992954465	1	1	EGASANI-ELISES, MA THERESA V	10/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126362	08	Family Practice	0	In state provider	MD	1450 TREAT BLVD	SUITE 160	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
66654	Fee-for-Service	1275528713	1275528713	1	1	ELKOTB, MOHAMED MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13677 W MCDOWELL RD	None	GOODYEAR	AZ	85395	2635	00	None	33.461982	-112.3535475	Maricopa County
66838	Fee-for-Service	1396063574	1396063574	1	1	ELGHAZI, FARES MD MEDICAL	12/20/2010	193400000X	NA	Other	026	PHYSICIANS	42219	13	Neurology (M.D. only)	0	In state provider	CORPORATION	1818 N ORANGE GROVE	STE 300	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
66911	Fee-for-Service	1790700144	1790700144	1	1	ESPINOZA, RANDALL T MD	10/1/1996	2084P0805X	NA	Psychiatry	026	PHYSICIANS	50906	36	Psychiatry	0	In state provider	None	300 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
66992	Fee-for-Service	1235282559	1235282559	1	1	EVANS, CLINTON E	4/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	8919	08	Family Practice	0	In state provider	None	2510 AIRPARK DR	STE 301	REDDING	CA	96001	2462	45	06089	40.57119566	-122.4016582	Shasta County
67007	Fee-for-Service	1023222908	1023222908	1	1	EDELSTEIN, SUSAN MD INC	5/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	62071	10	Gastroenterology (M.D. only)	0	In state provider	None	150 N ROBERTSON BLVD	STE 204	BEVERLY HILLS	CA	90211	2144	19	06037	34.06812722	-118.3837146	Los Angeles County
67162	Fee-for-Service	1366961914	1366961914	1	1	EMERGENCY PHYSICIANS URGENT	9/29/2020	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9917 OLIVE DR	None	BAKERSFIELD	CA	93312	9729	15	06029	35.41293571	-119.1123208	Kern County
67201	Fee-for-Service	1265774426	1265774426	1	1	EMEH, OGBUGO K MD	2/20/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	5400 S RAINBOW RD	None	LAS VEGAS	NV	89118	1859	00	None	36.090072	-115.2405585	Clark County
67239	Fee-for-Service	1215239603	1215239603	1	1	ESFANDIARI, ALI PHD	3/3/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	750 B	2870	SAN DIEGO	CA	92101	8114	37	06073	32.71782447	-117.157905	San Diego County
67263	Fee-for-Service	1619043437	1619043437	1	1	ENGLISH, MARLA J LCSW	8/27/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3233 3RD AVE	None	SAN DIEGO	CA	92103	5615	37	06073	32.73916528	-117.1621706	San Diego County
67295	Fee-for-Service	1023222908	1023222908	1	1	EDELSTEIN, SUSAN MD INC	5/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	62071	40	Pediatrics	0	In state provider	None	150 N ROBERTSON BLVD	STE 204	BEVERLY HILLS	CA	90211	2144	19	06037	34.06812722	-118.3837146	Los Angeles County
67399	Fee-for-Service	1689848533	1689848533	1	1	EDWARDS-BURROLA, KATHRYN M	10/26/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	47074	-	NOT APPLICABLE	0	In state provider	MFT	165 CLAY ST	None	SALINAS	CA	93901	2509	27	06053	36.67006578	-121.6591741	Monterey County
67451	Fee-for-Service	1366961914	1366961914	1	1	EMERGENCY PHYSICIANS URGENT	9/18/2018	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	9917 OLIVE DR	None	BAKERSFIELD	CA	93312	9729	15	06029	35.41293571	-119.1123208	Kern County
67474	Fee-for-Service	1184701112	1184701112	1	1	ELAINE LEE, O.D. INC.	5/30/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	19201 BEAR VALLEY RD	None	APPLE VALLEY	CA	92308	6763	36	06071	34.468614	-117.243513	San Bernardino County
67476	Fee-for-Service	1215063151	1215063151	1	1	EMANATE HEALTH MEDICAL	5/17/1996	273R00000X	NA	Other	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	CENTER	210 W SAN BERNARDINO RD	None	COVINA	CA	91723	1515	19	06037	34.088004	-117.893475	Los Angeles County
67544	Fee-for-Service	1588735542	1588735542	1	1	EFFIMOFF, CHRISTINE L MD	12/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	61922	08	Family Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
67568	Fee-for-Service	1578740007	1578740007	1	1	EASTSIDE NEIGHBORHOOD CL	11/21/2005	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	SANTA BARBARA NGHBRHD CL	915 N MILPAS ST	None	SANTA BARBARA	CA	93103	2331	42	06083	34.43040726	-119.6909855	Santa Barbara County
67600	Fee-for-Service	1871156729	1871156729	1	1	EASI HOSPICE INC	11/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	102 E PROSPECT AVE	None	BURBANK	CA	91502	2035	19	06037	34.1727361	-118.3004725	Los Angeles County
67620	Fee-for-Service	1669995817	1669995817	1	1	ENG, EMILY OD	1/21/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
67638	Fee-for-Service	1912948480	1912948480	1	1	ELGIN, THOMAS M MD	1/24/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	55569	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9920 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.7016655	-117.955521	Orange County
67679	Fee-for-Service	1760761142	1760761142	1	1	ESKRIDGE, ELIZABETH N	3/5/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	11600 WILSHIRE BLVD	STE 114	LOS ANGELES	CA	90025	1733	19	06037	34.05055194	-118.4594619	Los Angeles County
67725	Fee-for-Service	1962133843	1962133843	1	1	EVANS, HENRY J NP	8/5/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
67745	Fee-for-Service	1477790715	1477790715	1	2	EVELAND, JOANNA J MD	3/11/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	106039	None	None	0	In state provider	None	5189 HOSPITAL RD	None	MARIPOSA	CA	95338	9524	22	06043	37.50033166	-119.9769163	Mariposa County
67800	Fee-for-Service	1932338241	1932338241	1	1	EL DORADO COMMUNITY SERVICE	11/17/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	1733 EUCLID AVE	None	SAN DIEGO	CA	92105	5414	37	06073	32.72248701	-117.0848929	San Diego County
67805	Fee-for-Service	1033448782	1033448782	1	1	ENDOSCOPY SURGERY CENTER	1/1/2010	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SILICON VALLEY	2410 SAMARITAN DR	STE 101	SAN JOSE	CA	95124	3909	43	06085	37.25107654	-121.9451342	Santa Clara County
67831	Fee-for-Service	1366051120	1366051120	1	4	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3234 MARYSVILLE BLVD	None	SACRAMENTO	CA	95815	1411	34	06067	38.626371	-121.4322615	Sacramento County
67856	Fee-for-Service	1982619441	1982619441	1	1	EVE BOYD ESPEY MD	11/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2719	00	None	35.08771808	-106.6192188	Bernalillo County
67883	Fee-for-Service	1891307179	1891307179	1	1	EMPYREAN HOSPICE AND	3/28/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	2396 E FOOTHILL BLVD	None	PASADENA	CA	91107	2397	19	06037	34.14975868	-118.101	Los Angeles County
67887	Fee-for-Service	1871156729	1871156729	1	1	EASI HOSPICE INC	11/1/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	102 E PROSPECT AVE	None	BURBANK	CA	91502	2035	19	06037	34.1727361	-118.3004725	Los Angeles County
67953	Fee-for-Service	1598127896	1598127896	1	1	ESWARAN, VIDYA MD	6/26/2020	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
68006	Fee-for-Service	1750498440	1750498440	1	1	EASTWEST PROTO INC	9/28/2009	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LIFELINE AMBULANCE	6605 E WASHINGTON BLVD	None	COMMERCE	CA	90040	1813	19	06037	34.00001216	-118.135794	Los Angeles County
68048	Fee-for-Service	1881057255	1881057255	1	1	ESPINOSA, RAQUEL J MD	3/18/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157966	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
68081	Fee-for-Service	1225505100	1225505100	1	1	ESQUIVEL, GENEVIE LMFT	10/24/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
68088	Fee-for-Service	1932338241	1932338241	1	1	EL DORADO COMMUNITY SERVICE	2/9/2015	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	1733 EUCLID AVE	None	SAN DIEGO	CA	92105	5414	37	06073	32.72248701	-117.0848929	San Diego County
68119	Fee-for-Service	1366051120	1366051120	1	4	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3234 MARYSVILLE BLVD	None	SACRAMENTO	CA	95815	1411	34	06067	38.626371	-121.4322615	Sacramento County
68135	Fee-for-Service	1831926393	1831926393	1	1	EASTERN SUN LTD. LIABILITY	9/26/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	CO.	29751 ANA MARIA LN	None	LAGUNA NIGUEL	CA	92677	1004	30	06059	33.53017582	-117.7138464	Orange County
68172	Fee-for-Service	1891307179	1891307179	1	1	EMPYREAN HOSPICE AND	3/28/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	2396 E FOOTHILL BLVD	None	PASADENA	CA	91107	2397	19	06037	34.14975868	-118.101	Los Angeles County
68186	Fee-for-Service	1992124093	1992124093	1	1	EMELIFE, NANCY N MD	6/19/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	166392	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
68223	Fee-for-Service	1760975478	1760975478	1	1	EZEH, BETTY CNP	3/14/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8491 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90069	4218	19	06037	34.08988507	-118.3757716	Los Angeles County
68281	Fee-for-Service	1629156435	1629156435	1	1	EDWARDS, JAMES L MD	12/4/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	38232	36	Psychiatry	0	In state provider	None	107 PANORAMIC WAY	None	BERKELEY	CA	94704	1829	01	06001	37.86911094	-122.248688	Alameda County
68332	Fee-for-Service	1952950263	1952950263	1	1	EVANS, JENNIFER A CNP	1/22/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	401 VERNON ST	STE B	ROSEVILLE	CA	95678	2600	31	06061	38.74793156	-121.2853565	Placer County
68406	Fee-for-Service	1376968446	1376968446	1	1	ELMORE, DEBORAH M LMFT	1/7/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20 SHADOWBROOK STREET #6	None	LOLETA	CA	95551	0619	12	06023	40.64454083	-124.2187973	Humboldt County
68410	Fee-for-Service	1366051120	1366051120	1	4	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3234 MARYSVILLE BLVD	None	SACRAMENTO	CA	95815	1411	34	06067	38.626371	-121.4322615	Sacramento County
68412	Fee-for-Service	1467406132	1467406132	1	1	EMORY EASTSIDE MED CTR	6/1/1999	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1700 MEDICAL WAY	None	SNELLVILLE	GA	30078	2195	00	None	33.87782891	-84.01980642	Gwinnett County
68484	Fee-for-Service	1992928188	1992928188	1	1	EUBANK, ANDREW C PT	12/12/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	511 BATH ST	None	SANTA BARBARA	CA	93101	3403	42	06083	34.41386476	-119.6993335	Santa Barbara County
68578	Fee-for-Service	1891292025	1891292025	1	1	ELUMN, ALBERT J MD	3/25/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
68700	Fee-for-Service	1467406132	1467406132	1	1	EMORY EASTSIDE MED CTR	6/1/1999	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1700 MEDICAL WAY	None	SNELLVILLE	GA	30078	2195	00	None	33.87782891	-84.01980642	Gwinnett County
68742	Fee-for-Service	1154730828	1154730828	1	1	EL PROYECTO DEL BARRIO INC	10/1/2014	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	3942 MAINE AVE	None	BALDWIN PARK	CA	91706	4220	19	06037	34.0845949	-117.961636	Los Angeles County
68807	Fee-for-Service	1912529157	1912529157	1	1	EIV DIAGNOSTICS LLC	10/1/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	1477 E SHAW AVE	STE 170	FRESNO	CA	93710	8021	10	06019	36.80832659	-119.7614085	Fresno County
68846	Fee-for-Service	1831573633	1831573633	1	1	EMODI, KRISZTINA NP	5/30/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
68968	Fee-for-Service	1740346741	1740346741	1	1	ERICKSON, PAUL J MD	12/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86595	36	Psychiatry	0	In state provider	None	PUEBLO AT BATH STREET	None	SANTA BARBARA	CA	93102	0000	42	06083	34.430526	-119.72196	Santa Barbara County
68975	Fee-for-Service	1326582404	1326582404	1	1	ESQUERRA, LUCAS PT	11/19/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
69031	Fee-for-Service	1154730828	1154730828	1	1	EL PROYECTO DEL BARRIO INC	2/8/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	3942 MAINE AVE	None	BALDWIN PARK	CA	91706	4220	19	06037	34.0845949	-117.961636	Los Angeles County
69037	Fee-for-Service	1487195640	1487195640	1	1	EDMUNDSON, MORIAH N DO	8/11/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	16984	None	None	0	In state provider	None	26800 CROWN VALLEY PKWY	525, 545	MISSION VIEJO	CA	92691	8030	30	06059	33.56286021	-117.6673449	Orange County
69243	Fee-for-Service	1669227690	1669227690	1	1	ESPLANA, JOHN CNP	6/13/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
69266	Fee-for-Service	1063505972	1063505972	1	1	EDWARDS, CHARLES L MD	4/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	12322	36	Psychiatry	0	In state provider	None	13975 MONO WAY	STE G	SONORA	CA	95370	2824	55	06109	37.97831488	-120.3396851	Tuolumne County
69300	Fee-for-Service	1073086310	1073086310	1	1	ELISON, CASEY J CRNA	5/3/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
69319	Fee-for-Service	1154730828	1154730828	1	1	EL PROYECTO DEL BARRIO INC	10/1/2014	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	3942 MAINE AVE	None	BALDWIN PARK	CA	91706	4220	19	06037	34.0845949	-117.961636	Los Angeles County
69343	Fee-for-Service	1477790715	1477790715	1	1	EVELAND, JOANNA J MD	7/19/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	106039	-	NOT APPLICABLE	0	In state provider	None	230 GOLDEN GATE AVE	None	SAN FRANCISCO	CA	94102	3706	38	06075	37.78184696	-122.4142203	San Francisco County
69352	Fee-for-Service	1659451011	1659451011	1	1	ESPINOZA, GEORGE R	9/14/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1040 ELM AVE	STE 100	LONG BEACH	CA	90813	3265	19	06037	33.779799	-118.1879535	Los Angeles County
69375	Fee-for-Service	1316025083	1316025083	1	1	ELTORAI, MAHMOUD MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	50623	10	Gastroenterology (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
69401	Fee-for-Service	1043896061	1043896061	1	1	EYELLIANCE VISION PARTNERS A	3/13/2023	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	NAPA VALLEY	800 TRANCAS ST	SUITE B	NAPA	CA	94558	3044	28	06055	38.32419306	-122.2923825	Napa County
69433	Fee-for-Service	1063776516	1063776516	1	1	EISNER, JOSEPH A MD	8/15/2017	208600000X	NA	General Surgery	026	PHYSICIANS	128860	02	General Surgery	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
69498	Fee-for-Service	1659428084	1659428084	2	1	ECHMED MEDICAL SUPPLY INC	7/25/2019	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	101 N VICTORY BLVD	B	BURBANK	CA	91502	1847	19	06037	34.17368068	-118.3166235	Los Angeles County
69617	Fee-for-Service	1598932006	1598932006	1	1	EPSTEIN, VICTORIA MD	10/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109315	84	Surgery-Head and Neck	0	In state provider	None	450 6TH AVE	None	SAN FRANCISCO	CA	94118	3010	38	06075	37.7802547	-122.4642049	San Francisco County
69625	Fee-for-Service	1669473195	1669473195	1	1	EHRLICH, BETH A	7/1/2013	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	20101 LAKE CHABOT ROAD	FL 3	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
69703	Fee-for-Service	1659515054	1659515054	1	1	EASTER-GRIFFIN, TAMEIKA LMF	3/28/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T	1213 COFFEE AVE	STE P	MODESTO	CA	95355	4229	50	06099	37.660401	-120.975669	Stanislaus County
69723	Fee-for-Service	1265863096	1265863096	2	1	ECKLOR, TIFFANY L LMFT	1/1/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18245 HIGHWAY 18	STE 6	APPLE VALLEY	CA	92307	2217	36	06071	34.54026632	-117.2656302	San Bernardino County
69741	Fee-for-Service	1891984670	1891984670	1	1	EJ GUZMAN, MD INC	9/26/2017	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11514 ROSECRANS AVE	None	NORWALK	CA	90650	3802	19	06037	33.9020805	-118.088145	Los Angeles County
69775	Fee-for-Service	1609854173	1609854173	1	1	EDSON KNAPP	7/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4300 BARTLETT ST	None	HOMER	AK	99603	7005	00	None	59.65210843	-151.5501715	Kenai Peninsula Borough
69779	Fee-for-Service	1154378487	1154378487	1	1	EURASQUIN, WANDA E	7/7/2004	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1801 W ROMNEYA DR	STE 205	ANAHEIM	CA	92801	1825	30	06059	33.8506615	-117.946413	Orange County
69860	Fee-for-Service	1568060499	1568060499	1	1	ESSENTIAL PEACE OF MIND MARR	3/23/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	IAGE AND FAMILY THERAPY,	1451 CEDARMEADOW CT	None	SAN JOSE	CA	95131	3741	43	06085	37.38655272	-121.890768	Santa Clara County
69935	Fee-for-Service	1457518946	1457518946	1	1	EVANS, KIMBERLY A MD	8/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112322	02	General Surgery	0	In state provider	None	1090 THIRD STREET	SUITE B	SOUTH LAKE TAHOE	CA	96150	3462	09	06017	38.91492536	-119.9966528	El Dorado County
70085	Fee-for-Service	1861426314	1861426314	1	1	ESMAILIAN, FARDAD	3/31/1989	208G00000X	NA	General Surgery	026	PHYSICIANS	64353	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
70098	Fee-for-Service	1184706343	1184706343	1	1	EMANI, VENKATA R MD	4/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80313	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2800 N CALIFORNIA ST	STE 14	STOCKTON	CA	95204	3759	39	06077	37.97782434	-121.2919633	San Joaquin County
70118	Fee-for-Service	1396856373	1396856373	1	1	ENRIGHT, ANDREA M MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66201	40	Pediatrics	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
70305	Fee-for-Service	1487296190	1487296190	1	1	EGBERT, LINDSAY CRNA	9/11/2020	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
70477	Fee-for-Service	1780131003	1780131003	1	1	EWELL, SHERMON LMFT	10/20/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
70563	Fee-for-Service	1093802225	1093802225	1	1	ENDOSCOPY CENTER OF	7/27/1995	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CHULA VISTA, A CORP	681 3RD AVE	STE B	CHULA VISTA	CA	91910	5703	37	06073	32.6284656	-117.0748498	San Diego County
70622	Fee-for-Service	1003025032	1003025032	1	1	EL ABIAD, RAMI MD	11/10/2021	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
70659	Fee-for-Service	1306351895	1306351895	1	1	EBIZADEH, PAYAM MD	12/13/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	109881	01	General Practice	0	In state provider	None	22110 ROSCOE BLVD	STE 201	CANOGA PARK	CA	91304	3861	19	06037	34.21957849	-118.6082685	Los Angeles County
70772	Fee-for-Service	1093038127	1093038127	1	1	EIDAL,BRYAN OD OPTOMETRIC	4/6/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1630 11TH ST	None	REEDLEY	CA	93654	2902	10	06019	36.59686247	-119.4501247	Fresno County
70815	Fee-for-Service	1689627143	1689627143	1	1	ESLAMI, MICHELLE S MD	11/30/1993	207R00000X	NA	Other	026	PHYSICIANS	53670	38	Geriatrics	0	In state provider	None	200 MED PLAZA	STE 365	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
70867	Fee-for-Service	1033493374	1033493374	1	1	ELKINS, BRIONNE PHD	9/20/2024	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
70874	Fee-for-Service	1689860389	1689860389	1	1	ELLIS, CHANDRA V MD	6/6/2017	2086S0122X	NA	General Surgery	026	PHYSICIANS	93565	24	Plastic Surgery	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
70905	Fee-for-Service	1306344510	1306344510	1	1	EL CAMINO HOSPITAL	2/27/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2500 GRANT RD	STE 1B20	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
70929	Fee-for-Service	1386925329	1386925329	1	1	EPPERSON, MARY L CNP	7/22/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	45	06089	40.57278686	-122.3958519	Shasta County
70964	Fee-for-Service	1902333644	1902333644	1	1	EWA KOZLOWSKA	9/10/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10200 NE 132ND ST	None	KIRKLAND	WA	98034	2831	00	None	47.71853274	-122.2042278	King County
70970	Fee-for-Service	1740316900	1740316900	1	1	ECKBURG, PAUL MD	3/1/1999	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	63142	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
71045	Fee-for-Service	1295088672	1295088672	1	1	ENDRIGA, JONATHAN OT	10/3/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
71088	Fee-for-Service	1154749844	1154749844	1	1	EKEANYA, NORA N DO	3/5/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	22571	None	None	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
71105	Fee-for-Service	1912771569	1912771569	1	1	EMERGENCY PHYSICIANS OF ORAN	6/14/2024	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	GE COUNTY	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
71121	Fee-for-Service	1508995986	1508995986	1	1	ESAKOFF, TANIA F MD	5/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89210	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
71162	Fee-for-Service	1982602298	1982602298	1	1	EDILLON, EDWIN L MD	5/16/2009	2086S0129X	NA	General Surgery	026	PHYSICIANS	38045	01	General Practice	0	In state provider	SUNSET MEDICAL CLINIC	906 S SUNSET AVE	STE 103	WEST COVINA	CA	91790	3400	19	06037	34.06466364	-117.9424724	Los Angeles County
71252	Fee-for-Service	1851634612	1851634612	1	1	ERICKSON, KYLE N DO	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13613	41	Internal Medicine	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
71255	Fee-for-Service	1134767817	1134767817	1	1	ENRICO DALISAY PHYSICAL THER	6/18/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	APY INC	3535 E 7TH ST	None	LONG BEACH	CA	90804	5138	19	06037	33.77536647	-118.15047	Los Angeles County
71345	Fee-for-Service	1568713659	1568713659	1	1	ELLIS, ASHLEY	7/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
71404	Fee-for-Service	1992167076	1992167076	1	1	ESFANDIARIFARD, SAGHI MD	6/30/2022	207RH0003X	NA	Oncology	026	PHYSICIANS	160963	None	None	0	In state provider	None	18433 ROSCOE BLVD	SUITE 106	NORTHRIDGE	CA	91325	4129	19	06037	34.22076747	-118.534725	Los Angeles County
71412	Fee-for-Service	1326507393	1326507393	1	1	ELZUBEIR, HIBA MD	12/18/2022	208M00000X	NA	Other	026	PHYSICIANS	177879	None	None	0	In state provider	None	15615 POMERADO ROAD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
71519	Fee-for-Service	1790994523	1790994523	1	1	ESENER, DASIA E MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115742	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
71520	Fee-for-Service	1669488821	1669488821	1	1	EDELSTEIN, MARC A MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	61509	10	Gastroenterology (M.D. only)	0	In state provider	None	150 N ROBERTSON BLVD	STE 205	BEVERLY HILLS	CA	90211	2144	19	06037	34.06812722	-118.3837146	Los Angeles County
71603	Fee-for-Service	1497944656	1497944656	1	1	EL-KAREH, ROBERT E MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112957	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
71651	Fee-for-Service	1033682331	1033682331	1	1	ERIC NAASZ DPM INC	1/3/2025	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	CIALISTS	704 N HARBOR BLVD	None	FULLERTON	CA	92832	1520	30	06059	33.87672293	-117.9243089	Orange County
71770	Fee-for-Service	1629348669	1629348669	1	2	EMERALD TRIUNE HOME HEALTH	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	253 S ESCONDIDO BLVD	None	ESCONDIDO	CA	92025	4116	37	06073	33.11877301	-117.083187	San Diego County
71795	Fee-for-Service	1346842754	1346842754	1	1	ESCASENA, DIAVONTI	9/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1103 BUTTE HOUSE RD	SUITE E	YUBA CITY	CA	95991	3109	51	06101	39.14536728	-121.6306637	Sutter County
71811	Fee-for-Service	1669488821	1669488821	1	1	EDELSTEIN, MARC A MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	61509	41	Internal Medicine	0	In state provider	None	150 N ROBERTSON BLVD	STE 205	BEVERLY HILLS	CA	90211	2144	19	06037	34.06812722	-118.3837146	Los Angeles County
71843	Fee-for-Service	1992326391	1992326391	1	1	ESQUIVEL-VALDEZ, ABIGAIL LC	7/5/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
71971	Fee-for-Service	1407245293	1407245293	1	1	ELIM MEDICAL, INC.	5/5/2016	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	604 W MISSION BLVD	None	POMONA	CA	91766	1535	19	06037	34.05493247	-117.7558245	Los Angeles County
72048	Fee-for-Service	1003362435	1003362435	1	1	ELMS, JEFFREY W CPO	9/23/2016	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 OLD RIVER RD	STE 100	BAKERSFIELD	CA	93311	9504	15	06029	35.35127492	-119.1142991	Kern County
72144	Fee-for-Service	1285810994	1285810994	1	2	EAST-WEST EYE INSTITUTE A ME	7/22/2013	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	50 ALESSANDRO PL	SUITE 150	PASADENA	CA	91105	3169	19	06037	34.13101049	-118.151532	Los Angeles County
72159	Fee-for-Service	1881958064	1881958064	1	1	EDMUNDS, MICHELLE A MD	7/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129816	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
72211	Fee-for-Service	1366690018	1366690018	1	1	EMEMBOLU, FEYI N MD	7/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111176	66	Emergency Medicine (Urgent Care)	0	In state provider	None	43830 N 10TH ST WEST	None	LANCASTER	CA	93534	4826	19	06037	34.67913961	-118.1478725	Los Angeles County
72214	Fee-for-Service	1770050460	1770050460	1	1	ETHAN J BAUGHMAN MD INC A ME	6/30/2020	2086S0122X	NA	General Surgery	026	PHYSICIANS	None	24	Plastic Surgery	0	In state provider	DICAL CORPORATION	32144 AGOURA RD	STE 220	WESTLAKE VILLAGE	CA	91361	4057	56	06111	34.14848408	-118.8208595	Los Angeles County
72350	Fee-for-Service	1003493735	1003493735	1	1	ELAMSENTHIL, SUHANA MD	8/26/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	30 MARK WEST SPRINGS RD	None	SANTA ROSA	CA	95403	1436	49	06097	38.4962723	-122.752117	Sonoma County
72402	Fee-for-Service	1033205554	1033205554	1	1	EL-ZAYAT, ONSI H MD	10/31/1988	2084P0800X	NA	Psychiatry	026	PHYSICIANS	43498	36	Psychiatry	0	In state provider	None	1020 S ANAHEIM BLVE #215	None	ANAHEIM	CA	92805	0000	30	06059	33.82002206	-117.9087091	Orange County
72406	Fee-for-Service	1437165362	1437165362	1	1	ELIAS, RAMY N MD	8/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86043	20	Orthopedic Surgery	0	In state provider	None	5750 DOWNEY AVE	STE 308	LAKEWOOD	CA	90712	1482	19	06037	33.859611	-118.1511435	Los Angeles County
72499	Fee-for-Service	1417095597	1417095597	1	1	ERIC S MINKIN	3/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 BROOKDALE PLZ	None	BROOKLYN	NY	11212	3139	00	None	40.654503	-73.9124325	Kings County
72511	Fee-for-Service	1568872794	1568872794	1	1	ESCOBAR, DANIEL J MD	3/7/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	173250	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
72567	Fee-for-Service	1467688002	1467688002	1	1	EINAV, SHIRIT MD	3/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	81396	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
72573	Fee-for-Service	1457423410	1457423410	1	1	EASTMAN, COLETTE DO	12/31/1985	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	15706 POMERADO RD	STE 110	POWAY	CA	92064	2032	37	06073	32.99909223	-117.0579393	San Diego County
72630	Fee-for-Service	1760902290	1760902290	1	1	ESSENTIAL MEDICAL SUPPLIES	10/30/2017	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	175 W LEXINGTON AVE	STE A	EL CAJON	CA	92020	0603	37	06073	32.79268152	-116.9633025	San Diego County
72687	Fee-for-Service	1073513925	1073513925	1	1	EDDINGS-REECE, KIMBERLY	8/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	80753	41	Internal Medicine	0	In state provider	None	9930 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166152	-117.955521	Orange County
72830	Fee-for-Service	1114513371	1114513371	1	1	ERA HOSPICE INC	10/11/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2050 WEST CHAPMAN AVE	STE 246	ORANGE	CA	92868	2657	30	06059	33.78787054	-117.87498	Orange County
72875	Fee-for-Service	1790781409	1790781409	1	1	EYE CARE CENTER OF NAPA	4/18/2016	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	VALLEY AMC	895 TRANCAS ST	None	NAPA	CA	94558	3040	28	06055	38.32406807	-122.2928218	Napa County
72907	Fee-for-Service	1730570896	1730570896	1	1	ENGHELBERG, MOISES DO	7/1/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	17131	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
73004	Fee-for-Service	1801311477	1801311477	1	1	EVANS, ALLISON AU	5/29/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3840 HOMESTEAD	None	SANTA CLARA	CA	95051	5173	43	06085	37.33774954	-122.002065	Santa Clara County
73109	Fee-for-Service	1316364466	1316364466	1	1	ESTEVEZ, HUGO L	6/25/2014	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	327 COLLEGE STREET	SUITE 106	WOODLAND	CA	95695	3400	57	06113	38.67801116	-121.7746923	Yolo County
73117	Fee-for-Service	1114513371	1114513371	1	1	ERA HOSPICE INC	10/11/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2050 WEST CHAPMAN AVE	STE 246	ORANGE	CA	92868	2657	30	06059	33.78787054	-117.87498	Orange County
73164	Fee-for-Service	1790781409	1790781409	1	1	EYE CARE CENTER OF NAPA	11/19/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	VALLEY AMC	895 TRANCAS ST	None	NAPA	CA	94558	3040	28	06055	38.32406807	-122.2928218	Napa County
73255	Fee-for-Service	1609252345	1609252345	1	1	ELLISON, MELISSA M LCSW	2/3/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1501 TROUSDALE DR	215	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
73380	Fee-for-Service	1902408917	1902408917	1	1	EMMEL, LAUREN LMFT	10/25/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1840 S ELENA AVE	207	REDONDO BEACH	CA	90277	5717	19	06037	33.81689725	-118.3863885	Los Angeles County
73477	Fee-for-Service	1225144561	1225144561	1	1	ELGEE, SUSAN K MD	10/31/1992	207R00000X	NA	Other	026	PHYSICIANS	51151	41	Internal Medicine	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
73499	Fee-for-Service	1558797324	1558797324	1	1	ESCOBAR, NORA M LMFT	3/30/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	46650 ADAMS STREET	101	LA QUINTA	CA	92253	4532	33	06065	33.71077068	-116.2861321	Riverside County
73519	Fee-for-Service	1467211706	1467211706	1	1	EZ RYDE	4/9/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	4132 FLINT AVE	None	CLOVIS	CA	93619	8798	10	06019	36.7874607	-119.631982	Fresno County
73688	Fee-for-Service	1245401025	1245401025	1	1	EL-KHAWAM, RANIA MD	11/12/2024	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
73713	Fee-for-Service	1063711356	1063711356	1	2	EASTER, BENJAMIN D	6/26/2024	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	7402	19	06037	34.06633051	-118.4452686	Los Angeles County
73732	Fee-for-Service	1497932651	1497932651	1	1	EDMUNDSON, ALAN J PT	12/14/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	511 BATH ST	None	SANTA BARBARA	CA	93101	3403	42	06083	34.41386476	-119.6993335	Santa Barbara County
73775	Fee-for-Service	1518917582	1518917582	1	1	EVANS, BRIAN T MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120637	30	Radiology	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
73830	Fee-for-Service	1811587819	1811587819	1	1	ESPIRITU, EBONY A CNM	1/27/2024	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
73934	Fee-for-Service	1457300758	1457300758	1	1	EDWARD H TAN MD	3/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	612 W NOLANA AVE	STE 330	MCALLEN	TX	78504	3088	00	None	26.23891868	-98.22043536	Hidalgo County
74069	Fee-for-Service	1245716943	1245716943	1	2	ESCOBAR, TONYA S NP	1/10/2025	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	434 9TH STREET	None	CRESCENT CITY	CA	95531	3430	08	06015	41.7544514	-124.2050285	Del Norte County
74130	Fee-for-Service	1699702977	1699702977	1	1	EISENMAN, EDWARD A OD	3/29/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1230 HARRISON ST	None	OAKLAND	CA	94612	3913	01	06001	37.802134	-122.2680264	Alameda County
74176	Fee-for-Service	1043236169	1043236169	1	1	EMANATE HEALTH HOSPICE	2/26/1986	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	820 N PHILLIPS AVE	None	WEST COVINA	CA	91791	1121	19	06037	34.085601	-117.9055245	Los Angeles County
74188	Fee-for-Service	1831369594	1831369594	1	1	EAST BAY OPHTHALMIC	6/4/2008	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	ANESTHESIA INC	481 30TH ST	None	OAKLAND	CA	94609	3209	01	06001	37.81926665	-122.2664677	Alameda County
74191	Fee-for-Service	1356503502	1356503502	1	1	E PAUL DIETSCH HEARING AIDS	1/1/1979	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	INC	689 E MAIN ST	None	EL CAJON	CA	92020	4009	37	06073	32.7949225	-116.954424	San Diego County
74216	Fee-for-Service	1780649830	1780649830	1	1	EISENSTEIN, ISAAC MD	6/16/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	31303	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3650 SOUTH ST	STE 310	LAKEWOOD	CA	90712	1519	19	06037	33.86019847	-118.149255	Los Angeles County
74236	Fee-for-Service	1679512024	1679512024	1	1	ESCONDIDO OB-GYN MED GRP	8/1/1981	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ISTS	488 E VALLEY PKWY	STE 310	ESCONDIDO	CA	92025	3373	37	06073	33.12523814	-117.0769715	San Diego County
74238	Fee-for-Service	1336307735	1336307735	1	1	ERHUNMWUNSEE, LORETTA E MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137850	02	General Surgery	0	In state provider	None	1500 E DIARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
74264	Fee-for-Service	1770509291	1770509291	1	1	EVANS, NORA MD	3/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	73593	02	General Surgery	0	In state provider	None	24411 HEALTH CENTER DR	SUITE 350	LAGUNA HILLS	CA	92653	3687	30	06059	33.6087201	-117.7076948	Orange County
74267	Fee-for-Service	1548498454	1548498454	1	1	EROMO, ERSNO MD	4/4/2019	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	145666	None	None	0	In state provider	None	1513 S GRAND AVE	#300	LOS ANGELES	CA	90015	3067	19	06037	34.03596303	-118.266212	Los Angeles County
74292	Fee-for-Service	1043305113	1043305113	1	1	EISENHART, PAULA A MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61417	41	Internal Medicine	0	In state provider	None	10201 MISSION GORGE RD	None	SANTEE	CA	92071	3027	37	06073	32.83844552	-116.9759925	San Diego County
74418	Fee-for-Service	1851330260	1851330260	2	1	ERICKSON, MITCHELL D NP	10/8/2012	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
74467	Fee-for-Service	1740320068	1740320068	1	1	EHST,BENJAMIN D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3303 SW BOND AVE	None	PORTLAND	OR	97239	4501	00	None	45.49894088	-122.6708542	Multnomah County
74527	Fee-for-Service	1336307735	1336307735	1	1	ERHUNMWUNSEE, LORETTA E MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137850	33	Thoracic Surgery	0	In state provider	None	1500 E DIARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
74536	Fee-for-Service	1497993562	1497993562	1	1	ETEMADI, ALIREZA MD INC	8/12/2009	193400000X	NA	Other	026	PHYSICIANS	67093	08	Family Practice	0	In state provider	None	24881 ALICIA PKWY	STE N	LAGUNA HILLS	CA	92653	4617	30	06059	33.60104538	-117.6916176	Orange County
74569	Fee-for-Service	1467401844	1467401844	1	1	ELLIOTT, ROBERT C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38036	40	Pediatrics	0	In state provider	None	5800 HANNUM AVE	None	CULVER CITY	CA	90230	6502	19	06037	33.98724995	-118.3858338	Los Angeles County
74721	Fee-for-Service	1659670545	1659670545	1	1	ERIC BROOKS	12/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1990 INDUSTRIAL BLVD	None	HOUMA	LA	70363	7055	00	None	29.57007888	-90.68782355	Terrebonne Parish
74934	Fee-for-Service	1417901091	1417901091	1	1	ENLOE MEDICAL CENTER-	12/1/1977	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	ESPLANADE	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
74966	Fee-for-Service	1346541307	1346541307	2	1	EMERGENCY MEDICINE PHYSICIAN	1/29/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS OF RANCHO MIRAG	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
74989	Fee-for-Service	1609398882	1609398882	1	1	EDUN, ADNAAN MD	11/2/2020	208M00000X	NA	Other	026	PHYSICIANS	170003	41	Internal Medicine	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
75021	Fee-for-Service	1962803122	1962803122	1	1	ERNESTUS, STEPHANIE M PHD	11/20/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
75038	Fee-for-Service	1558099325	1558099325	1	1	EMPLOYEE MEDICAL CONSULTANTS	8/29/2023	261QM2500X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	14650 AVIATION BLVD	200	HAWTHORNE	CA	90250	6668	19	06037	33.898788	-118.3786825	Los Angeles County
75049	Fee-for-Service	1962988923	1962988923	1	1	EYEN, VANESSA E LMFT	9/24/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	THERAPY	7765 HEALDSBURG AVE	13	SEBASTOPOL	CA	95472	3309	49	06097	38.40525805	-122.8342649	Sonoma County
75222	Fee-for-Service	1417901091	1417901091	1	1	ENLOE MEDICAL CENTER-	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	ESPLANADE	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
75233	Fee-for-Service	1184144230	1184144230	1	1	EVANS, GRETCHEN C MD	8/17/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	186014	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
75283	Fee-for-Service	1457641086	1457641086	1	1	EDWARDS, MARTIN P MD	7/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141648	30	Radiology	0	In state provider	None	10833 LE CONTE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
75291	Fee-for-Service	1093212672	1093212672	1	1	EVANS, ERICA M MD	5/14/2021	390200000X	NA	Other	026	PHYSICIANS	166389	None	None	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
75341	Fee-for-Service	1407120421	1407120421	1	1	EVAN TAYLOR HOLDSWORTH MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9225 N 3RD ST	STE 304	PHOENIX	AZ	85020	2466	00	None	33.57054	-112.0692465	Maricopa County
75385	Fee-for-Service	1215043443	1215043443	1	1	EISER, ELYSE G	2/2/2009	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	0725	36	06071	34.5406159	-117.2658221	San Bernardino County
75505	Fee-for-Service	1629285465	1629285465	1	1	EBRAHAM, EVON G MD	4/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97683	08	Family Practice	0	In state provider	None	2210 E HIGHLAND AVE	STE 200	SAN BERNARDINO	CA	92404	4667	36	06071	34.13586449	-117.239841	San Bernardino County
75558	Fee-for-Service	1679290951	1679290951	1	1	ESTANISLAO, MARIJA VIRIA PT	8/28/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	137 S LAS POSAS RD	STE 254	SAN MARCOS	CA	92078	2475	37	06073	33.14138594	-117.1924065	San Diego County
75630	Fee-for-Service	1316962129	1316962129	1	1	ENYEDY, TRICIA M MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77546	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
75668	Fee-for-Service	1275112419	1275112419	1	1	ESCORIAL, NATHAN M MD	6/13/2023	207P00000X	NA	Other	026	PHYSICIANS	182076	None	None	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
75745	Fee-for-Service	1437205580	1437205580	1	1	ETSELL, DOUGLAS A MD	3/18/1986	174400000X	NA	Other	026	PHYSICIANS	56805	05	Anesthesiology	0	In state provider	None	425 W JUNIPERO ST	STE 3	SANTA BARBARA	CA	93105	4294	42	06083	34.42973253	-119.7249544	Santa Barbara County
75844	Fee-for-Service	1710997374	1710997374	1	1	ENGELSTAD, LINDA P MD	10/1/1995	174400000X	NA	Other	026	PHYSICIANS	41706	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
75874	Fee-for-Service	1386688539	1386688539	1	1	EMERGENCY PHYS MED GRP	12/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	MARSHALL WAY	None	PLACERVILLE	CA	95667	0000	09	06017	38.72587744	-120.791388	El Dorado County
75887	Fee-for-Service	1225231244	1225231244	1	1	ELLIOTT, ADRIAN MD	3/7/2019	207L00000X	NA	Other	026	PHYSICIANS	135793	05	Anesthesiology	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
75909	Fee-for-Service	1922185636	1922185636	1	1	EL CAMINO PATH MED GRP	5/31/1991	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	INC	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
75914	Fee-for-Service	1073778205	1073778205	1	1	ELGHOUL, HABIB MD	1/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133147	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
75927	Fee-for-Service	1720540628	1720540628	1	1	EDS-I/HOMANSKY PRACTICES OF	12/7/2019	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	2	Out of state provider	NEVADA PC	360 S LOLA LN	None	PAHRUMP	NV	89048	0884	00	None	36.214524	-116.025615	Nye County
75947	Fee-for-Service	1184052037	1184052037	1	1	EARTH VILLAGE PHARMACY INC	6/19/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5161 BEACH BLVD	UNIT C	BUENA PARK	CA	90621	1171	30	06059	33.88524753	-117.9951446	Orange County
75970	Fee-for-Service	1225145071	1225145071	1	1	EDW J SANDRETTO HEARING	1/1/1979	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	AID CTR	1635 MERIDIAN AVE	None	SAN JOSE	CA	95125	5533	43	06085	37.293219	-121.9135785	Santa Clara County
76095	Fee-for-Service	1992708788	1992708788	1	1	EDGARDO R LAUREL	1/6/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2545 E THOMAS RD	None	PHOENIX	AZ	85016	7969	00	None	33.480126	-112.0261815	Maricopa County
76097	Fee-for-Service	1063836013	1063836013	1	1	ELDER, MISHA A LCSW	9/12/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
76178	Fee-for-Service	1184010662	1184010662	1	1	EL-HAJJAOUI, MICHELLE DO	5/18/2022	207RH0003X	NA	Oncology	026	PHYSICIANS	15250	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
76190	Fee-for-Service	1871991042	1871991042	1	1	ELITE GOLDEN DREAMS	4/16/2015	207L00000X	NA	Other	026	PHYSICIANS	80408	05	Anesthesiology	0	In state provider	None	21530 PIONEER BLVD	None	HAWAIIAN GARDENS	CA	90716	2608	19	06037	33.83358457	-118.0817796	Los Angeles County
76320	Fee-for-Service	1770765547	1770765547	1	1	EGHRERINIOVO, MAUREEN N NP	7/28/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1307 WEST SIXTH STREET	105	CORONA	CA	92882	3294	33	06065	33.87790309	-117.589666	Riverside County
76326	Fee-for-Service	1649387309	1649387309	1	1	ESCOTO, LETICIA MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	64582	08	Family Practice	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
76346	Fee-for-Service	1902847395	1902847395	1	1	ESCARCHA, LORAINE A MD	11/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103282	40	Pediatrics	0	In state provider	None	2185 W GRANT LINE RD	None	TRACY	CA	95377	7309	39	06077	37.75425686	-121.4567805	San Joaquin County
76476	Fee-for-Service	1285810994	1285810994	1	1	EAST-WEST EYE INSTITUTE A ME	3/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	23441 MADISON ST	STE 120	TORRANCE	CA	90505	4734	19	06037	33.81240248	-118.3477463	Los Angeles County
76771	Fee-for-Service	1285632539	1285632539	1	1	EAGLE CO EM SVC HOS DIST	5/19/1999	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	2	Out of state provider	EAGLE CO HEALTH SVC DIST	1055 EDWARDS VILLAGE BLV	None	EDWARDS	CO	81632	8196	00	None	39.64419938	-106.5979307	Eagle County
76803	Fee-for-Service	1225039092	1225039092	1	1	ENG, CALVIN T MD	2/21/1990	207W00000X	NA	Ophthalmology	026	PHYSICIANS	55239	18	Ophthalmology	0	In state provider	None	850 S ATLANTIC BLVD	STE 301	MONTEREY PARK	CA	91754	4729	19	06037	34.05097684	-118.1379979	Los Angeles County
76949	Fee-for-Service	1679996086	1679996086	1	1	EDMONDSON, DANIEL E	8/24/2016	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	9625 MONTE VISTA AVE	STE 102	MONTCLAIR	CA	91763	2234	36	06071	34.08006762	-117.6982272	San Bernardino County
77043	Fee-for-Service	1437491222	1437491222	1	1	ESTEGHAMAT, NASEEM S MD	7/1/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	148594	68	Hematology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
77258	Fee-for-Service	1730522590	1730522590	1	1	EZEUKA, COLLINS MD	3/3/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	22141 VENTURA BLVD	309	WOODLAND HILLS	CA	91364	5734	19	06037	34.16866225	-118.6095572	Los Angeles County
77261	Fee-for-Service	1508259896	1508259896	1	1	ESPARZA, DANIELLA D LCSW	1/27/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
77313	Fee-for-Service	1518407055	1518407055	1	1	EKSTROM, JESSICA NP	7/11/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16147 WHITTIER BLVD	None	WHITTIER	CA	90603	2560	19	06037	33.94157588	-117.9859969	Los Angeles County
77338	Fee-for-Service	1750512158	1750512158	1	1	ETHAN SHIM MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9225 N 3RD ST	STE 304	PHOENIX	AZ	85020	2466	00	None	33.57054	-112.0692465	Maricopa County
77351	Fee-for-Service	1487947495	1487947495	1	1	ENOS, NICHOLAS A DO	1/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14101	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4101 TORRANCE BLVD	EM DEPT	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
77393	Fee-for-Service	1932287299	1932287299	1	1	EVERSON,GREGORY T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80042	1719	00	None	39.748041	-104.834673	Adams County
77433	Fee-for-Service	1679298046	1679298046	1	1	ESCAMILLA-ESCAMILLA, CINTYA	2/15/2023	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	Y NP	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
77504	Fee-for-Service	1477539229	1477539229	1	1	ENGOTT, ELAINE A CRNA	2/8/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
77517	Fee-for-Service	1790957124	1790957124	1	1	EXPRESS CARE/UNITED	5/1/1992	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	DOCTORS' MEDICAL GROUP	19036 COLIMA RD	STE C	ROWLAND HEIGHTS	CA	91748	2957	19	06037	33.98742686	-117.8882327	Los Angeles County
77544	Fee-for-Service	1730522590	1730522590	1	1	EZEUKA, COLLINS MD	3/3/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	22141 VENTURA BLVD	309	WOODLAND HILLS	CA	91364	5734	19	06037	34.16866225	-118.6095572	Los Angeles County
77605	Fee-for-Service	1225431448	1225431448	1	1	ESGUERRA, CAROLINE C MD	1/15/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	132724	08	Family Practice	0	In state provider	None	4400 DUCKHORN DR	STE 100	SACRAMENTO	CA	95834	2589	34	06067	38.65086	-121.531833	Sacramento County
77615	Fee-for-Service	1376695593	1376695593	1	1	ELSON, JOSEPH F MD	9/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	57765	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2648 E 14TH ST	None	OAKLAND	CA	94601	1506	01	06001	37.78093089	-122.2316571	Alameda County
77625	Fee-for-Service	1215411921	1215411921	1	1	EYE VIEW OPTOMETRY INC	10/23/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	605 E IMPERIAL HWY	SUITE C	BREA	CA	92821	5627	30	06059	33.91467486	-117.8951726	Orange County
77721	Fee-for-Service	1477630499	1477630499	1	1	EVERSON, LISA K MD	9/20/2007	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	63222	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3555 CESAR CHAVEZ	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.74802705	-122.4207367	San Francisco County
77731	Fee-for-Service	1437103942	1437103942	1	7	EMERGENCY & ACUTE CARE	4/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	435 H STREET	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
77833	Fee-for-Service	1730522590	1730522590	1	1	EZEUKA, COLLINS MD	3/3/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	22141 VENTURA BLVD	309	WOODLAND HILLS	CA	91364	5734	19	06037	34.16866225	-118.6095572	Los Angeles County
77957	Fee-for-Service	1619057288	1619057288	1	1	EASTERN CONTRA COSTA	12/13/2001	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TRANSIT AUTHORITY	801 WILBUR AVE	None	ANTIOCH	CA	94509	7500	07	06013	38.01229051	-121.7935485	Contra Costa County
77977	Fee-for-Service	1679927354	1679927354	1	1	EVANS, CHRISTINA T MD	3/18/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	155422	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
77993	Fee-for-Service	1841256773	1841256773	1	1	EIBLING, DAVID E MD	1/31/1983	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	40980	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1617 N CALIFORNIA ST	STE 2A	STOCKTON	CA	95204	6117	39	06077	37.9697906	-121.2890104	San Joaquin County
78023	Fee-for-Service	1437103942	1437103942	1	18	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	3030 BUNKER HILL ST	None	SAN DIEGO	CA	92109	5754	37	06073	32.80346216	-117.2151829	San Diego County
78118	Fee-for-Service	1366625212	1366625212	1	1	EVANS, KAREN B MD	8/30/2021	207L00000X	NA	Other	026	PHYSICIANS	171698	None	None	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
78217	Fee-for-Service	1578701173	1578701173	1	1	EPIPHANY CARE HOMES INC	11/26/2008	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	431 SARATOGA AVE	None	FILLMORE	CA	93015	1531	56	06111	34.40195481	-118.9115964	Ventura County
78286	Fee-for-Service	1497788145	1497788145	1	1	ENDOSCOPY CENTER OF	9/1/2004	261QE0800X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SOUTHERN CALIFORNIA	2336 SANTA MONICA BLVD	STE 204	SANTA MONICA	CA	90404	2093	19	06037	34.03136627	-118.4766854	Los Angeles County
78306	Fee-for-Service	1437103942	1437103942	1	7	EMERGENCY & ACUTE CARE	9/18/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	435 H STREET	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
78309	Fee-for-Service	1073296158	1073296158	1	1	EBERLY IMAGING LLC	6/12/2024	335V00000X	NA	Other	028	PORTABLE X-RAY	-	-	NOT APPLICABLE	0	In state provider	None	1731 120TH ST	None	LOS ANGELES	CA	90059	3051	19	06037	33.92461329	-118.2426436	Los Angeles County
78401	Fee-for-Service	1053881987	1053881987	1	1	ESHO, MARYAM MD A	1/7/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	71783	40	Pediatrics	0	In state provider	PROFESSIONAL CORPORATION	1729 N OLIVE AVE	STE 7	TURLOCK	CA	95382	2501	50	06099	37.50874586	-120.8399103	Stanislaus County
78409	Fee-for-Service	1417401548	1417401548	1	1	ELITE PROVIDER URGENT CARE	4/21/2017	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	NETWORK PC	201 S ALVARADO ST	STE 100	LOS ANGELES	CA	90057	2320	19	06037	34.06417777	-118.2719543	Los Angeles County
78424	Fee-for-Service	1821042292	1821042292	1	2	ELLIOTT, JOHN C MD	12/4/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	85668	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
78437	Fee-for-Service	1336580422	1336580422	1	2	ENLOE MEDICAL CENTER	1/16/2020	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	E CLINIC	251 COHASSET RD	SUITE 370	CHICO	CA	95926	2241	04	06007	39.75090044	-121.8522609	Butte County
78440	Fee-for-Service	1285078717	1285078717	1	1	ENTERAL PRODUCTS LLC	8/4/2014	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1760 MORIAH WOODS BLVD	STE 2-B	MEMPHIS	TN	38117	7128	00	None	35.08452623	-89.89615808	Shelby County
78482	Fee-for-Service	1275628992	1275628992	1	1	EAST BAY NEPHROLOGY MED	1/1/1979	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	GROUP INC	14020 SAN PABLO AVE	STE A	SAN PABLO	CA	94806	3604	07	06013	37.96124162	-122.3434731	Contra Costa County
78534	Fee-for-Service	1710941380	1710941380	1	1	EPSTEIN, A JAMES MD	7/3/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79730	05	Anesthesiology	0	In state provider	None	72925 FRED WARING DR	STE 102	PALM DESERT	CA	92260	9401	33	06065	33.72860149	-116.3920095	Riverside County
78537	Fee-for-Service	1003347063	1003347063	1	1	EDWARDS, MATTHEW L MD	3/9/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	157209	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
78597	Fee-for-Service	1437103942	1437103942	1	18	EMERGENCY & ACUTE CARE	2/28/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	3030 BUNKER HILL ST	None	SAN DIEGO	CA	92109	5754	37	06073	32.80346216	-117.2151829	San Diego County
78600	Fee-for-Service	1154369502	1154369502	2	1	ENERGY PHYSICAL THERAPY INC	1/29/2019	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	16573 VENTURA BLVD	5	ENCINO	CA	91436	2022	19	06037	34.1578643	-118.4944187	Los Angeles County
78647	Fee-for-Service	1851397459	1851397459	1	1	EASLEY, EVAN W MD	3/6/1997	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1107 US HIGHWAY 395 S	None	GARDNERVILLE	NV	89410	7030	00	None	38.76078609	-119.576046	Douglas County
78881	Fee-for-Service	1437103942	1437103942	1	7	EMERGENCY & ACUTE CARE	6/8/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	435 H STREET	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
78906	Fee-for-Service	1811384936	1811384936	1	1	ELANGO, VISHALAKCHI MD	5/3/2023	207R00000X	NA	Other	026	PHYSICIANS	155130	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
78919	Fee-for-Service	1790781409	1790781409	1	2	EYE CARE CENTER OF NAPA	9/22/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	VALLEY A MEDICAL CORP	3417 BROADWAY	SUITE J3	AMERICAN CANYON	CA	94503	1294	28	06055	38.16895446	-122.253148	Napa County
78996	Fee-for-Service	1023166816	1023166816	1	1	EWING, MARK T MD	9/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74992	10	Gastroenterology (M.D. only)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
79063	Fee-for-Service	1760256069	1760256069	1	1	EVEXIA HEALTH SERVICES, LLC	7/25/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	24941 DRACAEA AVE	None	MORENO VALLEY	CA	92553	3777	33	06065	33.92813353	-117.2272905	Riverside County
79083	Fee-for-Service	1932791258	1932791258	1	2	ESSENTIAL HEALTH, LLC	6/20/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	6850 CANBY AVE	STE 102	RESEDA	CA	91335	8779	19	06037	34.19488761	-118.5346692	Los Angeles County
79118	Fee-for-Service	1871605105	1871605105	1	2	EVERGREEN PHARMACEUTICAL OF	10/23/2019	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	20967 CABOT BLVD	None	HAYWARD	CA	94545	1155	01	06001	37.65115903	-122.138358	Alameda County
79203	Fee-for-Service	1396776688	1396776688	1	1	EISNER, ROBIN F MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	43641	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	321 N LARCHMONT BLVD	STE 808	LOS ANGELES	CA	90004	6408	19	06037	34.0769016	-118.323663	Los Angeles County
79208	Fee-for-Service	1790781409	1790781409	1	2	EYE CARE CENTER OF NAPA	4/18/2016	193200000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	VALLEY A MEDICAL CORP	3417 BROADWAY	SUITE J3	AMERICAN CANYON	CA	94503	1294	28	06055	38.16895446	-122.253148	Napa County
79220	Fee-for-Service	1104938901	1104938901	1	1	EL CENTRO DESERT VALLEY	12/1/1992	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	DIALYSIS CTR	110 S 5TH ST	None	EL CENTRO	CA	92243	3011	13	06025	32.79267895	-115.5547897	Imperial County
79229	Fee-for-Service	1528215704	1528215704	1	1	ELA-DALMAN, NOA MD	8/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	200 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06482757	-118.4443441	Los Angeles County
79255	Fee-for-Service	1962720821	1962720821	1	1	EVANGELISTA, MARISTELLA S MD	7/31/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	112635	24	Plastic Surgery	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
79270	Fee-for-Service	1407489057	1407489057	1	1	EMERGENCY PHYSICIANS URGENT	10/5/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	4040 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1012	15	06029	35.36749552	-119.047464	Kern County
79284	Fee-for-Service	1336281443	1336281443	1	1	EDWARD J PUTTRE JR MD IN	1/7/1975	207W00000X	NA	Ophthalmology	026	PHYSICIANS	22264	18	Ophthalmology	0	In state provider	None	1800 WESTERN AVE	STE 101	SAN BERNARDINO	CA	92411	1352	36	06071	34.1315778	-117.3182453	San Bernardino County
79285	Fee-for-Service	1396732046	1396732046	1	1	EMPRESS CARE CENTER, LLC	8/1/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1299 S BASCOM AVE	None	SAN JOSE	CA	95128	3514	43	06085	37.30181321	-121.9317363	Santa Clara County
79314	Fee-for-Service	1356789903	1356789903	1	1	EVANS, BRADY T MD	9/18/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	163166	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
79324	Fee-for-Service	1891810438	1891810438	1	1	ENRIQUEZ, AURELIO JR PHD	10/24/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	19	06037	34.06750236	-117.925203	Los Angeles County
79351	Fee-for-Service	1760256069	1760256069	1	1	EVEXIA HEALTH SERVICES, LLC	7/25/2024	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	24941 DRACAEA AVE	None	MORENO VALLEY	CA	92553	3777	33	06065	33.92813353	-117.2272905	Riverside County
79379	Fee-for-Service	1851170658	1851170658	1	1	EZ TRANSPORT SERVICES LLC	9/28/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3774 GROVE ST	STE L3	LEMON GROVE	CA	91945	1899	37	06073	32.74642662	-117.0271281	San Diego County
79470	Fee-for-Service	1952644262	1952644262	1	1	ESSENCE HEALTHCARE LLC	10/31/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	410 32 ND STREET	STE 201	NEWPORT BEACH	CA	92663	3804	30	06059	33.61601052	-117.9298125	Orange County
79499	Fee-for-Service	1467472753	1467472753	1	1	EPPLER, EDWIN M MD	6/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	5330 S HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
79515	Fee-for-Service	1609851674	1609851674	1	1	EIDSON-TON, WETONA S MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70407	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
79517	Fee-for-Service	1528215704	1528215704	1	1	ELA-DALMAN, NOA MD	8/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06482757	-118.4443441	Los Angeles County
79556	Fee-for-Service	1407489057	1407489057	1	1	EMERGENCY PHYSICIANS URGENT	1/22/2021	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4040 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1012	15	06029	35.36749552	-119.047464	Kern County
79560	Fee-for-Service	1033746789	1033746789	1	1	EDER, ADRIANNA E MD	5/29/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
79564	Fee-for-Service	1407478191	1407478191	1	1	ENLIGHTEN HOSPICE LLC	7/12/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	22024 LASSEN ST	STE 110	CHATSWORTH	CA	91311	3600	19	06037	34.2499425	-118.6069365	Los Angeles County
79662	Fee-for-Service	1861873796	1861873796	1	1	ENGLISH, JODON LCSW	2/1/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	65 MADISON AVENUE	601	PASADENA	CA	91101	2035	19	06037	34.14705803	-118.1384317	Los Angeles County
79758	Fee-for-Service	1952644262	1952644262	1	1	ESSENCE HEALTHCARE LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	410 32 ND STREET	STE 201	NEWPORT BEACH	CA	92663	3804	30	06059	33.61601052	-117.9298125	Orange County
79801	Fee-for-Service	1609851674	1609851674	1	1	EIDSON-TON, WETONA S MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70407	08	Family Practice	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
79855	Fee-for-Service	1407478191	1407478191	1	1	ENLIGHTEN HOSPICE LLC	7/12/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	22024 LASSEN ST	STE 110	CHATSWORTH	CA	91311	3600	19	06037	34.2499425	-118.6069365	Los Angeles County
79968	Fee-for-Service	1659688042	1659688042	1	1	EMEL, SHAKIR E MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119762	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
79997	Fee-for-Service	1740380880	1740380880	1	1	ERNEST, ANTONY C MD INC	8/25/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	31133	41	Internal Medicine	0	In state provider	None	44241 15TH ST W	STE 101	LANCASTER	CA	93534	5500	19	06037	34.68712999	-118.1569096	Los Angeles County
80211	Fee-for-Service	1952582249	1952582249	1	1	EDELMAN, FREDRIC L MD	5/1/1997	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	None	8610 S SEPULVEDA BLVD	None	LOS ANGELES	CA	90045	4008	19	06037	33.959448	-118.396202	Los Angeles County
80215	Fee-for-Service	1194864611	1194864611	1	1	ENGLISH, BRETT C DO	9/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11980	05	Anesthesiology	0	In state provider	None	3315 WATT AVENUE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
80230	Fee-for-Service	1679189088	1679189088	1	1	ELI HOME HEALTH INC	2/10/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	20812 VENTURA BLVD	STE 215	WOODLAND HILLS	CA	91364	2362	19	06037	34.1663428	-118.5865029	Los Angeles County
80252	Fee-for-Service	1902992381	1902992381	1	1	EGAN, ERIN A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
80273	Fee-for-Service	1497914030	1497914030	1	1	ESBIT, SCOTT	11/20/2023	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	780 W OLIVE AVE	100	MERCED	CA	95348	2437	24	06047	37.31916174	-120.4814268	Merced County
80331	Fee-for-Service	1760579072	1760579072	1	1	EMERGENCY PHYSICIANS MED	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	BAUDONNET, DEANA MD	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
80332	Fee-for-Service	1962586875	1962586875	1	1	EU, PANG-CHIEH J MD	5/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140068	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	301 W HUNTINGTON DR	STE 607	ARCADIA	CA	91007	1515	19	06037	34.13481053	-118.0425638	Los Angeles County
80407	Fee-for-Service	1477579720	1477579720	1	1	ENGLISH, JOEY D MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73999	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
80500	Fee-for-Service	1952582249	1952582249	1	1	EDELMAN, FREDRIC L MD	5/1/1997	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	None	8610 S SEPULVEDA BLVD	None	LOS ANGELES	CA	90045	4008	19	06037	33.959448	-118.396202	Los Angeles County
80614	Fee-for-Service	1447317797	1447317797	1	1	EHMAN, DONALD M MD INC	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	197 W LEGION RD	STE 300	BRAWLEY	CA	92227	7728	13	06025	32.95991293	-115.5524233	Imperial County
80683	Fee-for-Service	1417901091	1417901091	1	2	ENLOE MEDICAL CENTER-	6/1/1992	282N00000X	NA	Hospitals	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	FIFTH AVE & ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.741948	-121.848921	Butte County
80728	Fee-for-Service	1104202969	1104202969	1	1	EVANS, ANDREW DO	9/28/2021	207R00000X	NA	Other	026	PHYSICIANS	18687	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
80783	Fee-for-Service	1548443195	1548443195	1	1	EGAN, ELIZABETH S MD	5/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139865	77	Infectious Disease	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
80852	Fee-for-Service	1760845606	1760845606	1	1	EARP, CANDICE E NP	2/26/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
80867	Fee-for-Service	1003829284	1003829284	1	1	ERBE, PATRICIA L MD	7/31/1986	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	58365	None	None	0	In state provider	None	15 E ARRELLAGA ST	None	SANTA BARBARA	CA	93101	2531	42	06083	34.42731739	-119.7094444	Santa Barbara County
80923	Fee-for-Service	1437103942	1437103942	1	16	EMERGENCY & ACUTE CARE	4/25/2008	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
80932	Fee-for-Service	1396180428	1396180428	1	1	EDWARDS, YAMANDA M MD	8/17/2017	2084P0800X	NA	Psychiatry	026	PHYSICIANS	132722	36	Psychiatry	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
80962	Fee-for-Service	1265470637	1265470637	1	1	ETZELL, JOAN E MD	3/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	79064	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
80975	Fee-for-Service	1346684859	1346684859	1	1	ECKARD, ELENA NP	12/16/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	625 W CITRACADO PKWY	108	ESCONDIDO	CA	92025	6428	37	06073	33.09166731	-117.0784699	San Diego County
80993	Fee-for-Service	1093988800	1093988800	1	1	EKEKE, NANCY O MD	12/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112956	None	None	0	In state provider	None	3687 MT DIABLO BLVD	STE 200	LAFAYETTE	CA	94549	3746	07	06013	37.8898926	-122.1304235	Contra Costa County
81000	Fee-for-Service	1114191186	1114191186	1	1	ESHAGHIAN, PATRICIA H MD	5/20/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	93356	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	7002	19	06037	34.06527974	-118.4462792	Los Angeles County
81046	Fee-for-Service	1780798207	1780798207	1	1	ELIZABETH GODIN MD	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2450 RIVERSIDE AVE	None	MINNEAPOLIS	MN	55454	1450	00	None	44.96613258	-93.23756795	Hennepin County
81061	Fee-for-Service	1407967631	1407967631	1	1	EL-GABALAWY, MOHAMED MD	12/11/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	50305	None	None	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
81064	Fee-for-Service	1932257896	1932257896	1	1	ERICKSON, MICHAEL F MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74791	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
81080	Fee-for-Service	1558387027	1558387027	1	1	ECHALUSE-CHIONG, LOLITA	3/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	29708	41	Internal Medicine	0	In state provider	E MD	31776 ALVARADO BLVD	None	UNION CITY	CA	94587	5800	01	06001	37.59145442	-122.0725483	Alameda County
81085	Fee-for-Service	1548443195	1548443195	1	1	EGAN, ELIZABETH S MD	5/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139865	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
81098	Fee-for-Service	1184751232	1184751232	1	1	EPIPHANY CARE HOMES, INC	12/16/2005	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SURFRIDER HOME ICF/DD-H	2127 N JUSTIN AVE	None	SIMI VALLEY	CA	93065	2544	56	06111	34.27415578	-118.7547834	Ventura County
81136	Fee-for-Service	1922011550	1922011550	1	1	EVANS, TRENTON J CRNA	12/29/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	450 GREENFIELD AVENUE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
81140	Fee-for-Service	1881656692	1881656692	2	1	EDSON, STEVEN B MD	12/4/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	40258	30	Radiology	0	In state provider	None	29101 HOSPITAL RD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
81155	Fee-for-Service	1831499631	1831499631	2	1	ESTRELLA A. AGUINALDO, M.D.,	4/2/2020	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	INC.	23517 MAIN ST	104	CARSON	CA	90745	5235	19	06037	33.81129174	-118.2756933	Los Angeles County
81207	Fee-for-Service	1013026608	1013026608	1	2	EVERGREEN PHARMACEUTICAL OF	11/27/2019	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	879 2ND ST	None	SANTA ROSA	CA	95404	4621	49	06097	38.441889	-122.7073185	Sonoma County
81210	Fee-for-Service	1437103942	1437103942	1	16	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
81295	Fee-for-Service	1114191186	1114191186	1	1	ESHAGHIAN, PATRICIA H MD	5/20/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	93356	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	7002	19	06037	34.06527974	-118.4462792	Los Angeles County
81365	Fee-for-Service	1063711356	1063711356	1	1	EASTER, BENJAMIN D	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
81393	Fee-for-Service	1194138511	1194138511	1	1	ESHAGH, KARIN MD	7/29/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	153002	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA #530	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
81458	Fee-for-Service	1447283551	1447283551	1	1	EASOM, DELILAH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MERCY MED SVCS INC	7301 ROGERS AVE	None	FORT SMITH	AR	72903	0000	00	None	35.35551	-94.35276	Sebastian County
81499	Fee-for-Service	1508838541	1508838541	1	1	EBENEZER, DANIEL J MD	9/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	32625	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2 MEDICAL PLAZA DR	STE 175	ROSEVILLE	CA	95661	3049	31	06061	38.76507948	-121.2477476	Placer County
81633	Fee-for-Service	1255607263	1255607263	1	1	ELLSWORTH, KEVIN R MD	3/28/2021	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
81640	Fee-for-Service	1598323669	1598323669	1	1	EVERGREEN CARE CENTER LLC	11/12/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5265 E HUNTINGTON AVE	None	FRESNO	CA	93727	4013	10	06019	36.73954069	-119.7156308	Fresno County
81683	Fee-for-Service	1194138511	1194138511	1	1	ESHAGH, KARIN MD	7/29/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	153002	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA #530	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
81705	Fee-for-Service	1265524235	1265524235	1	1	EMERGENCY PHYSICIANS MED	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	RITCHER, MICHAEL MD	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
81714	Fee-for-Service	1689881971	1689881971	1	1	EXCELLENCE IN EYEWEAR	2/8/2015	156FX1800X	NA	Other	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	4710 N CEDAR AVE	STE 101	FRESNO	CA	93726	1086	10	06019	36.80341301	-119.7541087	Fresno County
81737	Fee-for-Service	1770508343	1770508343	1	1	EWING, CYNTHIA K MD	8/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	58381	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
81772	Fee-for-Service	1245310580	1245310580	1	1	ERFANI, SEAMAE MD	7/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101030	40	Pediatrics	0	In state provider	None	3030 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798889	-117.150826	San Diego County
81831	Fee-for-Service	1831342096	1831342096	1	1	ERIC RICHARDS	1/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1550 S POTOMAC WAY	STE 270	AURORA	CO	80012	3562	00	None	39.689235	-104.830335	Arapahoe County
81832	Fee-for-Service	1710302195	1710302195	1	1	ESKIF DABBAGH, BAKRI MD	8/15/2016	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	142856	40	Pediatrics	0	In state provider	None	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	54	06107	36.332757	-119.288682	Tulare County
81865	Fee-for-Service	1629008909	1629008909	1	1	ESMAEILI, KEYVAN MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72887	25	Physical Medicine and Rehabilitation	0	In state provider	None	7901 WALKER ST	None	LA PALMA	CA	90623	1722	30	06059	33.84755382	-118.0373024	Orange County
81986	Fee-for-Service	1174596746	1174596746	2	1	EASON, PHYLLIS MD	11/20/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	170232	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
82055	Fee-for-Service	1407103054	1407103054	1	1	EDWARDS, ASHER A DO	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13141	41	Internal Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
82078	Fee-for-Service	1588851372	1588851372	1	1	ESKAROS, STEPHEN M MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	104081	None	None	0	In state provider	None	2101 NORTH WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
82111	Fee-for-Service	1033286968	1033286968	1	1	ESKANDAR, ZIAD MD	7/1/1998	207R00000X	NA	Other	026	PHYSICIANS	63930	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
82121	Fee-for-Service	1033694625	1033694625	1	1	EVERSOLE, ADRIANA LMFT	12/9/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4401 SEPULVEDA BLVD	210	SHERMAN OAKS	CA	91403	3934	19	06037	34.150356	-118.467397	Los Angeles County
82160	Fee-for-Service	1316386451	1316386451	1	1	ELIM SENIOR SERVICES LLC	5/2/2014	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5126 CORAL COURT	None	CONCORD	CA	94521	2315	07	06013	37.9615536	-121.9638363	Contra Costa County
82350	Fee-for-Service	1871586826	1871586826	1	1	EASTHAM, KATHERINE E MD	9/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	69811	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
82404	Fee-for-Service	1164464566	1164464566	1	1	EIBSCHUTZ, BARRY	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	78005	None	None	0	In state provider	None	1551 BISHOP ST	STE 230	SAN LUIS OBISPO	CA	93401	4661	40	06079	35.27475609	-120.6454494	San Luis Obispo County
82606	Fee-for-Service	1104831551	1104831551	1	1	ESTELLA,TERWES MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	906 SUMMIT AVE	GROUND FLOOR	JERSEY CITY	NJ	07307	0000	00	None	40.74493113	-74.05310074	Hudson County
82637	Fee-for-Service	1225208408	1225208408	1	1	EMAMI, CLAUDIA N MD	11/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97146	02	General Surgery	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
82644	Fee-for-Service	1205152642	1205152642	1	1	ESTEBANEZ, FABIOLA PSYD	12/20/2024	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
82668	Fee-for-Service	1902194509	1902194509	1	1	ENBOM, ELENA T MD	7/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126989	22	Pathology (M.D. only)	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
82685	Fee-for-Service	1811246176	1811246176	1	1	ELMERGAWY, HESHAM A MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2865 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25240042	-121.7859055	Klamath County
82737	Fee-for-Service	1033314927	1033314927	1	1	ESTRADA, SERGIO D MD	7/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88591	05	Anesthesiology	0	In state provider	None	955 BLANCO CIR	STE A	SALINAS	CA	93901	4452	27	06053	36.65564507	-121.6367659	Monterey County
82844	Fee-for-Service	1689600314	1689600314	1	1	EAST BAY AIDS CTR MED GP	3/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	None	3100 SUMMIT ST	2ND FLOOR	OAKLAND	CA	94609	3410	01	06001	37.82018974	-122.2643221	Alameda County
82863	Fee-for-Service	1245214923	1245214923	1	1	ELLIS, LISA H MD	5/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69248	None	None	0	In state provider	None	1900 DRESDEN DRIVE	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
82930	Fee-for-Service	1225208408	1225208408	1	1	EMAMI, CLAUDIA N MD	11/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97146	85	Surgery-Pediatric	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
83049	Fee-for-Service	1578689600	1578689600	1	1	EDWARD,VIVIAN A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	415 6TH ST	None	LEWISTON	ID	83501	2431	00	None	46.416294	-117.024981	Nez Perce County
83053	Fee-for-Service	1043361819	1043361819	1	1	EWING, NANCY H PHD	12/29/2016	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6500 FAIRMOUNT AVE	SUITE 9	EL CERRITO	CA	94530	3661	07	06013	37.90115255	-122.3007746	Contra Costa County
83076	Fee-for-Service	1194858589	1194858589	1	1	EVANS, ELISABETH R NP	3/4/2011	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	8201	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
83134	Fee-for-Service	1689600314	1689600314	1	1	EAST BAY AIDS CTR MED GP	3/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	3100 SUMMIT ST	2ND FLOOR	OAKLAND	CA	94609	3410	01	06001	37.82018974	-122.2643221	Alameda County
83220	Fee-for-Service	1659396141	1659396141	1	1	ESTRADA, RAUL A MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	36414	40	Pediatrics	0	In state provider	None	1720 W BALL RD	STE 1	ANAHEIM	CA	92804	5585	30	06059	33.8178465	-117.9425115	Orange County
83384	Fee-for-Service	1316005218	1316005218	1	1	ESTEP, AARON	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
83404	Fee-for-Service	1790397883	1790397883	1	1	EDEM HOSPICE INC	8/18/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6742 VAN NUYS BLVD	STE 207	VAN NUYS	CA	91405	4611	19	06037	34.19343344	-118.4487213	Los Angeles County
83496	Fee-for-Service	1164476347	1164476347	1	1	ESKAROUS, NADY I MD	11/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55850	01	General Practice	0	In state provider	None	2110 N BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
83510	Fee-for-Service	1083422166	1083422166	1	1	ESPARZA, YVETTE LMFT	1/24/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 E GARVEY AVE N	B2	WEST COVINA	CA	91791	1544	19	06037	34.07280989	-117.8995249	Los Angeles County
83644	Fee-for-Service	1811045891	1811045891	1	1	ECONOMOU, TASIA E MD	12/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	49325	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
83694	Fee-for-Service	1790397883	1790397883	1	1	EDEM HOSPICE INC	8/18/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6742 VAN NUYS BLVD	STE 207	VAN NUYS	CA	91405	4611	19	06037	34.19343344	-118.4487213	Los Angeles County
83767	Fee-for-Service	1245890706	1245890706	1	1	EVAN JONATHAN VALLE PC	10/31/2024	2086S0127X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
83964	Fee-for-Service	1396927208	1396927208	1	1	ELLIS, JOHN G MD INC	9/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70713	20	Orthopedic Surgery	0	In state provider	None	40949 WINCHESTER ROAD	None	TEMECULA	CA	92591	6031	33	06065	33.52574268	-117.1589811	Riverside County
83994	Fee-for-Service	1316499536	1316499536	1	1	EVERETT FOREST BOARD & CARE,	1/30/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	11350 POPLAR STREET	None	LOMA LINDA	CA	92354	3510	36	06071	34.047522	-117.255078	San Bernardino County
84056	Fee-for-Service	1245890706	1245890706	1	1	EVAN JONATHAN VALLE PC	10/31/2024	2086S0127X	NA	General Surgery	026	PHYSICIANS	None	89	Surgery-Traumatic	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
84066	Fee-for-Service	1215217427	1215217427	1	1	ELFORD, MELISSA A	1/26/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
84113	Fee-for-Service	1477756955	1477756955	1	1	ENGLISH, ELIZABETH A LCSW	7/28/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	20473	-	NOT APPLICABLE	0	In state provider	None	3600 POWER INN ROAD	SUITE A	SACRAMENTO	CA	95826	3824	34	06067	38.541726	-121.4096355	Sacramento County
84114	Fee-for-Service	1407353279	1407353279	1	1	EVES, DANIELLE P MD	8/21/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
84126	Fee-for-Service	1053678086	1053678086	1	1	ELDER, JOSHUA W MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	127380	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
84137	Fee-for-Service	1669679494	1669679494	1	1	ELLIE CARMODY	5/17/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
84147	Fee-for-Service	1982725511	1982725511	1	1	EYEVUE OPTOMETRY INC	5/28/2008	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	61 SERRA WAY	STE 128	MILPITAS	CA	95035	8519	43	06085	37.42799329	-121.907974	Santa Clara County
84209	Fee-for-Service	1245825413	1245825413	1	1	EMPHATY PALLIATIVE CARE INC	7/20/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10523 BURBANK BLVD	SUITE 117	NORTH HOLLYWOOD	CA	91601	2236	19	06037	34.17216449	-118.36017	Los Angeles County
84270	Fee-for-Service	1376612317	1376612317	1	1	EKLUND, DIANE K MD	7/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87554	22	Pathology (M.D. only)	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
84291	Fee-for-Service	1952491540	1952491540	1	1	EDWARDS, HANNAH MD	10/30/2023	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	127791	None	None	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
84307	Fee-for-Service	1518962273	1518962273	1	1	ELMORE MEDICAL CENTER	8/1/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	895 N 6TH E	None	MOUNTAIN HOME	ID	83647	2207	00	None	43.13810029	-115.6925128	Elmore County
84317	Fee-for-Service	1730522186	1730522186	1	1	ESTES, MOLLY K MD	7/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131934	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
84488	Fee-for-Service	1093867210	1093867210	1	1	ENGEL, GORDON R MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	12207	20	Orthopedic Surgery	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
84497	Fee-for-Service	1245825413	1245825413	1	1	EMPHATY PALLIATIVE CARE INC	7/20/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10523 BURBANK BLVD	SUITE 117	NORTH HOLLYWOOD	CA	91601	2236	19	06037	34.17216449	-118.36017	Los Angeles County
84591	Fee-for-Service	1518962273	1518962273	1	1	ELMORE MEDICAL CENTER	7/22/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	895 N 6TH E	None	MOUNTAIN HOME	ID	83647	2207	00	None	43.13810029	-115.6925128	Elmore County
84609	Fee-for-Service	1629014618	1629014618	1	1	EYE PHYSICIANS OF THE	1/1/1979	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EAST BAY MED CORP	80 GRAND AVE	STE #700	OAKLAND	CA	94612	3744	01	06001	37.81147674	-122.2656076	Alameda County
84616	Fee-for-Service	1861873796	1861873796	1	2	ENGLISH, JODON LCSW	4/19/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	82045	-	NOT APPLICABLE	0	In state provider	None	1260 E ARROW HIGHWAY	BLDGS B AND C	UPLAND	CA	91786	4982	36	06071	34.09953339	-117.6333297	San Bernardino County
84629	Fee-for-Service	1265875199	1265875199	1	1	EDERY, GABRIEL Y DC	10/24/2020	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	7439 RESEDA BLVD	None	RESEDA	CA	91335	2819	19	06037	34.205814	-118.536078	Los Angeles County
84669	Fee-for-Service	1568788388	1568788388	1	1	EXPERTOX INC.	8/31/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	1430 CENTER ST	None	DEER PARK	TX	77536	3582	00	None	29.69804115	-95.12380318	Harris County
84724	Fee-for-Service	1982689972	1982689972	1	1	ELLIAS, JEREMIAH F DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	EMERGENCY MED SPEC	2550 S PARKER RD	STE 206	AURORA	CO	80014	1679	00	None	39.670515	-104.8642785	Arapahoe County
84791	Fee-for-Service	1336579713	1336579713	1	1	EL CENTRO DE LIBERTAD THE	7/25/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	FREEDOM CENTER	225 S CABRILLO HIGHWAY	201C	HALF MOON BAY	CA	94019	1709	41	06081	37.46542425	-122.4337617	San Mateo County
85018	Fee-for-Service	1588744627	1588744627	2	1	ESSILFIE, WILLIAM MD	11/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	46137	41	Internal Medicine	0	In state provider	None	1141 W REDONDO BEACH BLV	SUITE 307	GARDENA	CA	90247	3583	19	06037	33.89247036	-118.2941482	Los Angeles County
85099	Fee-for-Service	1275786634	1275786634	1	1	EVASON, KIMBERLEY J MD	6/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108232	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
85251	Fee-for-Service	1699712299	1699712299	1	1	EVAN C LEIBNER MD	8/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	475 S DOBSON RD	None	CHANDLER	AZ	85224	5605	00	None	33.29768043	-111.8761089	Maricopa County
85262	Fee-for-Service	1023202371	1023202371	1	1	ESTRELLA-ITCHON, RHODA G MD	2/21/2002	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55570	01	General Practice	0	In state provider	INC	25495 MEDICAL CENTER DR	SUITE 301	MURRIETA	CA	92562	4904	33	06065	33.55804188	-117.1834064	Riverside County
85297	Fee-for-Service	1346015138	1346015138	1	1	ELNA LLC	1/16/2024	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2000 5TH ST	546	BERKELEY	CA	94710	1811	01	06001	37.86757452	-122.2988028	Alameda County
85568	Fee-for-Service	1497998512	1497998512	1	1	EWALT, MARK D MD	8/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121762	68	Hematology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1864	19	06037	34.07671715	-118.3799413	Los Angeles County
85577	Fee-for-Service	1902855588	1902855588	1	1	EVNIN, KERRY B MD	8/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	55240	08	Family Practice	0	In state provider	None	3641 MITCHELL RD	STE H	CERES	CA	95307	5026	50	06099	37.584468	-120.9387795	Stanislaus County
85591	Fee-for-Service	1538787239	1538787239	1	1	EFUETNGU, MAVIS NP	2/24/2025	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
85593	Fee-for-Service	1891174850	1891174850	1	1	ELIZABETH ENGLAND	2/12/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
85604	Fee-for-Service	1831165521	1831165521	1	1	EMILE SABBAGH, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	14519 DETROIT AVE	None	LAKEWOOD	OH	44107	4316	00	None	41.48527894	-81.79643923	Cuyahoga County
85648	Fee-for-Service	1144545534	1144545534	1	1	ESKANDARI, FARAHNAZ MD	1/18/2021	207P00000X	NA	Other	026	PHYSICIANS	169450	None	None	0	In state provider	None	2623 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2926	19	06037	33.98921547	-118.2242565	Los Angeles County
85687	Fee-for-Service	1497734297	1497734297	1	1	EMELIN, JESSICA K MD	10/14/2008	390200000X	NA	Other	026	PHYSICIANS	85093	02	General Surgery	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
85714	Fee-for-Service	1578797171	1578797171	1	1	EL-MASRY, MONICA S MD	4/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114528	41	Internal Medicine	0	In state provider	None	11600 INDIAN HILLS RD	None	MISSION HILLS	CA	91345	1225	19	06037	34.2811228	-118.4588429	Los Angeles County
85718	Fee-for-Service	1649222506	1649222506	1	1	ENSIGN PLEASANTON LLC	4/1/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1349 S DORA	None	UKIAH	CA	95482	6512	23	06045	39.13021438	-123.2087742	Mendocino County
85781	Fee-for-Service	1952485674	1952485674	1	1	ENGEL, GREGORY A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	550 16TH AVE	STE 100	SEATTLE	WA	98122	5699	00	None	47.60743396	-122.311502	King County
85946	Fee-for-Service	1003073032	1003073032	1	1	EVANS, SARA E LMFT	12/1/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1325 E COOLEY DR	110	COLTON	CA	92324	3904	36	06071	34.05468148	-117.306261	San Bernardino County
85989	Fee-for-Service	1760895296	1760895296	1	1	EL HABR, ELIE LMFT	1/3/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21263 ERWIN STREET	None	WOODLAND HILLS	CA	91367	3715	19	06037	34.18286951	-118.5949215	Los Angeles County
86087	Fee-for-Service	1659345569	1659345569	1	1	ERICKSON, STEPHANIE R CNM	4/27/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
86259	Fee-for-Service	1457956872	1457956872	1	1	ENG, ERIK C CRNA	12/16/2023	390200000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
86265	Fee-for-Service	1578648523	1578648523	1	1	ESPARZA, RAYMOND J MD	7/31/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77594	40	Pediatrics	0	In state provider	INC	1330 W COVINA BLVD	STE 203	SAN DIMAS	CA	91773	3200	19	06037	34.09894509	-117.8340464	Los Angeles County
86411	Fee-for-Service	1770301400	1770301400	1	1	ENRIQUEZ, CHANTAL DOULA	10/3/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
86414	Fee-for-Service	1699002634	1699002634	1	1	EAST BAY INNOVATIONS	2/16/2010	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	EAST BAY INNOVATIONS	2450 WASHINGTON AVE	STE 240	SAN LEANDRO	CA	94577	5943	01	06001	37.7139863	-122.1490905	Alameda County
86417	Fee-for-Service	1053389338	1053389338	1	1	ELTAHIR,NADIR ALI MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61585	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1866 N ORANGE GROVE AVE	STE 102	POMONA	CA	91767	3031	19	06037	34.07771682	-117.7485431	Los Angeles County
86435	Fee-for-Service	1609525963	1609525963	1	1	ENRIQUEZ, FAUSTINO D CNP	3/8/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
86463	Fee-for-Service	1477843852	1477843852	1	1	EMMONS, JENNIFER E NP	10/11/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1526 N EDGEMONT STREET	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
86517	Fee-for-Service	1750846887	1750846887	1	1	ENAD, MCWAYNE M RCP	4/15/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	905 MAPLE ST	None	REDWOOD CITY	CA	94063	0000	41	06081	37.48767797	-122.223049	San Mateo County
86553	Fee-for-Service	1578648523	1578648523	1	1	ESPARZA, RAYMOND J MD	7/31/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77594	41	Internal Medicine	0	In state provider	INC	1330 W COVINA BLVD	STE 203	SAN DIMAS	CA	91773	3200	19	06037	34.09894509	-117.8340464	Los Angeles County
86611	Fee-for-Service	1508999749	1508999749	1	1	EISENBERG, MICHAEL L MD	8/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93272	34	Urology and Urological Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
86668	Fee-for-Service	1720099328	1720099328	1	2	ENLOE MEDICAL CENTER	3/1/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	178 E 7TH AVE	None	CHICO	CA	95926	3305	04	06007	39.74462634	-121.8491997	Butte County
86697	Fee-for-Service	1477108652	1477108652	1	1	ELIZONDO, IRENE R	8/26/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	42927 BADGER CIRCLE	None	COARSEGOLD	CA	93614	9395	20	06039	37.19724291	-119.7641328	Madera County
86705	Fee-for-Service	1184758575	1184758575	1	1	ESPALIN, SUZANNE M MD	5/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	76171	None	None	0	In state provider	None	500 40TH ST	None	BAKERSFIELD	CA	93301	1224	15	06029	35.39619932	-119.0074457	Kern County
86706	Fee-for-Service	1053389338	1053389338	1	1	ELTAHIR,NADIR ALI MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61585	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1866 N ORANGE GROVE AVE	STE 102	POMONA	CA	91767	3031	19	06037	34.07771682	-117.7485431	Los Angeles County
86794	Fee-for-Service	1366501959	1366501959	1	1	EKE, CLIFFORD C MD	12/1/1997	208600000X	NA	General Surgery	026	PHYSICIANS	77219	89	Surgery-Traumatic	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
86830	Fee-for-Service	1891815544	1891815544	1	1	ELGIN, MATTHEW A LMFT	2/24/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	565 CASTRO STREET	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38903016	-122.0819046	Santa Clara County
86856	Fee-for-Service	1588347629	1588347629	1	1	ESSICK, KRISTEN M BIRTH DOUL	11/17/2023	174N00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
86894	Fee-for-Service	1225713894	1225713894	1	1	EMANUEL, ERIN NP	12/21/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
86988	Fee-for-Service	1477108652	1477108652	1	1	ELIZONDO, IRENE R	8/26/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	42927 BADGER CIRCLE	None	COARSEGOLD	CA	93614	9395	20	06039	37.19724291	-119.7641328	Madera County
86993	Fee-for-Service	1518045400	1518045400	1	1	ENRILE, DIANA F MD	2/7/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52366	40	Pediatrics	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	0000	39	06077	37.88652418	-121.2820956	San Joaquin County
86994	Fee-for-Service	1053389338	1053389338	1	1	ELTAHIR,NADIR ALI MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61585	41	Internal Medicine	0	In state provider	None	1866 N ORANGE GROVE AVE	STE 102	POMONA	CA	91767	3031	19	06037	34.07771682	-117.7485431	Los Angeles County
87061	Fee-for-Service	1275863854	1275863854	1	1	ERICKSON, BRENDA MD	11/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	89348	36	Psychiatry	0	In state provider	None	4647 ZION AVENUE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
87072	Fee-for-Service	1154730828	1154730828	1	2	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8932 WOODMAN AVE	None	ARLETA	CA	91331	8021	19	06037	34.23207547	-118.4379725	Los Angeles County
87078	Fee-for-Service	1104376748	1104376748	1	1	EISENBERG, NINA PHD	9/11/2017	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2651	07	06013	38.00771973	-122.1331484	Contra Costa County
87154	Fee-for-Service	1437298452	1437298452	1	1	EMIL, NICOLE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
87186	Fee-for-Service	1275764615	1275764615	1	2	EMANUEL MEDICAL GROUP INC	8/2/2010	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2240 W MONTE VISTA AVE	None	TURLOCK	CA	95382	9667	50	06099	37.52173653	-120.8741705	Stanislaus County
87196	Fee-for-Service	1699835975	1699835975	1	1	ENGELHARDT, JIANYUN H LAC	2/12/2021	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1263 E ARQUES AVENUE	None	SUNNYVALE	CA	94085	4701	43	06085	37.38060846	-121.9896672	Santa Clara County
87342	Fee-for-Service	1477624419	1477624419	1	1	ESKANDARI, NILOOFAR MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68092	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
87350	Fee-for-Service	1023177870	1023177870	1	1	EDELSTEN, LEON E MD	9/29/1978	207N00000X	NA	Dermatology	026	PHYSICIANS	19208	07	Dermatology	0	In state provider	AMER WEST SKIN PATH CONS	1007 LIVE OAK BLVD	STE A1	YUBA CITY	CA	95991	3454	51	06101	39.14368281	-121.6207923	Sutter County
87360	Fee-for-Service	1154730828	1154730828	1	2	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8932 WOODMAN AVE	None	ARLETA	CA	91331	8021	19	06037	34.23207547	-118.4379725	Los Angeles County
87374	Fee-for-Service	1902827892	1902827892	1	1	EAST BAY PRIMARY CARE	9/16/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GROUP INC	373 9TH ST	STE 403	OAKLAND	CA	94607	6517	01	06001	37.80008607	-122.2714059	Alameda County
87394	Fee-for-Service	1598743254	1598743254	1	1	EZEANOLUE, ECHEZONA MD FAAP	10/31/2023	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	188191	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
87493	Fee-for-Service	1124451331	1124451331	1	1	ESPINOSA, SARA LMFT	5/7/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
87518	Fee-for-Service	1205853041	1205853041	1	1	EUCLID ENDOSCOPY CTR LP	6/8/2007	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	286 EUCLID AVE	STE 109	SAN DIEGO	CA	92114	3611	37	06073	32.70706919	-117.0850896	San Diego County
87587	Fee-for-Service	1144304122	1144304122	1	1	ELLIOTT, WILLIAM T MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42750	66	Emergency Medicine (Urgent Care)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
87605	Fee-for-Service	1942501960	1942501960	2	1	EMERGENCY MEDICINE PHYS OF	12/31/2012	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	CLARK SAINT ROSE MCCOURT	102 E LAKE MEAD PARKWAY	None	HENDERSON	NV	89015	5575	00	None	36.03815706	-114.9842287	Clark County
87799	Fee-for-Service	1487690574	1487690574	1	1	EAST BAY RETINA CONS	1/1/1995	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL GROUP INC	1860 MOWRY AVE	STE 308	FREMONT	CA	94538	1730	01	06001	37.55887933	-121.9797796	Alameda County
87840	Fee-for-Service	1851847545	1851847545	1	1	EMBER HOME HEALTH INC	10/21/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1110 SONORA AVE	STE 106	GLENDALE	CA	91201	3170	19	06037	34.1688301	-118.2852463	Los Angeles County
87902	Fee-for-Service	1053029918	1053029918	1	1	EVAGELOS COSKINAS MD A MEDIC	3/20/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	AL CORPORATION	301 VICTORIA ST	None	COSTA MESA	CA	92627	1995	30	06059	33.65258952	-117.9121545	Orange County
87965	Fee-for-Service	1306040712	1306040712	1	1	EHSANI, SHAUN S MD	1/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99065	08	Family Practice	0	In state provider	None	215 PESETAS LANE	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
87978	Fee-for-Service	1083931711	1083931711	1	1	EVJEN, AMY N MD	1/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	1325 S CLIFF AVENUE	None	SIOUX FALLS	SD	57105	1007	00	None	43.533945	-96.714819	Minnehaha County
88005	Fee-for-Service	1437103942	1437103942	1	20	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	7850 VISTA HILL AVE	None	SAN DIEGO	CA	92123	2717	37	06073	32.79493052	-117.155268	San Diego County
88153	Fee-for-Service	1154730828	1154730828	1	7	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	20800 SHERMAN WAY	None	WINNETKA	CA	91306	2707	19	06037	34.20097455	-118.586502	Los Angeles County
88188	Fee-for-Service	1881719383	1881719383	1	1	EPSTEIN, OREN G MD	8/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96466	20	Orthopedic Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
88246	Fee-for-Service	1184858896	1184858896	1	1	EANDI, KIRA J MD	9/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106136	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
88252	Fee-for-Service	1306040712	1306040712	1	1	EHSANI, SHAUN S MD	1/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99065	66	Emergency Medicine (Urgent Care)	0	In state provider	None	215 PESETAS LANE	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
88283	Fee-for-Service	1992701338	1992701338	1	1	ELY, EVELYN A MD	7/30/1991	208M00000X	NA	Other	026	PHYSICIANS	46639	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
88293	Fee-for-Service	1437103942	1437103942	1	20	EMERGENCY & ACUTE CARE	5/11/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7850 VISTA HILL AVE	None	SAN DIEGO	CA	92123	2717	37	06073	32.79493052	-117.155268	San Diego County
88330	Fee-for-Service	1639417322	1639417322	1	1	ELIZABETH PURVIS-JEFFREY FNP	5/10/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MEDICAL	None	OMAHA	NE	68198	7400	00	None	0	0	None
88345	Fee-for-Service	1336994847	1336994847	1	1	ELEMENT MEDICAL INC	1/9/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	29723 INDIGO PL	None	TEMECULA	CA	92592	4702	33	06065	33.50171002	-117.1379247	Riverside County
88367	Fee-for-Service	1073781126	1073781126	1	1	EAR NOSE & THROAT	10/27/2008	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	SPECIALIST INC	268 S HALCYON ROAD	None	ARROYO GRANDE	CA	93420	3135	40	06079	35.11512424	-120.5916674	San Luis Obispo County
88388	Fee-for-Service	1891730412	1891730412	1	1	EL-KHOUEIRY, ANTHONY MD	5/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71334	None	None	0	In state provider	None	1520 SAN PABLO ST	STE 1000	LOS ANGELES	CA	90033	5312	19	06037	34.06269295	-118.2030006	Los Angeles County
88439	Fee-for-Service	1154730828	1154730828	1	7	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	20800 SHERMAN WAY	None	WINNETKA	CA	91306	2707	19	06037	34.20097455	-118.586502	Los Angeles County
88486	Fee-for-Service	1932585007	1932585007	1	1	EUFRACIO, MARTHA LCSW	11/5/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	276 W COLLEGE ST	None	COVINA	CA	91723	1902	19	06037	34.08747441	-117.8941951	Los Angeles County
88518	Fee-for-Service	1922143791	1922143791	1	1	ERADAT, HERBERT A MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87471	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE # 365	LOS ANGELES	CA	90024	1002	19	06037	34.06527974	-118.4462792	Los Angeles County
88528	Fee-for-Service	1710057245	1710057245	1	1	EAST WEST EYE INSTITUTE A ME	3/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	420 E 3RD ST	STE 603	LOS ANGELES	CA	90013	1645	19	06037	34.04702011	-118.241912	Los Angeles County
88580	Fee-for-Service	1437103942	1437103942	1	20	EMERGENCY & ACUTE CARE	5/3/2016	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	7850 VISTA HILL AVE	None	SAN DIEGO	CA	92123	2717	37	06073	32.79493052	-117.155268	San Diego County
88583	Fee-for-Service	1699002550	1699002550	1	1	EZE, NWANDO U MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	103608	40	Pediatrics	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
88740	Fee-for-Service	1578754727	1578754727	1	1	EDELSTEIN, ELISABETH R MD	11/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128670	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
88780	Fee-for-Service	1780023788	1780023788	1	1	ELHILALI, OSAMA	6/13/2024	207R00000X	NA	Other	026	PHYSICIANS	170880	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
88810	Fee-for-Service	1922143791	1922143791	1	1	ERADAT, HERBERT A MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87471	68	Hematology	0	In state provider	None	200 MEDICAL PLAZA	SUITE # 365	LOS ANGELES	CA	90024	1002	19	06037	34.06527974	-118.4462792	Los Angeles County
88930	Fee-for-Service	1407160930	1407160930	1	1	EVANS, MONICA L	1/19/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
88968	Fee-for-Service	1811147853	1811147853	1	1	ESPOSO, ORIENTE M MD	10/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	42316	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	901 OLIVE DR	None	BAKERSFIELD	CA	93308	4137	15	06029	35.41225153	-119.0396655	Kern County
88991	Fee-for-Service	1972831162	1972831162	1	1	ETERNALLY YOURS HOSPICE INC	12/20/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2550 E AMAR ROAD UNIT	A1-G	WEST COVINA	CA	91792	2230	19	06037	34.02732265	-117.8963899	Los Angeles County
89091	Fee-for-Service	1922143791	1922143791	1	1	ERADAT, HERBERT A MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87471	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 MEDICAL PLAZA	SUITE # 365	LOS ANGELES	CA	90024	1002	19	06037	34.06527974	-118.4462792	Los Angeles County
89100	Fee-for-Service	1063428084	1063428084	1	1	EARLY, LORETTA F MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	11370	40	Pediatrics	0	In state provider	None	4100 35TH AVE	None	OAKLAND	CA	94619	1504	01	06001	37.79734197	-122.1943849	Alameda County
89151	Fee-for-Service	1841900594	1841900594	1	1	EMERALD SENIOR CARE INC	1/12/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	10401 ENCINO AVE	None	GRANADA HILLS	CA	91344	6043	19	06037	34.259679	-118.515487	Los Angeles County
89200	Fee-for-Service	1417373713	1417373713	1	1	EHAB YACOUB MD INC.	2/15/2023	2084P0804X	NA	Psychiatry	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
89209	Fee-for-Service	1811121809	1811121809	1	1	EAST BAY PULMONARY SPECIALIS	11/19/2009	193400000X	NA	Other	026	PHYSICIANS	97958	66	Emergency Medicine (Urgent Care)	0	In state provider	TS, INC	13847 E 14TH STREET	STE 119	SAN LEANDRO	CA	94578	2625	01	06001	37.71457844	-122.1418551	Alameda County
89240	Fee-for-Service	1609986777	1609986777	1	1	EAST BAY CARDIAC SURGERY	1/3/1994	208G00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CENTER MEDICAL GROUP	3300 WEBSTER ST	STE 500	OAKLAND	CA	94609	3149	01	06001	37.82132826	-122.2621843	Alameda County
89257	Fee-for-Service	1811147853	1811147853	1	1	ESPOSO, ORIENTE M MD	10/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	42316	41	Internal Medicine	0	In state provider	None	901 OLIVE DR	None	BAKERSFIELD	CA	93308	4137	15	06029	35.41225153	-119.0396655	Kern County
89279	Fee-for-Service	1972831162	1972831162	1	1	ETERNALLY YOURS HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2550 E AMAR ROAD UNIT	A1-G	WEST COVINA	CA	91792	2230	19	06037	34.02732265	-117.8963899	Los Angeles County
89360	Fee-for-Service	1093246928	1093246928	1	1	EBRIMA BANGURA	9/5/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10200 NE 132ND ST	None	KIRKLAND	WA	98034	2831	00	None	47.71853274	-122.2042278	King County
89372	Fee-for-Service	1184232886	1184232886	1	1	E.R.F. INCORPORATED	10/26/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	IES	3409 CALLOWAY DR	STE 502A	BAKERSFIELD	CA	93312	2528	15	06029	35.39132551	-119.11007	Kern County
89374	Fee-for-Service	1265130181	1265130181	1	1	ESIOBU MEDICAL GROUP PC	1/18/2024	2086S0129X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	255 TERRACINA BLVD	104B	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
89378	Fee-for-Service	1902085152	1902085152	1	1	EBRAHIMI, HAMI MD	9/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101490	41	Internal Medicine	0	In state provider	None	450 E ROMIE LANE	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
89473	Fee-for-Service	1508976739	1508976739	1	1	EDWARDS, ROBERT H MD	7/31/1993	2084N0400X	NA	Neurology	026	PHYSICIANS	47432	13	Neurology (M.D. only)	0	In state provider	None	300 UCLA MEDICAL PLZ	STE B200	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
89478	Fee-for-Service	1366002362	1366002362	1	1	ELIZONDO, DANIEL MD	7/12/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
89487	Fee-for-Service	1619294196	1619294196	1	1	EBERLE, JEAN-PAUL LMFT	11/3/2017	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	34 FORREST STREET	None	MILL VALLEY	CA	94941	2003	21	06041	37.90534713	-122.5451415	Marin County
89488	Fee-for-Service	1417373713	1417373713	1	1	EHAB YACOUB MD INC.	2/3/2022	2084P0804X	NA	Psychiatry	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
89503	Fee-for-Service	1811121809	1811121809	1	1	EAST BAY PULMONARY SPECIALIS	11/19/2009	193400000X	NA	Other	026	PHYSICIANS	97958	41	Internal Medicine	0	In state provider	TS, INC	13847 E 14TH STREET	STE 119	SAN LEANDRO	CA	94578	2625	01	06001	37.71457844	-122.1418551	Alameda County
89524	Fee-for-Service	1356107197	1356107197	1	1	EVERGREEN MARRIAGE AND FAMIL	4/1/2024	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	5079 HIGHWAY 140	None	MARIPOSA	CA	95338	2434	22	06043	37.48746975	-119.9681179	Mariposa County
89592	Fee-for-Service	1528303286	1528303286	1	1	ESTRADA, CLAUDIA A LMFT	2/21/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5850 EL CAMINO REAL	None	ATASCADERO	CA	93422	3318	40	06079	35.48962035	-120.670989	San Luis Obispo County
89668	Fee-for-Service	1861783599	1861783599	1	1	EYELID INSTITUTE INC	2/3/2012	207W00000X	NA	Ophthalmology	026	PHYSICIANS	115818	18	Ophthalmology	0	In state provider	None	36867 COOK STREET	SUITE 103	PALM DESERT	CA	92211	6064	33	06065	33.781293	-116.3586555	Riverside County
89709	Fee-for-Service	1891701744	1891701744	1	1	EVANS, RONALD C MD	9/1/1994	207W00000X	NA	Ophthalmology	026	PHYSICIANS	51003	18	Ophthalmology	0	In state provider	None	3105 CEDAR RAVINE RD	STE 103	PLACERVILLE	CA	95667	6561	09	06017	38.72626462	-120.7945035	El Dorado County
89766	Fee-for-Service	1144766890	1144766890	1	1	EDWARDS, BRIANNA V NP	9/14/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 WEST HENDERSON AVE	None	PORTERVILLE	CA	93257	1731	54	06107	36.0804034	-119.0217006	Tulare County
89772	Fee-for-Service	1790914323	1790914323	1	1	ELMER, JEFFREY C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SPOKANE CRITTICAL CARE	104 W 5TH AVE SUITE 400W	None	SPOKANE	WA	99204	0000	00	None	47.651625	-117.4141485	Spokane County
89774	Fee-for-Service	1417373713	1417373713	1	1	EHAB YACOUB MD INC.	9/3/2021	2084P0804X	NA	Psychiatry	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
89783	Fee-for-Service	1811121809	1811121809	1	1	EAST BAY PULMONARY SPECIALIS	11/19/2009	193400000X	NA	Other	026	PHYSICIANS	97958	29	Pulmonary Diseases (M.D. only)	0	In state provider	TS, INC	13847 E 14TH STREET	STE 119	SAN LEANDRO	CA	94578	2625	01	06001	37.71457844	-122.1418551	Alameda County
89791	Fee-for-Service	1700030418	1700030418	1	1	EZZATI, MOHAMMAD MD	7/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135887	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
89799	Fee-for-Service	1780259150	1780259150	1	1	ELK GROVE HOME HEALTH INC	4/10/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2386 MARITIME DR	STE 220	ELK GROVE	CA	95758	3643	34	06067	38.411235	-121.482738	Sacramento County
89811	Fee-for-Service	1356107197	1356107197	1	1	EVERGREEN MARRIAGE AND FAMIL	4/1/2024	101YM0800X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	5079 HIGHWAY 140	None	MARIPOSA	CA	95338	2434	22	06043	37.48746975	-119.9681179	Mariposa County
89915	Fee-for-Service	1861603821	1861603821	1	1	EASLEY, SAMANTHA E MD	5/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147650	22	Pathology (M.D. only)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
89945	Fee-for-Service	1861447658	1861447658	1	1	EISNER, PERRY M MD	9/30/1986	207L00000X	NA	Other	026	PHYSICIANS	59171	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
89955	Fee-for-Service	1972635498	1972635498	1	1	EDWARDS, KATHERINE C MD	7/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87624	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
89961	Fee-for-Service	1154771285	1154771285	1	1	EISNER, HAILEY DO	1/19/2024	208800000X	NA	Other	026	PHYSICIANS	21344	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
90012	Fee-for-Service	1770531485	1770531485	1	1	ENGLANOFF, GILAT MD	10/31/1996	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	77964	01	General Practice	0	In state provider	None	5525 W SLAUSON AVE	None	LOS ANGELES	CA	90056	1047	19	06037	33.98912847	-118.3784926	Los Angeles County
90052	Fee-for-Service	1821386491	1821386491	1	1	ELAMIR, SAMEH M MD	9/9/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163235	40	Pediatrics	0	In state provider	None	2221 ARGONNE AVE	None	LONG BEACH	CA	90815	2527	19	06037	33.79673846	-118.1362298	Los Angeles County
90060	Fee-for-Service	1588246342	1588246342	1	1	ESMAEILI GHAHFAROKHI, MELODY	7/10/2024	207R00000X	NA	Other	026	PHYSICIANS	181325	41	Internal Medicine	0	In state provider	MD	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
90063	Fee-for-Service	1417373713	1417373713	1	1	EHAB YACOUB MD INC.	9/3/2021	2084P0804X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
90084	Fee-for-Service	1740322098	1740322098	1	1	EHRLICH, BETH L	1/1/1979	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	20126 STANTON AVE	STE 205	CASTRO VALLEY	CA	94546	5270	01	06001	37.69722866	-122.090936	Alameda County
90222	Fee-for-Service	1073520920	1073520920	1	1	EMAD, BEHZAD MD	2/8/2015	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	55727	25	Physical Medicine and Rehabilitation	0	In state provider	SOUTHLAND INJURY MEDICAL	5757 WILSHIRE BLVD	STE 500	LOS ANGELES	CA	90036	3628	19	06037	34.0624504	-118.3534253	Los Angeles County
90299	Fee-for-Service	1770531485	1770531485	1	1	ENGLANOFF, GILAT MD	10/31/1996	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	77964	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5525 W SLAUSON AVE	None	LOS ANGELES	CA	90056	1047	19	06037	33.98912847	-118.3784926	Los Angeles County
90339	Fee-for-Service	1821386491	1821386491	1	1	ELAMIR, SAMEH M MD	3/1/2021	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	2221 ARGONNE AVE	None	LONG BEACH	CA	90815	2527	19	06037	33.79673846	-118.1362298	Los Angeles County
90354	Fee-for-Service	1417373713	1417373713	1	1	EHAB YACOUB MD INC.	5/16/2023	2084P0804X	NA	Psychiatry	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
90428	Fee-for-Service	1942274964	1942274964	1	1	ELMORE, KELLY O	4/12/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	105818	09	Gynecology (D.O. only)	0	In state provider	None	3040 IMPERIAL	None	SAN DIEGO	CA	92102	4128	37	06073	32.70643926	-117.1285458	San Diego County
90451	Fee-for-Service	1750452652	1750452652	1	1	EVENSEN, KAREN E MD	12/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83179	20	Orthopedic Surgery	0	In state provider	SUITE 140	200 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
90557	Fee-for-Service	1861547671	1861547671	1	1	EIMERS, ANTOINETTE M PSYD	11/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	228 W MAIN ST	None	TUSTIN	CA	92780	4320	30	06059	33.74205276	-117.8255581	Orange County
90574	Fee-for-Service	1558939272	1558939272	1	1	EGELI, BUGRA H MD	10/22/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
90628	Fee-for-Service	1750839908	1750839908	1	1	EVANGELISTA, MELISSA T CRNA	12/16/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
90681	Fee-for-Service	1083134738	1083134738	1	1	EXTRA HAND IN HOME CARE	7/10/2017	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	8439 WHITE OAK AVE	UNIT 104	RANCHO CUCAMONGA	CA	91730	3860	36	06071	34.10031486	-117.5650469	San Bernardino County
90686	Fee-for-Service	1053678086	1053678086	1	2	ELDER, JOSHUA W MD	5/24/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	127380	-	NOT APPLICABLE	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
90698	Fee-for-Service	1366520843	1366520843	1	1	EIBSCHUTZ, OFER M MD	1/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76576	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
90749	Fee-for-Service	1437103942	1437103942	1	6	EMERGENCY & ACUTE CARE	3/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	354 SANTA FE DRIVE	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
90876	Fee-for-Service	1316204894	1316204894	1	1	ELBATTA, MOHAMMAD A MD	8/20/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	162124	10	Gastroenterology (M.D. only)	0	In state provider	None	790 E BONITA AVE	FL 2	POMONA	CA	91767	1906	19	06037	34.09621447	-117.737406	Los Angeles County
90987	Fee-for-Service	1366520843	1366520843	1	1	EIBSCHUTZ, OFER M MD	1/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76576	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
91039	Fee-for-Service	1437103942	1437103942	1	6	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	354 SANTA FE DRIVE	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
91092	Fee-for-Service	1801197256	1801197256	1	1	ESOTERIX GENETIC	4/5/2011	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	LABORATORIES LLC	2000 VIVIGEN WAY	None	SANTA FE	NM	87505	5600	00	None	35.63769397	-105.9605126	Santa Fe County
91120	Fee-for-Service	1003162579	1003162579	1	1	EDICK, KIMBERLY L	1/24/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3450 E LA PALMA AVENUE	None	ANAHEIM	CA	92806	9999	30	06059	33.85417768	-117.8450896	Orange County
91234	Fee-for-Service	1669509733	1669509733	1	1	EISENBERG, TOM ANDREW PHD	8/24/2010	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2130 HUNTINGTON DR	STE 306	SOUTH PASADENA	CA	91030	4964	19	06037	34.10622227	-118.1358873	Los Angeles County
91257	Fee-for-Service	1801877212	1801877212	1	1	ENRIQUE CARROSCO-ROJAS	4/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	900 SOUTH BRYAN RD	None	MISSION	TX	78572	6613	00	None	26.19615756	-98.31278434	Hidalgo County
91261	Fee-for-Service	1124095062	1124095062	1	1	ENGINEER, SHIRIN MD	3/11/2025	207L00000X	NA	Other	026	PHYSICIANS	172442	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
91273	Fee-for-Service	1235190760	1235190760	1	1	ELIAS, ROGER E MD	11/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132709	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
91303	Fee-for-Service	1821024985	1821024985	1	1	ELIAS, MONTE F MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	STRAUB CLINIC & HOSPITAL	888 SOUTH KING STREET	None	HONOLULU	HI	96813	0000	00	None	21.30218603	-157.8505732	Honolulu County
91384	Fee-for-Service	1154730828	1154730828	1	6	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	18250 ROSCOE BLVD	STE 200	NORTHRIDGE	CA	91325	4226	19	06037	34.22076142	-118.5313223	Los Angeles County
91387	Fee-for-Service	1730152174	1730152174	1	1	ECKHOLDT, PATRICIA A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2000 W BETHANY HOME RD	None	PHOENIX	AZ	85015	2443	00	None	33.525405	-112.102461	Maricopa County
91449	Fee-for-Service	1922495712	1922495712	1	1	ELSISSY, JOSEPH G MD	7/23/2020	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	143906	20	Orthopedic Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
91513	Fee-for-Service	1861750846	1861750846	1	1	ELYOUSEF, RAMI S MD	6/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	142399	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVENUE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
91538	Fee-for-Service	1306987938	1306987938	1	1	EDLER, ALICE A MD	11/16/2000	207L00000X	NA	Other	026	PHYSICIANS	46952	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
91633	Fee-for-Service	1871603829	1871603829	2	1	EGARI, ROY MD	6/11/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	37407	34	Urology and Urological Surgery	0	In state provider	None	8635 W 3RD ST	STE 855W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
91672	Fee-for-Service	1154730828	1154730828	1	6	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	18250 ROSCOE BLVD	STE 200	NORTHRIDGE	CA	91325	4226	19	06037	34.22076142	-118.5313223	Los Angeles County
91716	Fee-for-Service	1619491669	1619491669	1	1	ESTRADA, MARISOL LMFT	3/23/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
91749	Fee-for-Service	1801933999	1801933999	1	1	ESTRADA, DIANE LMFT	8/15/2023	225C00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
91859	Fee-for-Service	1366943060	1366943060	1	1	ESTABILLO, JASPER PHD	10/20/2021	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
91959	Fee-for-Service	1154730828	1154730828	1	6	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	18250 ROSCOE BLVD	STE 200	NORTHRIDGE	CA	91325	4226	19	06037	34.22076142	-118.5313223	Los Angeles County
91988	Fee-for-Service	1952460693	1952460693	1	1	ELLINI, KAYVAN A MD	2/28/2008	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	80456	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
92019	Fee-for-Service	1780027649	1780027649	1	1	ELLINOY, JESSICA R MD	3/14/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	135240	None	None	0	In state provider	None	2340 CLAY ST	7TH FLOOR	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
92080	Fee-for-Service	1528125135	1528125135	1	1	EKSTRAND, BRADLEY C MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71243	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
92082	Fee-for-Service	1720405897	1720405897	1	1	EASTMAN, KARINA S MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142031	40	Pediatrics	0	In state provider	None	8501 WILSHIRE BLVD	None	LOS ANGELES	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles
92084	Fee-for-Service	1497882591	1497882591	1	1	EPIPHANY CARE HOMES INC	8/1/2003	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SEASHORE HOME ICF/DD-H	1260 INDIGO PL	None	OXNARD	CA	93036	1510	56	06111	34.227333	-119.191704	Ventura County
92100	Fee-for-Service	1912954835	1912954835	1	1	EWING, WILLIE B MD	11/30/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38731	01	General Practice	0	In state provider	None	810 E D ST	None	LEMOORE	CA	93245	9545	16	06031	36.30069303	-119.7694815	Kings County
92167	Fee-for-Service	1982732129	1982732129	1	1	ELLSMORE, ALBERT E LMFT	9/10/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1320 STANDIFORD AVE	STE 5	MODESTO	CA	95350	0726	50	06099	37.68934252	-121.0140405	Stanislaus County
92226	Fee-for-Service	1447395017	1447395017	1	1	EWAK, EUNJU L	2/8/2015	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1530 S OLIVE STREET	None	LOS ANGELES	CA	90015	3023	19	06037	34.03542552	-118.2652073	Los Angeles County
92247	Fee-for-Service	1154730828	1154730828	1	6	EL PROYECTO DEL BARRIO INC	1/15/2025	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	18250 ROSCOE BLVD	STE 200	NORTHRIDGE	CA	91325	4226	19	06037	34.22076142	-118.5313223	Los Angeles County
92308	Fee-for-Service	1457648446	1457648446	1	1	ETCHEPARE, MARIA CNP	5/11/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2900 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2730	19	06037	33.896799	-118.3959415	Los Angeles County
92320	Fee-for-Service	1629279864	1629279864	1	1	ESMAILI, DANIEL D MD	6/13/2013	207W00000X	NA	Ophthalmology	026	PHYSICIANS	91049	18	Ophthalmology	0	In state provider	None	1808 VERDUGO BOULEVARD	SUITE 206	GLENDALE	CA	91208	1412	19	06037	34.2056211	-118.2154553	Los Angeles County
92367	Fee-for-Service	1528125135	1528125135	1	1	EKSTRAND, BRADLEY C MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71243	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
92546	Fee-for-Service	1588831630	1588831630	1	1	ELMS, ANDREW MD	6/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104999	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
92568	Fee-for-Service	1386902021	1386902021	1	1	EDWARDS, JOHN R LCSW	10/7/2013	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2939 SUMMIT STREET	SUITE 203	OAKLAND	CA	94609	3404	01	06001	37.81854368	-122.264813	Alameda County
92623	Fee-for-Service	1568812642	1568812642	1	1	EDEN, MICHAEL G DO	2/12/2020	207R00000X	NA	Other	026	PHYSICIANS	16047	41	Internal Medicine	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	0001	39	06077	37.97026329	-121.2890849	San Joaquin County
92628	Fee-for-Service	1659548980	1659548980	1	1	ELLISON, DENISE M CNM	1/7/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
92733	Fee-for-Service	1497141360	1497141360	1	1	EMERUWA, EZINNE N MD	5/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149452	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
92800	Fee-for-Service	1114513710	1114513710	1	1	EAGLE GLEN HOSPICE CARE	12/16/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10600 MAGNOLIA AVE	SUITE H	RIVERSIDE	CA	92505	1819	33	06065	33.90819148	-117.4676613	Riverside County
92819	Fee-for-Service	1255489035	1255489035	1	1	ESTEBAN, EVERARD T MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65847	08	Family Practice	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
92912	Fee-for-Service	1831485408	1831485408	1	1	EMMANUEL HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4640 LANKERSHIM BLVD	SUITE 110	NORTH HOLLYWOOD	CA	91602	1845	19	06037	34.15483659	-118.368496	Los Angeles County
92947	Fee-for-Service	1447670534	1447670534	1	1	EMPOWER SPEECH THERAPY AND L	5/23/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	IFE SKILLS CENTER PC	745 E LOCUST AVE	STE. 110	FRESNO	CA	93720	3000	10	06019	36.84055248	-119.7718605	Fresno County
92966	Fee-for-Service	1306203211	1306203211	1	1	ESPINOZA, GENESIS LMFT	10/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	330 N. MACLAY AVE.	SUITE 206	SAN FERNANDO	CA	91340	1554	19	06037	34.28638902	-118.4370428	Los Angeles County
93053	Fee-for-Service	1437103942	1437103942	1	5	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	9888 GENESSEE AVENUE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
93074	Fee-for-Service	1801193768	1801193768	1	1	EUREKA REHABILITATION &	4/1/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNES CENTER LP	2353 23RD ST	None	EUREKA	CA	95501	3201	12	06023	40.7869233	-124.1433638	Humboldt County
93089	Fee-for-Service	1114513710	1114513710	1	1	EAGLE GLEN HOSPICE CARE	12/16/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10600 MAGNOLIA AVE	SUITE H	RIVERSIDE	CA	92505	1819	33	06065	33.90819148	-117.4676613	Riverside County
93127	Fee-for-Service	1063814671	1063814671	1	1	EASE & COMFORT HOME HEALTH	12/28/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	5301 LAUREL CANYON BLVD	SUITE 132	VALLEY VILLAGE	CA	91607	4935	19	06037	34.166907	-118.396546	Los Angeles County
93145	Fee-for-Service	1083782452	1083782452	1	1	ELIAZAR, ANGELICA	6/5/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1132 MCKENDRIE ST	None	SAN JOSE	CA	95126	2220	43	06085	37.34121241	-121.9246913	Santa Clara County
93199	Fee-for-Service	1831485408	1831485408	1	1	EMMANUEL HOSPICE INC	8/9/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4640 LANKERSHIM BLVD	SUITE 110	NORTH HOLLYWOOD	CA	91602	1845	19	06037	34.15483659	-118.368496	Los Angeles County
93222	Fee-for-Service	1124105937	1124105937	1	1	ELATI, VIJAYSHEKAR R MD	1/31/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94250	01	General Practice	0	In state provider	None	1180 E SHAW AVE	STE 101	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
93228	Fee-for-Service	1811635162	1811635162	1	1	EBERSOLE, RYAN M PT	4/23/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	907 EMBARCADERO DR	None	EL DORADO HILLS	CA	95762	4087	09	06017	38.70864351	-121.0826115	El Dorado County
93290	Fee-for-Service	1265852172	1265852172	1	1	EDELSON, ERIC PSYD	6/21/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2001 JUNIPERO SERRA BLVD	STE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
93340	Fee-for-Service	1437103942	1437103942	1	5	EMERGENCY & ACUTE CARE	3/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9888 GENESSEE AVENUE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
93430	Fee-for-Service	1649459983	1649459983	1	1	ELSAYED, SAMI S MD	2/9/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183469	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
93434	Fee-for-Service	1790399574	1790399574	1	1	ERNST, WESTON W NP	7/12/2022	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
93465	Fee-for-Service	1770724627	1770724627	1	1	ELNEMR-ARKZAT, AYDAH LCSW	3/13/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
93493	Fee-for-Service	1679651731	1679651731	1	1	ELEFTHERIADIS, IOANNIS E	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	61315	41	Internal Medicine	0	In state provider	None	5601 DEER VALLEY RD	None	ANTIOCH	CA	94531	8577	07	06013	37.9518204	-121.7780768	Contra Costa County
93516	Fee-for-Service	1669215000	1669215000	1	1	EZENWAKA, EKENEDILICHUKWU N	3/1/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	P	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
93631	Fee-for-Service	1518083872	1518083872	1	1	EKEH, OBIAGERI T MD	8/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
93664	Fee-for-Service	1699345900	1699345900	1	1	EXCELL POST ACUTE LLC	7/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3025 HIGH ST	None	OAKLAND	CA	94619	1807	01	06001	37.78454091	-122.2002993	Alameda County
93750	Fee-for-Service	1225423957	1225423957	1	1	EBINU, JULIUS O MD	9/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151022	14	Neurological Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
93902	Fee-for-Service	1770745747	1770745747	1	1	EVERHART, JENNIFER L MD	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	100207	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
93921	Fee-for-Service	1245716943	1245716943	1	1	ESCOBAR, TONYA S NP	7/15/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	588278	-	NOT APPLICABLE	0	In state provider	None	2960 CAMINO DIABLO	105	WALNUT CREEK	CA	94597	3988	07	06013	37.89859467	-122.0843018	Contra Costa County
94061	Fee-for-Service	1528303781	1528303781	1	1	EGEM, ANNE M NP	12/16/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1524 MCHENRY AVE	STE 135	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
94115	Fee-for-Service	1669542916	1669542916	1	1	ESPIRITU, ARLENE D OD	9/4/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2615 CAPITOL AVE	None	SACRAMENTO	CA	95816	5904	34	06067	38.571399	-121.472532	Sacramento County
94176	Fee-for-Service	1609858802	1609858802	1	1	EWIG, AUDREY N MD	1/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77548	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
94258	Fee-for-Service	1861503351	1861503351	1	1	EAST BAY VASCULAR MED GR	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	A PROF CORPORATION	365 HAWTHORNE AVE	STE 103	OAKLAND	CA	94609	3115	01	06001	37.82079728	-122.2633226	Alameda County
94393	Fee-for-Service	1609830066	1609830066	1	1	ENRIQUEZ, LYDIA LCSW	8/2/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8002 HAVEN AVE	None	RANCHO CUCAMONGA	CA	91730	3047	36	06071	34.1081217	-117.5759884	San Bernardino County
94403	Fee-for-Service	1487748729	1487748729	1	1	EMMICK, CHRISTINE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	333 SCHOOL ST	None	PAWTUCKET	RI	02860	5334	00	None	41.86713306	-71.37702412	Providence County
94420	Fee-for-Service	1649392432	1649392432	1	1	EVANS, TOMI MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	51873	02	General Surgery	0	In state provider	WOMENS SURGICAL ASSOC	701 E 28TH ST	STE 411	LONG BEACH	CA	90806	2789	19	06037	33.80803441	-118.1847137	Los Angeles County
94440	Fee-for-Service	1699777391	1699777391	1	1	EDSON, DARREN S MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	50141	66	Emergency Medicine (Urgent Care)	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
94472	Fee-for-Service	1083233118	1083233118	1	1	ENRIQUEZ, CYNTHIA MD	6/29/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	185139	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
94649	Fee-for-Service	1922536721	1922536721	1	1	ESTRADA, PAMELA V MD	8/12/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	172320	None	None	0	In state provider	None	1514 VALLEY VISTA DR	None	DIAMOND BAR	CA	91765	3929	19	06037	33.99491668	-117.8399137	Los Angeles County
94697	Fee-for-Service	1851698609	1851698609	1	1	EXPRESS AMBULANCE INC	12/27/2011	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	5595 MAGNATRON BLVD	#P	SAN DIEGO	CA	92111	1310	37	06073	32.83810181	-117.1405616	San Diego County
94732	Fee-for-Service	1427403146	1427403146	1	1	EDWARD, SHIRLEY M MD	8/20/2019	207R00000X	NA	Other	026	PHYSICIANS	155899	41	Internal Medicine	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
94750	Fee-for-Service	1356429369	1356429369	1	2	EVERGREEN PHARMACEUTICAL OF	4/2/2020	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	NIA #48214	850 S GUILD AVE	None	LODI	CA	95240	3170	39	06077	38.1240871	-121.2477142	San Joaquin County
94807	Fee-for-Service	1366051120	1366051120	1	3	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5385 FRANKLIN BLVD	STE K	SACRAMENTO	CA	95820	4717	34	06067	38.526282	-121.471398	Sacramento County
94888	Fee-for-Service	1245220649	1245220649	1	1	EIRICH, GREGORY DPM	7/1/1991	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	661 W 1ST ST	None	TUSTIN	CA	92780	2939	30	06059	33.74578153	-117.831231	Orange County
94907	Fee-for-Service	1437103942	1437103942	1	13	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
94936	Fee-for-Service	1790991560	1790991560	2	1	E&P EVANGELISTA & ASSOC	3/5/2008	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INC	933 NEWMAN DR	None	S SAN FRANCISCO	CA	94080	1110	41	06081	37.66458647	-122.4579	San Mateo County
95029	Fee-for-Service	1679728927	1679728927	1	1	ESTRADA, VIRGINIA OD	1/26/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4403 S VERMONT AVE	None	LOS ANGELES	CA	90037	2413	19	06037	34.00342736	-118.2915892	Los Angeles County
95097	Fee-for-Service	1366051120	1366051120	1	5	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6339 MACK RD	None	SACRAMENTO	CA	95823	4655	34	06067	38.475585	-121.4285265	Sacramento County
95125	Fee-for-Service	1851346084	1851346084	1	1	ESCOBEDO, JODIE A MD	2/22/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80677	08	Family Practice	0	In state provider	None	2336 SANTA MONICA BLVD	STE 302	SANTA MONICA	CA	90404	2067	19	06037	34.03136627	-118.4766854	Los Angeles County
95169	Fee-for-Service	1245494517	1245494517	1	1	EXAGEN INC	12/22/2014	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	1261 LIBERTY WAY	STE C	VISTA	CA	92081	8356	37	06073	33.13797382	-117.2317732	San Diego County
95198	Fee-for-Service	1437103942	1437103942	1	13	EMERGENCY & ACUTE CARE	2/2/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
95246	Fee-for-Service	1346375235	1346375235	1	1	EDWARD D ELLISON MD	3/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	980 W IRONWOOD DR	STE 104	COEUR D ALENE	ID	83814	2668	00	None	47.69584675	-116.7984629	Kootenai County
95268	Fee-for-Service	1699715425	1699715425	1	1	EMERGENCY PHYSICIANS	10/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL GROUP	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
95369	Fee-for-Service	1285900910	1285900910	1	1	ESENSTEN, JONATHAN H MD	7/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128404	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
95383	Fee-for-Service	1366051120	1366051120	1	5	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6339 MACK RD	None	SACRAMENTO	CA	95823	4655	34	06067	38.475585	-121.4285265	Sacramento County
95442	Fee-for-Service	1538463658	1538463658	1	1	ESPARZA, ASHLEY LCSW	9/25/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6800 INDIANA AVE	130	RIVERSIDE	CA	92506	4266	33	06065	33.94303679	-117.391856	Riverside County
95447	Fee-for-Service	1609063262	1609063262	1	1	ELLIOT, CHRISTOPHER STEPHEN	11/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	94018	34	Urology and Urological Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
95463	Fee-for-Service	1497134670	1497134670	1	1	ESPIRITU, MONICA MD	1/24/2018	390200000X	NA	Other	026	PHYSICIANS	138960	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
95483	Fee-for-Service	1154418622	1154418622	1	1	EGAN, BARBARA T MD	12/1/1998	207R00000X	NA	Other	026	PHYSICIANS	74485	41	Internal Medicine	0	In state provider	None	5720 STONERIDGE MALL RD	STE 310	PLEASANTON	CA	94588	2855	01	06001	37.69247085	-121.9301884	Alameda County
95488	Fee-for-Service	1023082542	1023082542	1	1	EDWARDS, ROBERT MD	9/7/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183633	None	None	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
95504	Fee-for-Service	1942751623	1942751623	1	1	EL FAKIH, NADIA M MD	10/8/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	141174	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
95572	Fee-for-Service	1326628330	1326628330	1	1	ENTREGA PHARMACY LLC	5/20/2021	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	44469 10TH SREET W	B	LANCASTER	CA	93534	3324	19	06037	34.691454	-118.148068	Los Angeles County
95575	Fee-for-Service	1518174846	1518174846	1	1	EDMINSTER JOEL D.MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 WEST 8TH AVE	None	SPOKANE	WA	99205	0000	00	None	47.647989	-117.4112415	Spokane County
95610	Fee-for-Service	1023630514	1023630514	1	1	EXCELLENCE IN REHABILITATION	2/10/2021	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	None	None	0	In state provider	MEDICAL GROUP INC	345 S HALCYON RD	None	ARROYO GRANDE	CA	93420	3899	40	06079	35.113419	-120.5915945	San Luis Obispo County
95672	Fee-for-Service	1366051120	1366051120	1	3	ELICA HEALTH CENTERS	12/1/2022	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5385 FRANKLIN BLVD	STE K	SACRAMENTO	CA	95820	4717	34	06067	38.526282	-121.471398	Sacramento County
95691	Fee-for-Service	1730476854	1730476854	1	1	EDNEY, ELIZABETH A MD	12/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	EMILE @ 42ND	None	OMAHA	NE	68198	0001	00	None	41.254236	-95.97573	Douglas County
95775	Fee-for-Service	1346451820	1346451820	1	1	ESPINOSA, RAQUEL G LCSW	6/8/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5850 EL CAMINO REAL	None	ATASCADERO	CA	93422	3318	40	06079	35.48962035	-120.670989	San Luis Obispo County
95778	Fee-for-Service	1174655740	1174655740	1	1	ELLIOTT, ERIC T. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1717 ARLINGTON AVE	None	CALDWELL	ID	83605	4802	00	None	43.654374	-116.694738	Canyon County
95795	Fee-for-Service	1538126008	1538126008	1	1	ERIC R WYATT MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1190 WAIANUENUE AVE	None	HILO	HI	96720	2089	00	None	19.71752563	-155.1129745	Hawaii County
95809	Fee-for-Service	1376039016	1376039016	1	1	EXNER, AMELIA C LMFT	1/14/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	122481	-	NOT APPLICABLE	0	In state provider	None	3288 EL CAJON BLVD	STE 1A,1B,3,5-6,8-13	SAN DIEGO	CA	92104	1430	37	06073	32.75537145	-117.1228095	San Diego County
95851	Fee-for-Service	1225422033	1225422033	1	2	EDWARD P. LAURANCE, M.D., IN	8/7/2024	2080P0206X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	C	460 W SIERRA MADRE BLVD	None	SIERRA MADRE	CA	91024	2314	19	06037	34.16178952	-118.0623555	Los Angeles County
95904	Fee-for-Service	1043389323	1043389323	1	1	EISENBERG, BURTON L MD	3/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129126	02	General Surgery	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06238259	-118.2030986	Los Angeles County
95952	Fee-for-Service	1881813483	1881813483	1	2	ECKER, CAROLYN M OT	12/21/2021	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3416 AMERICAN RIVER DR S	None	SACRAMENTO	CA	95864	5753	34	06067	38.569212	-121.3840755	Sacramento County
95953	Fee-for-Service	1548417546	1548417546	1	1	ELLIOTT, WENDY M LCSW	11/15/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27941	-	NOT APPLICABLE	0	In state provider	None	1200 N MAIN ST	STE 100B, 301, 500	SANTA ANA	CA	92648	5636	30	06059	33.755175	-117.8676195	Orange County
95965	Fee-for-Service	1366051120	1366051120	1	5	ELICA HEALTH CENTERS	5/11/2024	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6339 MACK RD	None	SACRAMENTO	CA	95823	4655	34	06067	38.475585	-121.4285265	Sacramento County
96041	Fee-for-Service	1730115148	1730115148	1	1	ENGLESTAD, BARRY L MD	11/30/1987	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	41359	30	Radiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
96056	Fee-for-Service	1750376679	1750376679	1	1	EDWARD F PHILBIN M.D.	1/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	43 NEW SCOTLAND AVE	None	ALBANY	NY	12208	3412	00	None	42.653133	-73.7752995	Albany County
96079	Fee-for-Service	1831397801	1831397801	1	1	EARHART, MATTHEW W OD	10/23/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2020 J STREET	None	SACRAMENTO	CA	95811	3120	34	06067	38.576331	-121.4791155	Sacramento County
96089	Fee-for-Service	1316163744	1316163744	1	1	EHSAN, AMIRHESAM MD	12/30/2008	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	97145	20	Orthopedic Surgery	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
96108	Fee-for-Service	1043538499	1043538499	1	1	EKREN, KATHY M LMFT	2/11/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5755 MOUNTAIN HAWK DR	SUITE 209	SANTA ROSA	CA	95409	4450	49	06097	38.46338265	-122.6432284	Sonoma County
96129	Fee-for-Service	1477721868	1477721868	1	1	EAST VALLEY HEMATOLOGY	5/1/2006	207RH0003X	NA	Oncology	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	AND ONCOLOGY	2601 W ALAMEDA AVE	STE 210	BURBANK	CA	91505	4810	19	06037	34.15783817	-118.3293969	Los Angeles County
96135	Fee-for-Service	1730207093	1730207093	1	1	EWER, STEVEN M MD	1/27/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	600 HIGHLAND AVE	None	MADISON	WI	53792	0001	00	None	43.07868393	-89.4316606	Dane County
96144	Fee-for-Service	1205167491	1205167491	1	5	ENVISION SCHOOLS	7/1/2012	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	2560 DARWIN STREET	None	HAYWARD	CA	94545	3451	01	06001	37.63130676	-122.1026406	Alameda County
96209	Fee-for-Service	1639647019	1639647019	1	1	EJIOGU, KENNETH NP	3/31/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	24700 CALAROGA AVE	STE 103	HAYWARD	CA	94545	2160	01	06001	37.64903435	-122.1018438	Alameda County
96246	Fee-for-Service	1366051120	1366051120	1	3	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5385 FRANKLIN BLVD	STE K	SACRAMENTO	CA	95820	4717	34	06067	38.526282	-121.471398	Sacramento County
96424	Fee-for-Service	1932966348	1932966348	1	1	EPIPHANY WOMEN IN FOCUS	9/10/2024	251S00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	5081 LOGAN AVE	101	SAN DIEGO	CA	92113	3013	37	06073	32.69670539	-117.0857556	San Diego County
96485	Fee-for-Service	1679192793	1679192793	1	1	ERLICH, JESSICA MD	7/1/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	185284	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
96540	Fee-for-Service	1366051120	1366051120	1	5	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6339 MACK RD	None	SACRAMENTO	CA	95823	4655	34	06067	38.475585	-121.4285265	Sacramento County
96558	Fee-for-Service	1780166983	1780166983	1	1	ELSOHEMY, AMAL S MD	12/9/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	145171	08	Family Practice	0	In state provider	None	1000 FRANKLIN PARKWAY	None	SAN MATEO	CA	94403	1922	41	06081	37.54350476	-122.2913782	San Mateo County
96590	Fee-for-Service	1497066492	1497066492	1	1	ENNIS, JOSHUA J MD	8/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124600	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
96595	Fee-for-Service	1013356625	1013356625	1	1	ELLINWOOD AUMAN, SAMANTHA E	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133762	40	Pediatrics	0	In state provider	MD	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
96637	Fee-for-Service	1518165638	1518165638	1	1	EAGLE IMAGING MEDICAL	3/17/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP, INC	10 POINTE DR	STE 110	BREA	CA	92821	3690	30	06059	33.92675206	-117.8771089	Orange County
96638	Fee-for-Service	1780780577	1780780577	1	1	EMAMIAN, MOHAMMED H MD	2/26/1997	174400000X	NA	Other	026	PHYSICIANS	47957	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1045 ATLANTIC AVE	STE 714	LONG BEACH	CA	90813	3408	19	06037	33.780267	-118.1850795	Los Angeles County
96719	Fee-for-Service	1164570693	1164570693	1	1	EVANS, GWENDOLYN PHD	12/21/2007	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVENUE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
96778	Fee-for-Service	1619924362	1619924362	1	1	EAST ORANGE GENERAL HOSP	6/17/2008	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	300 CENTRAL AVENUE	None	EAST ORANGE	NJ	07019	2819	00	None	40.75429518	-74.21409304	Essex County
96878	Fee-for-Service	1275834236	1275834236	1	1	EMERGENCY MEDICINE PHYSICIAN	1/1/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS OF SACRAMENTO	4001 J STREET	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
96938	Fee-for-Service	1780922823	1780922823	1	1	EXPLORE & EXPRESS FAMILY	5/21/2015	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNSELING INC	3637 SACRAMENTO ST	SUITE G	SAN FRANCISCO	CA	94118	1726	38	06075	37.78743747	-122.4526382	San Francisco County
96954	Fee-for-Service	1265804397	1265804397	1	1	EASTLAND SUBACUTE AND REHAB	11/1/2015	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	3825 DURFEE AVENUE	None	EL MONTE	CA	91732	2505	19	06037	34.07091109	-118.0078772	Los Angeles County
96960	Fee-for-Service	1336580422	1336580422	1	1	ENLOE MEDICAL CENTER	10/16/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	SPECIALISTS	251 COHASSET ROAD	STE 370	CHICO	CA	95926	2276	04	06007	39.75090044	-121.8522609	Butte County
97019	Fee-for-Service	1265775845	1265775845	1	1	EMILYS MEDICAL GROUP APC	5/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	105304	None	None	0	In state provider	None	230 AVOCADO AVE	None	EL CAJON	CA	92020	4604	37	06073	32.793093	-116.957647	San Diego County
97026	Fee-for-Service	1790562551	1790562551	1	2	ENLOE HEALTH AND WELLNESS	11/4/2024	193400000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	IOLOGY- OROVILLE	2860 OLIVE HWY	SUITE B	OROVILLE	CA	95966	6122	04	06007	39.50347297	-121.5404768	Butte County
97059	Fee-for-Service	1336658210	1336658210	1	1	ELKINS, HILARY	2/13/2025	363LW0102X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	765 MEDICAL CENTER CT	SUITE 203	CHULA VISTA	CA	91911	6600	37	06073	32.619069	-117.020835	San Diego County
97071	Fee-for-Service	1619924362	1619924362	1	1	EAST ORANGE GENERAL HOSP	6/17/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	300 CENTRAL AVENUE	None	EAST ORANGE	NJ	07019	2819	00	None	40.75429518	-74.21409304	Essex County
97228	Fee-for-Service	1780922823	1780922823	1	1	EXPLORE & EXPRESS FAMILY	5/21/2015	193200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	COUNSELING INC	3637 SACRAMENTO ST	SUITE G	SAN FRANCISCO	CA	94118	1726	38	06075	37.78743747	-122.4526382	San Francisco County
97270	Fee-for-Service	1417307745	1417307745	1	1	ENGELMAN, GLENN DO	10/4/2021	208600000X	NA	General Surgery	026	PHYSICIANS	18711	None	None	0	In state provider	None	616 E CHAPEL ST	None	SANTA MARIA	CA	93454	4522	42	06083	34.95426953	-120.427596	Santa Barbara County
97314	Fee-for-Service	1790562551	1790562551	1	2	ENLOE HEALTH AND WELLNESS	11/4/2024	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	IOLOGY- OROVILLE	2860 OLIVE HWY	SUITE B	OROVILLE	CA	95966	6122	04	06007	39.50347297	-121.5404768	Butte County
97393	Fee-for-Service	1558560482	1558560482	1	1	ESTILO, GENEVIEVE K MD	11/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111797	45	Nephrology (Renal-Kidney)	0	In state provider	None	1300 S ELISEO DRIVE	SUITE #104	GREENBRAE	CA	94904	2014	21	06041	37.94447529	-122.53657	Marin County
97588	Fee-for-Service	1548264591	1548264591	1	1	EVERSANA LIFE SCIENCE SERVIC	1/5/2022	3336S0011X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	ES, LLC	17877 CHESTERFIELD AIRPO	None	CHESTERFIELD	MO	63005	1211	00	None	38.66881683	-90.62959058	St. Louis County
97648	Fee-for-Service	1164993762	1164993762	1	1	ELAHI, MOHAMMED M RCP	2/25/2019	2279G1100X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
97689	Fee-for-Service	1083845556	1083845556	1	1	ERICKSON, ROSANNA NP	11/9/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
97709	Fee-for-Service	1326001439	1326001439	1	1	EGBUJOR, MERCY C NP	8/14/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
97789	Fee-for-Service	1437103942	1437103942	1	1	EMERGENCY & ACUTE CARE	12/1/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
97894	Fee-for-Service	1992724447	1992724447	1	1	EVANS, TIMOTHY M MD	1/4/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50746	41	Internal Medicine	0	In state provider	None	6311 N FRESNO ST	STE 106	FRESNO	CA	93710	5290	10	06019	36.82866273	-119.7814168	Fresno County
97923	Fee-for-Service	1427754019	1427754019	1	1	EISEN, ARIELLE L DOULA	2/15/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	43	06085	0	0	None
97925	Fee-for-Service	1609872415	1609872415	1	1	EASTERN PLUMAS HOSPITAL-	9/11/1990	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	PORTOLA CAMPUS D/P SNF	500 1ST AVE	None	PORTOLA	CA	96122	9406	32	06063	39.80595392	-120.4626723	Plumas County
97994	Fee-for-Service	1023073673	1023073673	1	1	EVERYTHING MEDICAL INC	10/10/2003	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	200 S PALM AVENUE	SUITE A	ALHAMBRA	CA	91801	3184	19	06037	34.08820843	-118.1465406	Los Angeles County
97996	Fee-for-Service	1265687545	1265687545	1	1	EDWARDS, NANCY J MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108695	13	Neurology (M.D. only)	0	In state provider	None	1001 POTRERO AVE	# 4M	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
98075	Fee-for-Service	1700053824	1700053824	1	1	ENAYAT, SAMIM MD	9/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132027	67	Endocrinology	0	In state provider	None	100 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3813	30	06059	33.89343304	-117.9279349	Orange County
98076	Fee-for-Service	1437103942	1437103942	1	1	EMERGENCY & ACUTE CARE	4/19/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
98093	Fee-for-Service	1902091432	1902091432	2	1	EDWARDS, ALLISON L	1/22/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
98104	Fee-for-Service	1386002012	1386002012	1	1	EGBERT, PAUL C	11/29/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	41769 ENTERPRISE CIR N	STE 104	TEMECULA	CA	92590	5626	33	06065	33.51823541	-117.1701538	Riverside County
98168	Fee-for-Service	1699757393	1699757393	1	1	EAST CAROLINA HEALTH	8/24/2007	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	111 HOSPITAL DR	None	TARBORO	NC	27886	2011	00	None	35.92175385	-77.55697328	Edgecombe County
98183	Fee-for-Service	1669599825	1669599825	1	2	ENTEZARI, TOKAMEH MD	12/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155796	None	None	0	In state provider	None	24411 HEALTH CENTER DR	STE 680	LAGUNA HILLS	CA	92653	3692	30	06059	33.6087201	-117.7076948	Orange County
98193	Fee-for-Service	1245327808	1245327808	1	1	ESPELETA, VIDAL J MD	1/14/2014	207RP1001X	NA	Pulmonology	026	PHYSICIANS	83599	41	Internal Medicine	0	In state provider	None	31700 TEMECULA PARKWAY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
98216	Fee-for-Service	1952427411	1952427411	1	1	EAST VALLEY COMM HLTH	9/1/1997	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	19	06037	34.06750236	-117.925203	Los Angeles County
98227	Fee-for-Service	1427059336	1427059336	1	1	EYE INSTITUTE OF CALIFORNIA	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	480 4TH AVE	STE 201	CHULA VISTA	CA	91910	4412	37	06073	32.63411298	-117.0816772	San Diego County
98258	Fee-for-Service	1255382248	1255382248	1	1	ELITE ANESTHESIA MEDICAL	12/12/2002	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	GROUP INC	9400 NO NAME UNO	None	GILROY	CA	95020	3528	43	06085	37.03498475	-121.5729235	Santa Clara County
98315	Fee-for-Service	1295806065	1295806065	1	1	EISCHEN-LEE, STEPHANIE PHD	9/3/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7060 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92111	1003	37	06073	32.83272447	-117.1648125	San Diego County
98348	Fee-for-Service	1275660730	1275660730	1	1	ELLIS, JOANNA LMFT	11/6/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1355 WESTWOOD BLVD	STE. 214	LOS ANGELES	CA	90024	4944	19	06037	34.05601038	-118.442237	Los Angeles County
98366	Fee-for-Service	1437103942	1437103942	1	1	EMERGENCY & ACUTE CARE	4/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
98455	Fee-for-Service	1699757393	1699757393	1	1	EAST CAROLINA HEALTH	8/24/2007	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	111 HOSPITAL DR	None	TARBORO	NC	27886	2011	00	None	35.92175385	-77.55697328	Edgecombe County
98499	Fee-for-Service	1952438251	1952438251	1	1	EAST BAY HEAD AND NECK	8/6/1986	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	SURGERY MED GRP INC	2316 DWIGHT WAY	None	BERKELEY	CA	94704	2212	01	06001	37.86460853	-122.2621987	Alameda County
98524	Fee-for-Service	1720099328	1720099328	1	1	ENLOE MEDICAL CENTER	3/1/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	ESPLANADE	185 E 7TH AVE	None	CHICO	CA	95926	3356	04	06007	39.74473059	-121.8488381	Butte County
98529	Fee-for-Service	1083829535	1083829535	1	1	E&V ADULT DAY HEALTH INC	8/29/2011	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	CARE CENTER	2005 N WILMINGTON AVE	None	COMPTON	CA	90222	2031	19	06037	33.910929	-118.2391875	Los Angeles County
98535	Fee-for-Service	1831573815	1831573815	1	1	E. TSIMERINOV, M.D., NEUROLO	6/17/2020	261QM2500X	NA	Other	026	PHYSICIANS	None	13	Neurology (M.D. only)	0	In state provider	GY, INC.	8700 BEVERLY	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
98569	Fee-for-Service	1427001809	1427001809	1	1	EVAN B ELLER M.D.	9/30/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 W CLARENDON AVE	STE 142	PHOENIX	AZ	85013	3449	00	None	33.49179	-112.07844	Maricopa County
98639	Fee-for-Service	1346437787	1346437787	1	1	ETEFIA, KENNETH K MD	11/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108553	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
98690	Fee-for-Service	1932735867	1932735867	1	1	ETHAN SANDLER DO	8/1/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	22 S GREENE ST	None	BALTIMORE	MD	21201	1544	00	None	39.28815298	-76.62364605	Baltimore city
98691	Fee-for-Service	1568531036	1568531036	1	1	EL DORADO COMMUNITY SVCS	6/20/1997	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	PALMDALE MED & MNTL HLTH	2710-20 E PALMDALE BLVD	STE 129	PALMDALE	CA	93550	4946	19	06037	34.58011781	-118.0808338	Los Angeles County
98698	Fee-for-Service	1508112590	1508112590	1	1	ESPEJO, MARISSA E NP	1/8/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
98710	Fee-for-Service	1275616302	1275616302	1	1	ENLOE MEDICAL CENTER	6/1/1994	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1390 E LASSEN AVE	STE 6	CHICO	CA	95973	7823	04	06007	39.77300289	-121.8389237	Butte County
98750	Fee-for-Service	1073651766	1073651766	1	1	ENCINITAS PODIATRY GROUP	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	501 N EL CAMINO REAL	SUITE 201	None	ENCINITAS	CA	92024	0000	37	06073	0	0	None
98787	Fee-for-Service	1003028473	1003028473	1	1	ELLEDGE, ROBERTA M LMFT	12/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	819 15TH ST	None	MODESTO	CA	95354	1113	50	06099	37.64268844	-120.9939135	Stanislaus County
98882	Fee-for-Service	1194118851	1194118851	1	1	EAST BAY FOOT & ANKLE CLINIC	11/14/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	INC	13847 E 14TH ST	SUITE 210	SAN LEANDRO	CA	94578	2626	01	06001	37.71457844	-122.1418551	Alameda County
98891	Fee-for-Service	1740245729	1740245729	1	1	EISNER, MARK D MD	3/23/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	78543	41	Internal Medicine	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
98913	Fee-for-Service	1457768731	1457768731	1	2	EVLYN AVANESSIAN, MD, INC	9/21/2020	261Q00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	3628 FOOTHILL BLVD	None	LA CRESCENTA	CA	91214	1724	19	06037	34.23557933	-118.2584143	Los Angeles County
98920	Fee-for-Service	1295376663	1295376663	1	1	ECKLUND, MARINA NP	2/6/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	26010657	-	NOT APPLICABLE	0	In state provider	None	280 E STANDLEY ST	None	UKIAH	CA	95482	4414	23	06045	39.15101964	-123.205602	Mendocino County
99022	Fee-for-Service	1568588622	1568588622	1	1	EITEL, JENNIFER M MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	104530	None	None	0	In state provider	None	17822 BEACH BLVD	SUITE 278	HUNTINGTON BEACH	CA	92647	7180	30	06059	33.70331388	-117.9890471	Orange County
99180	Fee-for-Service	1740245729	1740245729	1	1	EISNER, MARK D MD	3/23/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	78543	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
99235	Fee-for-Service	1588711105	1588711105	1	1	ENFIEDJIAN, TAMARA S PT	6/15/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	100 BARRANCA	380	WEST COVINA	CA	91791	1637	19	06037	34.073073	-117.8812535	Los Angeles County
99279	Fee-for-Service	1255812780	1255812780	1	4	ENLOE MEDICAL CENTER	2/26/2024	163WM0705X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	251 COHASSET	None	CHICO	CA	95926	2241	04	06007	39.75090044	-121.8522609	Butte County
99388	Fee-for-Service	1437103942	1437103942	1	19	EMERGENCY & ACUTE CARE	5/3/2016	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
99389	Fee-for-Service	1942753769	1942753769	1	1	ECKERT, RACHEL C NP	8/3/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
99420	Fee-for-Service	1083886881	1083886881	1	1	EBBERT, TIMOTHY J MD	2/4/2020	207L00000X	NA	Other	026	PHYSICIANS	161824	05	Anesthesiology	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	8580	30	06059	33.56008604	-117.6657795	Orange County
99567	Fee-for-Service	1255812780	1255812780	1	4	ENLOE MEDICAL CENTER	5/5/2022	163WM0705X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	251 COHASSET	None	CHICO	CA	95926	2241	04	06007	39.75090044	-121.8522609	Butte County
99582	Fee-for-Service	1205931912	1205931912	1	1	ETHERIDGE, SUZANNE M LMFT	8/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
99676	Fee-for-Service	1437103942	1437103942	1	19	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
99719	Fee-for-Service	1649582909	1649582909	1	1	ELIZARRARAZ, PATRICIA LCSW	7/12/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	100 S IMPERIAL HWY	None	ANAHEIM	CA	92807	3943	30	06059	33.85001282	-117.7903584	Orange County
99856	Fee-for-Service	1255812780	1255812780	1	4	ENLOE MEDICAL CENTER	10/13/2021	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	251 COHASSET	None	CHICO	CA	95926	2241	04	06007	39.75090044	-121.8522609	Butte County
99893	Fee-for-Service	1881643724	1881643724	1	1	ETTEFAGH, LEILA	7/29/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	89632	07	Dermatology	0	In state provider	None	360 SAN MIGUEL DR	STE 309	NEWPORT BEACH	CA	92660	7836	30	06059	33.61321911	-117.8722084	Orange County
99962	Fee-for-Service	1124349634	1124349634	1	1	EIL, ROBERT L MD	12/18/2020	208600000X	NA	General Surgery	026	PHYSICIANS	-	None	None	2	Out of state provider	None	3181 SW SAM JACKSON PARK	RD	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
99965	Fee-for-Service	1922501741	1922501741	1	1	EGBERT, NITIN K MD	7/10/2023	207R00000X	NA	Other	026	PHYSICIANS	181929	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
100053	Fee-for-Service	1669506341	1669506341	1	1	ESPARZA, SARAH L LMFT	12/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
100139	Fee-for-Service	1255812780	1255812780	1	4	ENLOE MEDICAL CENTER	10/13/2021	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	251 COHASSET	None	CHICO	CA	95926	2241	04	06007	39.75090044	-121.8522609	Butte County
100316	Fee-for-Service	1902250244	1902250244	1	1	ETTORE, MARK MD	4/9/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
100353	Fee-for-Service	1750492617	1750492617	1	1	EVERGREEN PHARMACEUTICAL, LL	5/1/2023	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	2820 N ASTOR ST	None	SPOKANE	WA	99207	2112	00	None	47.683872	-117.4042215	Spokane County
100399	Fee-for-Service	1912986944	1912986944	1	1	EUBANY, JACQUELINE A MD	5/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134183	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	801 N TUSTIN AVE	STE 706	SANTA ANA	CA	92705	3611	30	06059	33.752286	-117.8341735	Orange County
100424	Fee-for-Service	1598117590	1598117590	1	1	ECKMAN, DENISE M PSYD	2/5/2020	103K00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3002 DOW AVE	SUITE 122	TUSTIN	CA	92780	7233	30	06059	33.70954889	-117.8043627	Orange County
100453	Fee-for-Service	1992853709	1992853709	1	1	ESCANDON, LOUIS MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34397	01	General Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
100458	Fee-for-Service	1528728029	1528728029	1	1	EDMISTEN, JANIFER	9/10/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
100474	Fee-for-Service	1578583431	1578583431	1	1	ENGEL, MARTIN R MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85949	30	Radiology	0	In state provider	None	155 GLASSON WAY	None	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
100496	Fee-for-Service	1619976552	1619976552	1	1	ENSIGN SANTA ROSA, LLC	7/31/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SUMMERFIELD HEALTH CARE	1280 SUMMERFIELD RD	None	SANTA ROSA	CA	95405	7313	49	06097	38.445534	-122.6642715	Sonoma County
100560	Fee-for-Service	1760462824	1760462824	1	1	EISENDORF, BRUCE R MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	69536	08	Family Practice	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
100640	Fee-for-Service	1073930343	1073930343	1	1	ELMI, EMAN DPM	8/26/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
100725	Fee-for-Service	1891228698	1891228698	1	1	ESTRADA, YVONNE M LMFT	1/19/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
100745	Fee-for-Service	1992853709	1992853709	1	1	ESCANDON, LOUIS MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34397	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
100767	Fee-for-Service	1184456253	1184456253	1	1	ESCALANTE, AUDRA	11/20/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	41	06081	0	0	None
100810	Fee-for-Service	1972634699	1972634699	1	1	ESTRADA, HECTOR H LCSW	3/18/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
100822	Fee-for-Service	1225199581	1225199581	1	1	ESTOCK, ERIKA S MD	1/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70982	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
100856	Fee-for-Service	1114697828	1114697828	1	1	EXACT HOME HEALTH CARE	10/17/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	740 E COLORADO BLVD	STE 201	PASADENA	CA	91101	2130	19	06037	34.14586053	-118.135044	Los Angeles County
100896	Fee-for-Service	1255341962	1255341962	1	1	EDWARDS, ANDREA G MD	8/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83742	78	Neoplastic Diseases/Oncology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
100929	Fee-for-Service	1538608856	1538608856	1	1	ESPARZA, NOEMI D NP	6/4/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	207 W LEGION ROAD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
100987	Fee-for-Service	1992219463	1992219463	1	1	EAGLE HOME HEALTH	10/4/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6005 VINELAND AVE	STE 204	NORTH HOLLYWOOD	CA	91606	4984	19	06037	34.179921	-118.3703275	Los Angeles County
101154	Fee-for-Service	1477181303	1477181303	1	1	EICHBERGER, LISA MD	8/11/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	184808	None	None	0	In state provider	None	8701 CUYAMACA ST	None	SANTEE	CA	92071	4253	37	06073	32.83439779	-116.98366	San Diego County
101168	Fee-for-Service	1417164518	1417164518	1	1	ELIAS, RAMIZ N MD	4/2/2008	261QP2300X	NA	Other	026	PHYSICIANS	99956	41	Internal Medicine	0	In state provider	None	1685 E MAIN ST	STE 102	EL CAJON	CA	92021	5225	37	06073	32.81132509	-116.9192044	San Diego County
101212	Fee-for-Service	1467837096	1467837096	1	1	ELIXIR HOME HEALTH CARE &	10/28/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	HOSPICE, INC	1420 W KETTLEMAN LN	SUITE S1	LODI	CA	95242	4577	39	06077	38.11534153	-121.289823	San Joaquin County
101227	Fee-for-Service	1275211534	1275211534	1	1	EDS-I HOMANSKY PRACTICES OF	4/1/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	NEVADA PC	2375 PRATER WAY	None	SPARKS	NV	89434	9641	00	None	39.54247495	-119.6975356	Washoe County
101263	Fee-for-Service	1780266817	1780266817	1	1	EXCELLENT HOME CARE INC	3/20/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5311 TOPANGA CANYON BLVD	STE 205	WOODLAND HILLS	CA	91364	1770	19	06037	34.166313	-118.6059365	Los Angeles County
101343	Fee-for-Service	1386304426	1386304426	1	1	EKANEM, UWEM	1/13/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	10609 CHARBONO WAY	None	RANCHO CORDOVA	CA	95670	4813	34	06067	38.595978	-121.2943815	Sacramento County
101374	Fee-for-Service	1548027964	1548027964	1	1	EDNACOT, KARYNNE NP	3/27/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	340 FOURTH AVE	SUITE 4	CHULA VISTA	CA	91910	4414	37	06073	32.63831293	-117.0833536	San Diego County
101477	Fee-for-Service	1770967754	1770967754	1	1	EGINI, OGECHUKWU K MD	6/15/2023	207R00000X	NA	Other	026	PHYSICIANS	175849	None	None	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
101479	Fee-for-Service	1407957749	1407957749	1	1	ECHO,BARBARA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 W 8TH AVE	None	SPOKANE	WA	99204	2307	00	None	47.647989	-117.4112415	Spokane County
101500	Fee-for-Service	1467837096	1467837096	1	1	ELIXIR HOME HEALTH CARE &	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	HOSPICE, INC	1420 W KETTLEMAN LN	SUITE S1	LODI	CA	95242	4577	39	06077	38.11534153	-121.289823	San Joaquin County
101514	Fee-for-Service	1689997876	1689997876	1	1	ELLIS, BRANDI LMFT	8/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
101640	Fee-for-Service	1568513455	1568513455	1	1	EVANS, BELETA D OD	12/2/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 E HERNDON AVE	STE 401	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
101663	Fee-for-Service	1447285382	1447285382	1	1	EYE SURGICAL CENTER	10/14/2011	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1809 VERDUGO BLVD	STE 140	GLENDALE	CA	91208	1402	19	06037	34.20568088	-118.2154356	Los Angeles County
101977	Fee-for-Service	1538471305	1538471305	1	1	ELLIS, PREETIVI MD	4/17/2020	207R00000X	NA	Other	026	PHYSICIANS	122222	41	Internal Medicine	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
101997	Fee-for-Service	1932671864	1932671864	1	1	ESCAMILLA, SERGIO E	8/31/2021	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	26504 BOUQUET CANYON	None	SANTA CLARITA	CA	91350	2353	19	06037	34.42742329	-118.5368396	Los Angeles County
102053	Fee-for-Service	1043438179	1043438179	1	1	ERNST, KAVITA V MD	9/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83529	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
102107	Fee-for-Service	1821357161	1821357161	1	1	ERNST, JEREMY M DO	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15123	36	Psychiatry	0	In state provider	None	3581 PALMER DR	STE 602	CAMERON PARK	CA	95682	8238	09	06017	38.66109103	-120.9649544	El Dorado County
102127	Fee-for-Service	1043388507	1043388507	1	1	ESTRADA, JOSE M LMFT	8/22/2022	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
102151	Fee-for-Service	1114215225	1114215225	1	1	EVONNE M KRUSHANSKY DO	8/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 CHILDRENS HOSPITAL DR	None	PITTSBURGH	PA	15224	1529	00	None	40.46651441	-79.9524674	Allegheny County
102174	Fee-for-Service	1962633685	1962633685	1	1	ELITE MEDICAL SUPPLY INC	6/8/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	3168 N GAREY	None	POMONA	CA	91767	1306	19	06037	34.10520744	-117.7484533	Los Angeles County
102225	Fee-for-Service	1811331747	1811331747	1	1	ERMAKOV, SIMON MD	2/5/2021	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	134064	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
102245	Fee-for-Service	1730124124	1730124124	1	1	ENDOSCOPY CENTER OF	5/9/2003	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SANTA MARIA INC	1315 S MILLER ST	STE 101	SANTA MARIA	CA	93454	6910	42	06083	34.93799144	-120.4316337	Santa Barbara County
102261	Fee-for-Service	1053368530	1053368530	1	1	EAST LOS ANGELES CLINICA	10/17/1996	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICA GENERAL, MED CNTR	6125 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4503	19	06037	34.01665326	-118.1394029	Los Angeles County
102301	Fee-for-Service	1427019009	1427019009	1	1	EISENMESSER, BRETT H MD	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1600 MEDICAL PARKWAY	None	CARSON CITY	NV	89703	4625	00	None	39.202263	-119.7841095	Consolidated Municipality of Carson City
102321	Fee-for-Service	1407868706	1407868706	1	1	EFTHIMIOS A. BAKALAKOS	10/26/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	112 SAINT OLAF AVE S	None	CANBY	MN	56220	1433	00	None	44.70763388	-96.27792114	Yellow Medicine County
102341	Fee-for-Service	1043438179	1043438179	1	1	ERNST, KAVITA V MD	9/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83529	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
102344	Fee-for-Service	1437103942	1437103942	1	11	EMERGENCY & ACUTE CARE	12/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
102346	Fee-for-Service	1639461734	1639461734	1	1	EDWARDS-JACKSON, NNEKA S MD	7/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124478	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5548	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
102357	Fee-for-Service	1598749715	1598749715	1	1	EZZEDDINE, DINA Z MD	8/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137543	10	Gastroenterology (M.D. only)	0	In state provider	None	2850 TELEGRAPH AVE	SUITE 120	BERKELEY	CA	94705	1159	01	06001	37.85808554	-122.2594469	Alameda County
102394	Fee-for-Service	1821357161	1821357161	1	1	ERNST, JEREMY M DO	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15123	26	Psychiatry (child)	0	In state provider	None	3581 PALMER DR	STE 602	CAMERON PARK	CA	95682	8238	09	06017	38.66109103	-120.9649544	El Dorado County
102436	Fee-for-Service	1457768913	1457768913	1	1	EAST WEST URGENT CARE INC	5/19/2016	261QU0200X	NA	Other	026	PHYSICIANS	86156	None	None	0	In state provider	None	38345 30TH ST EAST	STE B-1A	PALMDALE	CA	93550	6508	19	06037	34.579296	-118.0762765	Los Angeles County
102457	Fee-for-Service	1871881201	1871881201	1	1	EDWARDS, THOMAS A DO	8/7/2020	390200000X	NA	Other	026	PHYSICIANS	18310	09	Gynecology (D.O. only)	0	In state provider	None	115 MALL	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
102485	Fee-for-Service	1477583953	1477583953	1	1	ENENBACH, MICHAEL J MD	3/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	75986	36	Psychiatry	0	In state provider	None	300 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
102496	Fee-for-Service	1508009127	1508009127	1	1	ELSON, DAVID A MD	5/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122419	01	General Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
102509	Fee-for-Service	1760476659	1760476659	1	1	EAST TENNESSEE CHILDREN'S	1/11/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL ASSOCIATION INC	2018 CLINICH AVE	None	KNOXVILLE	TN	37916	2301	00	None	0	0	None
102530	Fee-for-Service	1124582374	1124582374	1	1	ELIASSON, MARK D RCP	7/25/2020	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
102589	Fee-for-Service	1669209037	1669209037	1	1	EDUCATION FOUNDATION OF CALI	11/26/2024	171M00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	FORNIA	790 BOLSA RD	None	HOLLISTER	CA	95023	9361	35	06069	36.86777226	-121.4049529	San Benito County
102637	Fee-for-Service	1437103942	1437103942	1	11	EMERGENCY & ACUTE CARE	9/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
102710	Fee-for-Service	1831502541	1831502541	1	1	ELSTER, MARTHA J MD	8/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138423	40	Pediatrics	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
102725	Fee-for-Service	1558394080	1558394080	1	1	EREMIA, SORIN MD	2/8/2015	207N00000X	NA	Dermatology	026	PHYSICIANS	42033	01	General Practice	0	In state provider	STE 200	4440 BROCKTON AVE	None	RIVERSIDE	CA	92501	4068	33	06065	33.97764104	-117.3838896	Riverside County
102744	Fee-for-Service	1871881201	1871881201	1	1	EDWARDS, THOMAS A DO	8/7/2020	390200000X	NA	Other	026	PHYSICIANS	18310	15	Obstetrics (D.O. only)	0	In state provider	None	115 MALL	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
102786	Fee-for-Service	1508009127	1508009127	1	1	ELSON, DAVID A MD	5/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122419	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
102797	Fee-for-Service	1760476659	1760476659	1	1	EAST TENNESSEE CHILDREN'S	1/11/2009	282NC2000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL ASSOCIATION INC	2018 CLINICH AVE	None	KNOXVILLE	TN	37916	2301	00	None	0	0	None
102896	Fee-for-Service	1821280017	1821280017	1	1	EICKER, ANN C LCSW	5/30/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3200 E GUASTI RD	#100	ONTARIO	CA	91761	8660	36	06071	34.06518	-117.5822055	San Bernardino County
102921	Fee-for-Service	1437103942	1437103942	1	11	EMERGENCY & ACUTE CARE	1/18/2022	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
102933	Fee-for-Service	1023665213	1023665213	1	1	EDOUARD E RIVERA MD PC	1/1/2020	207LP2900X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	400 NEWPORT CENTER DR	SUITE 601	NEWPORT BEACH	CA	92660	7685	30	06059	33.6142606	-117.8726808	Orange County
102958	Fee-for-Service	1346307519	1346307519	1	1	EL PROYECTO DEL BARRIO	7/30/2004	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	MOBILE UNIT	150 N AZUSA AVE	None	AZUSA	CA	91702	3521	19	06037	34.12348703	-117.9075659	Los Angeles County
103024	Fee-for-Service	1528129814	1528129814	1	1	EICKMEYER, MARY PHD	9/12/2011	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	659 CHERRY STREET	SUITE 102	SANTA ROSA	CA	95404	4207	49	06097	38.444841	-122.7151035	Sonoma County
103093	Fee-for-Service	1508399122	1508399122	1	1	ESLAMI, SETARE MD	6/23/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	163460	None	None	0	In state provider	None	4045 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2021	15	06029	35.3540847	-119.0536548	Kern County
103112	Fee-for-Service	1366051120	1366051120	1	7	ELICA HEALTH CENTERS	3/1/2023	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	923 V STREET	None	SACRAMENTO	CA	95818	1331	34	06067	38.567547	-121.499739	Sacramento County
103258	Fee-for-Service	1205887916	1205887916	1	1	EDMOND REG MED CTR LLC	4/30/2006	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1 S BRYANT AVE	None	EDMOND	OK	73034	6309	00	None	35.654526	-97.46049903	Oklahoma County
103345	Fee-for-Service	1063484376	1063484376	1	1	ERICKSON, CLINTON M MD	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1600 MEDICAL PARKWAY	None	CARSON CITY	NV	89703	4625	00	None	39.202263	-119.7841095	Consolidated Municipality of Carson City
103389	Fee-for-Service	1861448268	1861448268	1	1	EINZIGER, JERALD P MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33950	30	Radiology	0	In state provider	None	18344 CLARK ST	STE 101	TARZANA	CA	91356	3564	19	06037	34.1697537	-118.5323738	Los Angeles County
103399	Fee-for-Service	1366051120	1366051120	1	7	ELICA HEALTH CENTERS	3/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	923 V STREET	None	SACRAMENTO	CA	95818	1331	34	06067	38.567547	-121.499739	Sacramento County
103464	Fee-for-Service	1225680853	1225680853	1	1	EVANS, JORDAN OD	1/18/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2801 PARK MARINA DR	None	REDDING	CA	96001	2822	45	06089	40.5736108	-122.3737048	Shasta County
103470	Fee-for-Service	1083927115	1083927115	1	1	ERADAT, JILBERT MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107977	30	Radiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
103489	Fee-for-Service	1639517881	1639517881	1	1	ENTEZARI, PEGAH	7/19/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	160361	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
103503	Fee-for-Service	1043210016	1043210016	1	1	ENRIQUEZ, JORGE A MD	7/25/2009	208600000X	NA	General Surgery	026	PHYSICIANS	49936	02	General Surgery	0	In state provider	None	2521 G ST	None	BAKERSFIELD	CA	93301	2811	15	06029	35.382393	-119.0223575	Kern County
103508	Fee-for-Service	1972589869	1972589869	1	1	ESHAGHIAN, JOSEPH MD	3/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	38640	18	Ophthalmology	0	In state provider	DR JOSPEH'S EYE MED CLIN	1211 N VERMONT AVE	STE 200	LOS ANGELES	CA	90029	1748	19	06037	34.093836	-118.2917885	Los Angeles County
103546	Fee-for-Service	1205887916	1205887916	1	1	EDMOND REG MED CTR LLC	4/30/2006	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1 S BRYANT AVE	None	EDMOND	OK	73034	6309	00	None	35.654526	-97.46049903	Oklahoma County
103610	Fee-for-Service	1689883308	1689883308	1	1	ESPLIN, EDWARD D MD	9/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	116495	02	General Surgery	0	In state provider	None	2350 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3305	38	06075	37.78305866	-122.4421313	San Francisco County
103637	Fee-for-Service	1134122690	1134122690	1	1	ERSKINE, JAMES F YUSUF Q	12/1/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	5942	08	Family Practice	0	In state provider	FAMILY WELLNES MEDICAL	1141 GRAVENSTEIN HWY S	None	SEBASTOPOL	CA	95472	4861	49	06097	38.38812075	-122.8141754	Sonoma County
103677	Fee-for-Service	1861448268	1861448268	1	1	EINZIGER, JERALD P MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33950	42	Nuclear Medicine	0	In state provider	None	18344 CLARK ST	STE 101	TARZANA	CA	91356	3564	19	06037	34.1697537	-118.5323738	Los Angeles County
103687	Fee-for-Service	1366051120	1366051120	1	7	ELICA HEALTH CENTERS	3/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	923 V STREET	None	SACRAMENTO	CA	95818	1331	34	06067	38.567547	-121.499739	Sacramento County
103688	Fee-for-Service	1619947306	1619947306	1	1	ESTES, STEPHEN J MD	8/1/1977	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	37306	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1700 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	5115	36	06071	34.130214	-117.2788065	San Bernardino County
103765	Fee-for-Service	1518911775	1518911775	1	1	ELGASH, AMEEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9327 N 3RD ST	STE 206	PHOENIX	AZ	85020	2473	00	None	33.571089	-112.069287	Maricopa County
103769	Fee-for-Service	1881005445	1881005445	1	1	ENTEZARALMAHDI, MAHNAZ MD	11/4/2019	2084P2900X	NA	Neurology	026	PHYSICIANS	147204	13	Neurology (M.D. only)	0	In state provider	None	10565 CIVIC CENTER DR	WEST BLDG., SUITE 165	RANCHO CUCAMONGA	CA	91730	3853	36	06071	34.10278226	-117.5747989	San Bernardino County
103826	Fee-for-Service	1073080214	1073080214	1	1	ESCALANTE, AYLA	5/28/2024	2355S0801X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
103975	Fee-for-Service	1891338935	1891338935	1	1	EXCELSIOR SURGERY CENTER	12/9/2022	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1320 EL CAPITAN DR	#120	DANVILLE	CA	94526	6258	07	06013	37.78476866	-121.9658691	Contra Costa County
104005	Fee-for-Service	1134858616	1134858616	1	1	ENBURIO INC	4/19/2023	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	2365 QUIMBY RD	STE 250	SAN JOSE	CA	95122	1337	43	06085	37.325106	-121.8094335	Santa Clara County
104068	Fee-for-Service	1518623131	1518623131	1	1	EXLINE, ANNISA P LMFT	2/18/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 E SHAW AVE	STE 230	FRESNO	CA	93710	7708	10	06019	36.80886739	-119.7731624	Fresno County
104070	Fee-for-Service	1417396227	1417396227	1	1	EDWARDS, CEAZON T	8/16/2021	2086S0129X	NA	General Surgery	026	PHYSICIANS	162861	None	None	0	In state provider	None	38920 TRADE CENTER DR.	None	PALMDALE	CA	93551	3715	19	06037	34.58884303	-118.1430688	Los Angeles County
104200	Fee-for-Service	1043487762	1043487762	1	1	EL SAID, KHALED M	12/24/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	103426	08	Family Practice	0	In state provider	None	2925 N PALO VERDE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
104235	Fee-for-Service	1730608423	1730608423	1	1	EVA HEALTH LLC	8/22/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	457 S CITRUS AVE	None	COVINA	CA	91723	2928	19	06037	34.08132909	-117.8902007	Los Angeles County
104301	Fee-for-Service	1235787110	1235787110	1	1	ELLER, COURTNEY E LMFT	2/17/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
104386	Fee-for-Service	1154657716	1154657716	1	1	ELAHI, FOAD MD	11/5/2019	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	106279	25	Physical Medicine and Rehabilitation	0	In state provider	None	1144 NORMAN DR	104	MANTECA	CA	95336	5925	39	06077	37.79425166	-121.1998524	San Joaquin County
104399	Fee-for-Service	1538514427	1538514427	1	1	ELOUSTAZ, MOHAMED H MD	7/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138884	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
104469	Fee-for-Service	1578853750	1578853750	1	1	ELLSTROM, CHRISTOPHER L MD	3/15/2018	2086S0122X	NA	General Surgery	026	PHYSICIANS	125977	24	Plastic Surgery	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
104624	Fee-for-Service	1417901091	1417901091	1	12	ENLOE MEDICAL CENTER-	7/12/2017	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1423 MAGNOLIA AVENUE	SUITE B	CHICO	CA	95926	3226	04	06007	39.74063551	-121.8499048	Butte County
104642	Fee-for-Service	1114068509	1114068509	1	1	ENRICHING, INC	7/15/1985	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9514 SMOKE TREE AVE	None	FOUNTAIN VALLEY	CA	92708	7258	30	06059	33.68807817	-117.9624749	Orange County
104684	Fee-for-Service	1669592739	1669592739	1	1	ESCOTO, SUSAN A LMFT	5/31/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	155 HOSPITALITY LN	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
104703	Fee-for-Service	1376287961	1376287961	1	1	ERDOSI, MIRIAM A LCSW	8/23/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	26400 LA ALAMEDA UNDEFIN	SUITE 208	MISSION VIEJO	CA	92691	6318	30	06059	33.5637103	-117.669431	Orange County
104706	Fee-for-Service	1427469386	1427469386	1	1	ELDORADO COMMUNITY SERVICE	11/21/2014	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	21619 NORWALK BLVD	None	HAWAIIAN GARDENS	CA	90716	1123	19	06037	33.83264348	-118.0720753	Los Angeles County
104707	Fee-for-Service	1720713902	1720713902	1	1	ESCOBAR, MIKAELA C LCSW	9/14/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
104746	Fee-for-Service	1396753281	1396753281	1	1	ENLOE MEDICAL CENTER	12/19/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	888 LAKESIDE VLG CMNS	None	CHICO	CA	95928	3979	04	06007	39.750084	-121.7934327	Butte County
104748	Fee-for-Service	1306477021	1306477021	1	1	ESQUIVEL-CHAND, GEORGETTE A	1/11/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	307 S. B ST.	None	SAN MATEO	CA	94401	4053	41	06081	37.56539871	-122.3222584	San Mateo County
104795	Fee-for-Service	1164503850	1164503850	3	1	EL TEJON HEALTHCARE INC	9/16/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2900 BRUNDAGE LN	None	BAKERSFIELD	CA	93304	2430	15	06029	35.35414549	-119.035422	Kern County
104944	Fee-for-Service	1720113483	1720113483	1	1	EDEN, EVE D LCSW	8/5/2008	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	740 FRONT ST	STE 330	SANTA CRUZ	CA	95060	4560	44	06087	36.97547419	-122.0254852	Santa Cruz County
104999	Fee-for-Service	1710375142	1710375142	1	1	ESQUIVEL, AFEL C OT	9/9/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
105040	Fee-for-Service	1700212735	1700212735	2	1	EXCELTOX LABORATORIES, LLC.	11/17/2020	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	15375 BARRANCA PKWY	STE E104	IRVINE	CA	92618	2207	30	06059	33.66174175	-117.7431116	Orange County
105270	Fee-for-Service	1114075074	1114075074	1	1	ESTRICK, MICHELLE S MD	5/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77547	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
105299	Fee-for-Service	1952326928	1952326928	1	1	EDWARDS, JOHN D MD INC	9/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	26085	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2001 SANTA MONICA BLVD	STE 1265W	SANTA MONICA	CA	90404	2113	19	06037	34.02891163	-118.4797466	Los Angeles County
105343	Fee-for-Service	1114981925	1114981925	1	1	EZATVAR, MANIJEH	11/29/2004	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1000 NEWBURY RD	STE 120	THOUSAND OAKS	CA	91320	6437	56	06111	34.18353384	-118.9044556	Ventura County
105365	Fee-for-Service	1720450778	1720450778	1	1	EMIZA HOME HEALTH CARE INC	5/14/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	816 N HOLLYWOOD WAY	UNIT 4	BURBANK	CA	91505	2831	19	06037	34.16503922	-118.3455811	Los Angeles County
105410	Fee-for-Service	1255382248	1255382248	1	2	ELITE ANESTHESIA MEDICAL	5/18/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	75 NEILSON ST	None	WATSONVILLE	CA	95076	2468	44	06087	36.92823955	-121.792905	Santa Cruz County
105422	Fee-for-Service	1659429637	1659429637	1	1	ENDO, MARY A MD	10/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83462	30	Radiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
105430	Fee-for-Service	1619411154	1619411154	1	1	ENOS, CORINNE E LCSW	8/31/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13300 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92843	2207	30	06059	33.7743865	-117.9001575	Orange County
105526	Fee-for-Service	1508278524	1508278524	1	1	ESPINO, JENNIFER N LMFT	5/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
105528	Fee-for-Service	1215053582	1215053582	1	1	EZEANOLUE, KANAYO MD	3/4/2024	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
105535	Fee-for-Service	1124068523	1124068523	1	1	EYE SURGICAL AND MEDICAL	8/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	ASSOCIATES, INC	5021 W NOBLE AVE	STE A	VISALIA	CA	93277	8310	54	06107	36.326655	-119.345895	Tulare County
105610	Fee-for-Service	1215943899	1215943899	1	1	ERNST, AMY MD	3/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
105857	Fee-for-Service	1245390970	1245390970	1	1	EYMANN, JONATHAN W LMFT	4/2/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	546 ASILOMAR WAY	UNIT 104	GOLETA	CA	93117	3860	42	06083	34.43125644	-119.8223002	Santa Barbara County
105917	Fee-for-Service	1285397026	1285397026	1	1	EXELA PHARMACY, INC.	11/3/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6039 GREENBACK LN	None	CITRUS HEIGHTS	CA	95621	4740	34	06067	38.681046	-121.321683	Sacramento County
105922	Fee-for-Service	1689954513	1689954513	1	1	EMAMIMOGHADAM-TEHRANI, SINA	10/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	142845	45	Nephrology (Renal-Kidney)	0	In state provider	MD	200 MED PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
105991	Fee-for-Service	1780093393	1780093393	1	1	EAST TERRACE REHAB &	10/11/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTRE, LP	2415 S WESTERN AVE	None	LOS ANGELES	CA	90018	2608	19	06037	34.034364	-118.3090095	Los Angeles County
106054	Fee-for-Service	1043445893	1043445893	1	1	ESTIPONA, DIANA J PT	4/5/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
106088	Fee-for-Service	1063974285	1063974285	1	1	EL CAJON POST ACUTE LLC	4/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1580 BROADWAY	None	EL CAJON	CA	92021	5124	37	06073	32.80773958	-116.923909	San Diego County
106199	Fee-for-Service	1689954513	1689954513	1	1	EMAMIMOGHADAM-TEHRANI, SINA	10/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	142845	41	Internal Medicine	0	In state provider	MD	200 MED PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
106257	Fee-for-Service	1770698607	1770698607	1	1	EZRA, ESHAGH MD INC	4/24/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	3095 OLD CONEJO RD	None	THOUSAND OAKS	CA	91320	2130	56	06111	34.18969088	-118.9412876	Ventura County
106260	Fee-for-Service	1245226117	1245226117	1	1	ESCOBAR, STEVEN J MD	1/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54135	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1092	37	06073	32.89687721	-117.2418677	San Diego County
106311	Fee-for-Service	1245380054	1245380054	1	1	EAST, JEFFREY A MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	68090	01	General Practice	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
106337	Fee-for-Service	1518683135	1518683135	1	1	EASY RIDE, LLC	5/25/2023	347C00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	10061 TALBERT AVE	SUITE 360	FOUNTAIN VALLEY	CA	92708	5143	30	06059	33.70179254	-117.953191	Orange County
106353	Fee-for-Service	1588664684	1588664684	1	1	ENDRESS, DON M MD	12/11/2002	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	53357	08	Family Practice	0	In state provider	None	350 S OAK AVE	None	OAKDALE	CA	95361	3519	50	06099	37.75764557	-120.8600743	Stanislaus County
106466	Fee-for-Service	1528085404	1528085404	1	1	EVEREST, RUSSELL MD	2/1/1994	207R00000X	NA	Other	026	PHYSICIANS	46792	None	None	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
106546	Fee-for-Service	1245226117	1245226117	1	1	ESCOBAR, STEVEN J MD	1/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54135	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1092	37	06073	32.89687721	-117.2418677	San Diego County
106680	Fee-for-Service	1205858396	1205858396	1	1	ELANDER, TROY R MD	11/9/2010	207W00000X	NA	Ophthalmology	026	PHYSICIANS	65935	18	Ophthalmology	0	In state provider	None	242 26TH ST	None	SANTA MONICA	CA	90402	2552	19	06037	34.0474311	-118.4908612	Los Angeles County
106699	Fee-for-Service	1639145121	1639145121	1	1	EANDI, JONATHAN A MD	8/14/2008	208800000X	NA	Other	026	PHYSICIANS	84755	34	Urology and Urological Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
106790	Fee-for-Service	1336467380	1336467380	1	1	EZINWA, NGOZI M MD	8/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138015	01	General Practice	0	In state provider	None	25455 BARTON RD	SUITE 108A	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
106838	Fee-for-Service	1245226117	1245226117	1	1	ESCOBAR, STEVEN J MD	1/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54135	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1092	37	06073	32.89687721	-117.2418677	San Diego County
106886	Fee-for-Service	1922038520	1922038520	1	1	EVE L GILLESPIE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 HERITAGE WAY	STE 2100	KALISPELL	MT	59901	3157	00	None	48.21762176	-114.3243028	Flathead County
106906	Fee-for-Service	1770801540	1770801540	1	1	ECHEGOYEN, JULIO C MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121431	18	Ophthalmology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
106993	Fee-for-Service	1295131753	1295131753	1	1	ERB, CHARLETTA LMFT	1/2/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2140 EASTMAN AVE	STE 112	VENTURA	CA	93003	7786	56	06111	34.25340343	-119.2298871	Ventura County
107005	Fee-for-Service	1376632547	1376632547	1	1	ENRIQUEZ, EDGAR A MD	3/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80489	02	General Surgery	0	In state provider	None	25775 MCBEAN PKWY	STE 216	VALENCIA	CA	91355	3703	19	06037	34.40042013	-118.5511416	Los Angeles County
107160	Fee-for-Service	1730134404	1730134404	1	1	EVANS, ROBERT K MD	4/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54892	66	Emergency Medicine (Urgent Care)	0	In state provider	None	800 EAST WASHINGTON BLVD	None	CRESCENT CITY	CA	95531	8359	08	06015	41.77272521	-124.1940494	Del Norte County
107189	Fee-for-Service	1275758237	1275758237	1	1	ELLICE, JENNIFER A MD	2/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104282	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
107281	Fee-for-Service	1417107673	1417107673	1	1	EVAZYAN, TALIN MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107116	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
107354	Fee-for-Service	1942695499	1942695499	1	1	EASY CARE HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	520 E WILSON AVE	STE 115	GLENDALE	CA	91206	4374	19	06037	34.14812361	-118.2491324	Los Angeles County
107549	Fee-for-Service	1760479919	1760479919	1	1	EMBLING, MICHELLE L MD	12/10/2019	207PP0204X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
107578	Fee-for-Service	1972595122	1972595122	1	1	ENGELHARDT, DAVID E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	63529	41	Internal Medicine	0	In state provider	None	659 E 15TH ST	STE F	UPLAND	CA	91786	2333	36	06071	34.11796453	-117.6423075	San Bernardino County
107595	Fee-for-Service	1215682729	1215682729	1	1	EZEA, INEZ NP	6/6/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9377 HAVEN AVE	STE 100	RANCHO CUCAMONGA	CA	91730	5340	36	06071	34.083504	-117.575611	San Bernardino County
107640	Fee-for-Service	1942695499	1942695499	1	1	EASY CARE HOSPICE INC	11/26/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	520 E WILSON AVE	STE 115	GLENDALE	CA	91206	4374	19	06037	34.14812361	-118.2491324	Los Angeles County
107704	Fee-for-Service	1861766255	1861766255	1	1	EAST BAY CARDIOLOGY INC	6/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	45567	None	None	0	In state provider	None	39231 LIBERTY ST	None	FREMONT	CA	94538	1501	01	06001	37.55061601	-121.9816447	Alameda County
107779	Fee-for-Service	1154980506	1154980506	1	1	ETERNAL HOPE HOSPICE INC	12/30/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7416 FOOTHILLS BLVD	None	TUJUNGA	CA	91042	2722	19	06037	34.25157058	-118.2936795	Los Angeles County
107799	Fee-for-Service	1649868654	1649868654	1	1	EK HOPE HOSPICE & PALLIATIVE	5/25/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	14545 FRIAR STREET	STE 271	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
107810	Fee-for-Service	1437103942	1437103942	1	17	EMERGENCY & ACUTE CARE	8/15/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
107833	Fee-for-Service	1518500792	1518500792	1	1	EAST VALLEY HOSPICE, INC	6/28/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10646 ZELZAH AVENUE	SUITE 201	GRANADA HILLS	CA	91344	5957	19	06037	34.26341579	-118.5233607	Los Angeles County
107919	Fee-for-Service	1831127497	1831127497	1	1	ELPEDES, BERNARD T DO	7/25/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	6887	None	None	0	In state provider	None	27231 LA PAZ RD	STE A	LAGUNA NIGUEL	CA	92677	3627	30	06059	33.56889655	-117.7077443	Orange County
108041	Fee-for-Service	1053365122	1053365122	1	1	ERNSTER, DALE J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	DAKOTA CLINIC, LTD	419 5TH AVE NE	None	JAMESTOWN	ND	58401	0000	00	None	46.91195065	-98.70261211	Stutsman County
108068	Fee-for-Service	1154980506	1154980506	1	1	ETERNAL HOPE HOSPICE INC	12/30/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7416 FOOTHILLS BLVD	None	TUJUNGA	CA	91042	2722	19	06037	34.25157058	-118.2936795	Los Angeles County
108086	Fee-for-Service	1649868654	1649868654	1	1	EK HOPE HOSPICE & PALLIATIVE	5/25/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE INC	14545 FRIAR STREET	STE 271	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
108097	Fee-for-Service	1437103942	1437103942	1	17	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
108102	Fee-for-Service	1720178411	1720178411	1	1	ERNST, DAVID RICHARD MD	10/31/1995	207R00000X	NA	Other	026	PHYSICIANS	48002	36	Psychiatry	0	In state provider	None	336 BELL LN	None	MILL VALLEY	CA	94941	4038	21	06041	37.87491029	-122.5279793	Marin County
108121	Fee-for-Service	1518500792	1518500792	1	1	EAST VALLEY HOSPICE, INC	6/28/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10646 ZELZAH AVENUE	SUITE 201	GRANADA HILLS	CA	91344	5957	19	06037	34.26341579	-118.5233607	Los Angeles County
108297	Fee-for-Service	1467408302	1467408302	1	1	EISLER, EDWARD A MD	7/25/2005	207L00000X	NA	Other	026	PHYSICIANS	49858	05	Anesthesiology	0	In state provider	None	3700 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
108351	Fee-for-Service	1104316587	1104316587	1	1	ELK GROVE HEARING CLINIC, IN	12/5/2019	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	9300 W STOCKTON BLVD	STE 103	ELK GROVE	CA	95758	8070	34	06067	38.419101	-121.3945425	Sacramento County
108391	Fee-for-Service	1720178411	1720178411	1	1	ERNST, DAVID RICHARD MD	10/31/1995	207R00000X	NA	Other	026	PHYSICIANS	48002	41	Internal Medicine	0	In state provider	None	336 BELL LN	None	MILL VALLEY	CA	94941	4038	21	06041	37.87491029	-122.5279793	Marin County
108487	Fee-for-Service	1790204246	1790204246	1	1	EHRIG, MICHAEL LMFT	4/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	UNIT 203	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
108488	Fee-for-Service	1891910501	1891910501	1	1	EISERMANN, BRIAN J	5/31/2022	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1074 EAST AVE	K-2	CHICO	CA	95926	9596	04	06007	39.76099443	-121.8353929	Butte County
108494	Fee-for-Service	1548308414	1548308414	1	1	EAGLE MEDICAL TRANSPORT INC	4/15/2001	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	EAGLE MEDICAL TRANSPORT	4515 EAGLE ROCK BLVD	STE 117	LOS ANGELES	CA	90041	3396	19	06037	34.12670966	-118.2187005	Los Angeles County
108500	Fee-for-Service	1568420768	1568420768	1	1	EPSTEIN, EDWARD J MD	2/28/1988	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	58270	40	Pediatrics	0	In state provider	None	161 THUNDER DR	STE 111	VISTA	CA	92083	6051	37	06073	33.18638925	-117.2882216	San Diego County
108530	Fee-for-Service	1578820155	1578820155	1	1	ELREFAIE, AHMED A MD	9/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129399	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13100 STUDEBAKER ROAD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
108601	Fee-for-Service	1669483269	1669483269	1	1	EILE, SUSAN C MD	1/13/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	47685	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	13847 E 14TH ST	STE 214	SAN LEANDRO	CA	94578	2626	01	06001	37.71457844	-122.1418551	Alameda County
108612	Fee-for-Service	1669535597	1669535597	1	1	EDWARDS, AUTUMN M MD	6/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78379	08	Family Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
108638	Fee-for-Service	1104316587	1104316587	1	1	ELK GROVE HEARING CLINIC, IN	12/5/2019	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	9300 W STOCKTON BLVD	STE 103	ELK GROVE	CA	95758	8070	34	06067	38.419101	-121.3945425	Sacramento County
108679	Fee-for-Service	1366771727	1366771727	1	1	EBRAHIMI, MORVARID MD	11/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121682	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
108723	Fee-for-Service	1811902612	1811902612	1	1	EMAD, LELA M	1/31/2001	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	61698	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 DOYLE PARK DR	STE 103	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
108752	Fee-for-Service	1174151963	1174151963	1	1	ERICKSON-DAVIS, CORDELIA R M	10/4/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	186000	36	Psychiatry	0	In state provider	D	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
108779	Fee-for-Service	1336143734	1336143734	1	1	ENDOSCOPY CENTER AT	7/23/2002	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SKYPARK	23441 MADISON ST	STE 230	TORRANCE	CA	90505	4757	19	06037	33.81240248	-118.3477463	Los Angeles County
108792	Fee-for-Service	1124682745	1124682745	1	1	ELBERT, GRIFFIN M DO	8/10/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19673	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
108807	Fee-for-Service	1033647029	1033647029	1	1	EALES, THOMAS W DO	7/1/2020	207P00000X	NA	Other	026	PHYSICIANS	18321	66	Emergency Medicine (Urgent Care)	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
108816	Fee-for-Service	1770698607	1770698607	1	2	ESHAGH EZRA M.D., INC.	5/6/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	18433 ROSCOE BLVD	202	NORTHRIDGE	CA	91325	4108	19	06037	34.22076747	-118.534725	Los Angeles County
108875	Fee-for-Service	1699009753	1699009753	1	1	EB PSYCHOTHERAPY, INC	11/19/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2001 S BARRINGTON AVE	SUITE 314	LOS ANGELES	CA	90025	5379	19	06037	34.03672191	-118.4500156	Los Angeles County
108887	Fee-for-Service	1669483269	1669483269	1	1	EILE, SUSAN C MD	1/13/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	47685	01	General Practice	0	In state provider	None	13847 E 14TH ST	STE 214	SAN LEANDRO	CA	94578	2626	01	06001	37.71457844	-122.1418551	Alameda County
108896	Fee-for-Service	1801184031	1801184031	1	1	EISMAN, SCOTT A MD INC	2/5/2018	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	326 SANTA FE DRIVE	100	ENCINITAS	CA	92024	5138	37	06073	33.040332	-117.285102	San Diego County
108961	Fee-for-Service	1689893075	1689893075	1	1	EXPRESSIONS-SPEECH LANGUAGE	1/23/2015	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	PATHOLOGY SERVICES	12062 VALLEY VIEW ST	STE 137	GARDEN GROVE	CA	92845	1741	30	06059	33.78720885	-118.028413	Orange County
108969	Fee-for-Service	1437103942	1437103942	1	15	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
109023	Fee-for-Service	1679285472	1679285472	1	1	EZIGBO, MARTINA NP	3/6/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
109044	Fee-for-Service	1992184311	1992184311	1	1	ELIZALDE-PESCHEK, MARLENE L	10/23/2019	103T00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MFT	13200 CROSSROADS PARKWAY	SUITE 335	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
109074	Fee-for-Service	1073941118	1073941118	1	1	EXCEL-CARE SERVICES, INC	5/16/2014	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	22720 BURTON ST	None	WEST HILLS	CA	91304	3708	19	06037	34.21847555	-118.6221015	Los Angeles County
109077	Fee-for-Service	1265016133	1265016133	1	1	ESPERANZA HOME HEALTH INC	7/19/2023	251E00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	6924 FOOTHILL BLVD	None	TUJUNGA	CA	91042	2713	19	06037	34.24780566	-118.2827853	Los Angeles County
109102	Fee-for-Service	1962460501	1962460501	2	1	ELIAS, ZOUHEIR H	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	33856	None	None	0	In state provider	None	18350 ROSECOE BLVD	SUITE 401	NORTHRIDGE	CA	91325	4169	19	06037	34.22071855	-118.5341175	Los Angeles County
109166	Fee-for-Service	1467847905	1467847905	1	1	ELSENSOHN, ASHLEY MD	12/18/2018	207N00000X	NA	Dermatology	026	PHYSICIANS	148423	07	Dermatology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
109176	Fee-for-Service	1962433839	1962433839	1	1	EKKENS, DANIEL A MD	10/1/1995	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	21365	01	General Practice	0	In state provider	None	1040 MANGROVE AVE	None	CHICO	CA	95926	3509	04	06007	39.7403994	-121.8373152	Butte County
109183	Fee-for-Service	1801184031	1801184031	1	1	EISMAN, SCOTT A MD INC	2/5/2018	193400000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	326 SANTA FE DRIVE	100	ENCINITAS	CA	92024	5138	37	06073	33.040332	-117.285102	San Diego County
109223	Fee-for-Service	1407443849	1407443849	1	1	ELEONOR'S PLACE INC.	2/5/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	24152 JAGGER STREET	None	LAKE FOREST	CA	92630	3658	30	06059	33.62890922	-117.7086608	Orange County
109257	Fee-for-Service	1437103942	1437103942	1	15	EMERGENCY & ACUTE CARE	3/11/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
109278	Fee-for-Service	1124617212	1124617212	1	1	EVANS, MARTINE M	10/4/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
109282	Fee-for-Service	1467786889	1467786889	1	1	ENVISION SURGERY CENTER, LLC	12/21/2010	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	42442 10TH ST WEST	STE G	LANCASTER	CA	93534	7067	19	06037	34.65427909	-118.147575	Los Angeles County
109412	Fee-for-Service	1013929157	1013929157	1	1	ELSHIMALI, YAHYA I MD	6/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	55296	22	Pathology (M.D. only)	0	In state provider	None	7855 HASKELL AVE	STE 302	VAN NUYS	CA	91406	1902	19	06037	34.213572	-118.4749495	Los Angeles County
109470	Fee-for-Service	1801184031	1801184031	1	1	EISMAN, SCOTT A MD INC	2/5/2018	193400000X	NA	Other	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	326 SANTA FE DRIVE	100	ENCINITAS	CA	92024	5138	37	06073	33.040332	-117.285102	San Diego County
109487	Fee-for-Service	1356714745	1356714745	1	1	EXCEL KIDNEY CARE IN A	3/17/2016	193400000X	NA	Other	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	PROFESSIONAL MEDICAL COR	1140 NORMAN DRIVE	STE 104	MANTECA	CA	95336	5900	39	06077	37.79425988	-121.1998134	San Joaquin County
109517	Fee-for-Service	1609823145	1609823145	1	1	ERIC BEAN DO	6/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1627 CHEW ST	None	ALLENTOWN	PA	18102	3648	00	None	40.60095406	-75.49376064	Lehigh County
109545	Fee-for-Service	1952028441	1952028441	1	1	E & J CARE PROVIDER INC	6/5/2024	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3262 SANTA ISABELLA	COURT	UNION CITY	CA	94587	2736	01	06001	37.59222798	-122.0668471	Alameda County
109641	Fee-for-Service	1952744773	1952744773	1	1	EVERETT, ESTELLE M MD	3/14/2022	207RE0101X	NA	Endocrinology	026	PHYSICIANS	163817	None	None	0	In state provider	None	27235 TOURNEY	2500	VALENCIA	CA	91355	5908	19	06037	34.41755702	-118.5772646	Los Angeles County
109785	Fee-for-Service	1629056684	1629056684	1	1	ECHENIQUE, ANA M MD	2/8/2015	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	88654	30	Radiology	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
109959	Fee-for-Service	1356578553	1356578553	1	1	ELDRIDGE, MATTHEW L MD	10/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113748	77	Infectious Disease	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
109991	Fee-for-Service	1558695163	1558695163	1	1	ELL, SARAH A	4/10/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
110015	Fee-for-Service	1174708093	1174708093	1	1	EDWARDS, ASHLEY G CRNA	2/8/2015	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2615	15	06029	35.38333823	-119.0188872	Kern County
110061	Fee-for-Service	1245399815	1245399815	1	1	ELPERIN, LOUIS S MD	3/16/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	60614	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
110084	Fee-for-Service	1932966355	1932966355	1	1	EDET, IJEOMA V DOULA	5/30/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
110102	Fee-for-Service	1053643700	1053643700	1	1	ELNAGGAR, MOHAMED Y MD	3/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135253	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3605 LONG BEACH BLVD	SUITE 405	LONG BEACH	CA	90807	4026	19	06037	33.822693	-118.1893765	Los Angeles County
110128	Fee-for-Service	1962720920	1962720920	1	1	EHIE, ODINAKACHUKWU A MD	8/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130716	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.7634502	-122.4579779	San Francisco County
110204	Fee-for-Service	1629478185	1629478185	1	1	EARLY, JILLIAN M LCSW	6/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
110207	Fee-for-Service	1881311876	1881311876	1	1	EMBRACE PSYCHOLOGICAL AND CO	11/16/2022	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	UNSELING SERVICES INC	18811 HUNTINGTON ST	200	HUNTINGTON BEACH	CA	92648	6003	30	06059	33.68962104	-117.9954102	Orange County
110246	Fee-for-Service	1356578553	1356578553	1	1	ELDRIDGE, MATTHEW L MD	10/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113748	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
110338	Fee-for-Service	1104825520	1104825520	1	1	ENSIGN MONTGOMERY LLC	4/1/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	PARK VIEW GARDENS MONTGO	3751 MONTGOMERY DR	None	SANTA ROSA	CA	95405	5214	49	06097	38.453472	-122.6758185	Sonoma County
110365	Fee-for-Service	1194473231	1194473231	1	1	ENDURE URGENT CARE	7/29/2022	261QU0200X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4451 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4847	19	06037	34.00253339	-118.4062438	Los Angeles County
110391	Fee-for-Service	1053643700	1053643700	1	1	ELNAGGAR, MOHAMED Y MD	3/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135253	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3605 LONG BEACH BLVD	SUITE 405	LONG BEACH	CA	90807	4026	19	06037	33.822693	-118.1893765	Los Angeles County
110419	Fee-for-Service	1285731661	1285731661	1	1	ELLIS, ADAM P MD	9/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53403	41	Internal Medicine	0	In state provider	None	354 SANTA FE DRIVE	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
110453	Fee-for-Service	1639144850	1639144850	1	1	EMAD G KALDAWI M.D.	11/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 W BERYL AVE	None	PHOENIX	AZ	85021	1606	00	None	33.579549	-112.1147235	Maricopa County
110561	Fee-for-Service	1831806405	1831806405	1	1	ENTERSURG PC	5/1/2024	2086S0129X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	PECIALISTS	591 E ELDER ST	SUITE B	FALLBROOK	CA	92028	5001	37	06073	33.3801147	-117.2454154	San Diego County
110601	Fee-for-Service	1316089113	1316089113	1	1	ESTEVES, CARLO S MD	11/26/2007	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	25	Physical Medicine and Rehabilitation	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
110660	Fee-for-Service	1922378306	1922378306	1	1	ELSINGA, ELYSIA N CNM	4/26/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
110771	Fee-for-Service	1861904161	1861904161	1	1	EMI HOME HEALTH SERVICES INC	3/26/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14555 HAMLIN ST	UNIT 1	VAN NUYS	CA	91411	1612	19	06037	34.18872722	-118.4506359	Los Angeles County
110801	Fee-for-Service	1740310432	1740310432	1	1	ELLYSON CHIROPRACTIC	2/1/2006	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	605 E ST	None	MARYSVILLE	CA	95901	5502	58	06115	39.14152304	-121.5906329	Yuba County
110875	Fee-for-Service	1821388182	1821388182	1	1	ESENTHER, BRANDON R MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136073	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	SUITE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
110894	Fee-for-Service	1154346724	1154346724	1	1	EILBER, FREDERICK R MD	5/2/1974	2086X0206X	NA	General Surgery	026	PHYSICIANS	35113	02	General Surgery	0	In state provider	None	924 WESTWOOD BLVD	STE 40	LOS ANGELES	CA	90024	2910	19	06037	34.06309787	-118.4452763	Los Angeles County
110920	Fee-for-Service	1225440217	1225440217	1	2	EZROJ, DANIEL B G MD	2/14/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	144743	40	Pediatrics	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
110955	Fee-for-Service	1548334857	1548334857	1	1	EGGERS, GARRETT G MD	1/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89067	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
110960	Fee-for-Service	1376803288	1376803288	1	1	EATON, PHILIP D DO	7/25/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	13280	30	Radiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
110969	Fee-for-Service	1699834226	1699834226	1	1	EDISON HOLLAND,KAREN MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67333	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
110973	Fee-for-Service	1396049029	1396049029	1	1	ELSAYED, SARAH S MD	8/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	114220	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	18111 BROOKHURST ST	STE 5100	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
111004	Fee-for-Service	1376127209	1376127209	1	1	EMBRACING ARMS HOME HEALTH C	10/4/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2600 FOOTHILL BLVD	STE 109	LA CRESCENTA	CA	91214	4578	19	06037	34.22121465	-118.2352382	Los Angeles County
111166	Fee-for-Service	1316540917	1316540917	1	1	ETS HOSPICE CARE INC	6/7/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6410 VAN NUYS BLVD	STE F202	VAN NUYS	CA	91401	6263	19	06037	34.187085	-118.4487115	Los Angeles County
111178	Fee-for-Service	1427052190	1427052190	1	1	EYE TREATMENT CENTER AN	1/5/2022	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INCORPORATED MED GRP INC	3900 LONG BEACH BLVD	None	LONG BEACH	CA	90807	2615	19	06037	33.829236	-118.1893235	Los Angeles County
111185	Fee-for-Service	1831225549	1831225549	1	1	ECKLUND, NATHAN B DPM	10/23/2007	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	310 S HALCYON RD	STE 101	ARROYO GRANDE	CA	93420	3863	40	06079	35.11464177	-120.5916364	San Luis Obispo County
111253	Fee-for-Service	1720498942	1720498942	1	1	EWING, RACHEL J LMFT	4/7/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	94702	-	NOT APPLICABLE	0	In state provider	None	401 S. STREET	None	SACRAMENTO	CA	95811	6919	34	06067	38.572677	-121.5050805	Sacramento County
111330	Fee-for-Service	1639221096	1639221096	1	1	EKANEJ, AMIR T MD	11/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	60862	10	Gastroenterology (M.D. only)	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
111455	Fee-for-Service	1316540917	1316540917	1	1	ETS HOSPICE CARE INC	6/7/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6410 VAN NUYS BLVD	STE F202	VAN NUYS	CA	91401	6263	19	06037	34.187085	-118.4487115	Los Angeles County
111465	Fee-for-Service	1427052190	1427052190	1	1	EYE TREATMENT CENTER AN	5/31/1995	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INCORPORATED MED GRP INC	3900 LONG BEACH BLVD	None	LONG BEACH	CA	90807	2615	19	06037	33.829236	-118.1893235	Los Angeles County
111489	Fee-for-Service	1336228436	1336228436	1	1	ELLISON, SAMUEL F MD	2/8/2015	207N00000X	NA	Dermatology	026	PHYSICIANS	41459	07	Dermatology	0	In state provider	None	2001 UNION ST	STE 480	SAN FRANCISCO	CA	94123	4128	38	06075	37.7974427	-122.432532	San Francisco County
111663	Fee-for-Service	1417901091	1417901091	1	5	ENLOE MEDICAL CENTER-	9/3/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	SURGICAL PROC ASSESSMENT	251 COHASSET ROAD	STE 110	CHICO	CA	95926	2235	04	06007	39.75090044	-121.8522609	Butte County
111679	Fee-for-Service	1356358121	1356358121	1	1	EMILIA TALAMAS M.D	7/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11167 LA QUINTA PL	None	EL PASO	TX	79936	5221	00	None	31.7557211	-106.3211966	El Paso County
111701	Fee-for-Service	1598972838	1598972838	1	1	EDDI, RODNEY MD	10/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122143	10	Gastroenterology (M.D. only)	0	In state provider	None	680 GUZZI LN	STE 206	SONORA	CA	95370	5929	55	06109	37.97611058	-120.3719921	Tuolumne County
111761	Fee-for-Service	1649614637	1649614637	1	1	EXCELLENCE HOSPICE PROVIDERS	4/21/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	11760 CENTRAL AVE	STE 201	CHINO	CA	91710	1909	36	06071	34.03926	-117.6896155	San Bernardino County
111771	Fee-for-Service	1356530638	1356530638	1	1	ENGLUND, GARY L OD	1/1/1979	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	#E	2238 BAYVIEW HEIGHTS DR	None	LOS OSOS	CA	93402	3921	40	06079	35.31038553	-120.8334714	San Luis Obispo County
111808	Fee-for-Service	1124441662	1124441662	1	1	EBERT, AMY LPCC	2/22/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	3987	-	NOT APPLICABLE	0	In state provider	None	6109 AFTON PLACE	None	LOS ANGELES	CA	90028	8313	19	06037	34.09531447	-118.3226631	Los Angeles County
111892	Fee-for-Service	1740214733	1740214733	2	1	EMERGENCY MEDICINE SPECIALIS	4/7/2020	207PP0204X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	TS OF ORANGE COUNTY	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
111921	Fee-for-Service	1306105721	1306105721	1	1	ENLOE SPECIALTY PHYSICIANS	10/11/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	INC	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
111984	Fee-for-Service	1801226162	1801226162	1	2	ENLOE MEDICAL CENTER	10/28/2020	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	NIC	111 RALEY BLVD	SUITE 100	CHICO	CA	95928	8351	04	06007	39.71601447	-121.790817	Butte County
111989	Fee-for-Service	1124029491	1124029491	1	1	EDOUARD, PHILIPPE R MD	7/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	51257	41	Internal Medicine	0	In state provider	None	24 W EL ROSE DRIVE	None	PETALUMA	CA	94952	4023	49	06097	38.22308352	-122.646555	Sonoma County
112048	Fee-for-Service	1649614637	1649614637	1	1	EXCELLENCE HOSPICE PROVIDERS	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	11760 CENTRAL AVE	STE 201	CHINO	CA	91710	1909	36	06071	34.03926	-117.6896155	San Bernardino County
112086	Fee-for-Service	1073100244	1073100244	1	1	ELITE HOSPICE & PALLIATIVE	10/28/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE, INC	8400 MAPLE PL	STE 109	RANCHO CUCAMONGA	CA	91730	3874	36	06071	34.10073009	-117.5628588	San Bernardino County
112171	Fee-for-Service	1750682712	1750682712	1	1	EMERGENCY MEDICINE PHYSICIAN	1/1/2011	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS OF RIVERSIDE CO	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	33	06065	33.89552551	-117.186021	Riverside County
112184	Fee-for-Service	1740214733	1740214733	2	1	EMERGENCY MEDICINE SPECIALIS	4/7/2020	207PP0204X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	TS OF ORANGE COUNTY	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
112208	Fee-for-Service	1306105721	1306105721	1	1	ENLOE SPECIALTY PHYSICIANS	10/11/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	INC	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
112255	Fee-for-Service	1740214733	1740214733	2	2	EMERGENCY MEDICINE SPECIALIS	4/7/2020	207PP0204X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	TS OF ORANGE COUNTY	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
112271	Fee-for-Service	1801226162	1801226162	1	2	ENLOE MEDICAL CENTER	10/28/2020	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	NIC	111 RALEY BLVD	SUITE 100	CHICO	CA	95928	8351	04	06007	39.71601447	-121.790817	Butte County
112308	Fee-for-Service	1275764615	1275764615	1	1	EMANUEL MEDICAL GROUP INC	8/2/2010	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2121 COLORADO AVE	SUITE C	TURLOCK	CA	95382	2012	50	06099	37.5117454	-120.8353096	Stanislaus County
112309	Fee-for-Service	1780311548	1780311548	1	1	EMPIRE VEIN & VASCULAR SPECI	8/2/2023	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	ALISTS ASC LLC	72120 MAGNESIA FALLS DR	BLDG C6-14	RANCHO MIRAGE	CA	92270	4938	33	06065	33.73596753	-116.4056409	Riverside County
112337	Fee-for-Service	1427708957	1427708957	1	1	EWALD, ANNA LMFT	10/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4675 VIA LOS SANTOS	None	SANTA BARBARA	CA	93111	1346	42	06083	34.4561269	-119.7851783	Santa Barbara County
112373	Fee-for-Service	1073100244	1073100244	1	1	ELITE HOSPICE & PALLIATIVE	10/28/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE, INC	8400 MAPLE PL	STE 109	RANCHO CUCAMONGA	CA	91730	3874	36	06071	34.10073009	-117.5628588	San Bernardino County
112395	Fee-for-Service	1285039909	1285039909	1	1	EDBERG, DANIEL M MD	11/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138663	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
112402	Fee-for-Service	1649278904	1649278904	1	1	EDGAR, KENNETH MD	12/15/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	170621	None	None	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
112426	Fee-for-Service	1841240256	1841240256	1	1	ENDO, CLIFFORD K DPM	12/30/1997	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2690 PACIFIC AVE	STE 370	LONG BEACH	CA	90806	2661	19	06037	33.805854	-118.1936805	Los Angeles County
112514	Fee-for-Service	1285670679	1285670679	1	1	EASTWIND PARTNERS, INC.	12/4/2008	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HEALTHY FAMILY PHARMACY	7932 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	6804	19	06037	33.965703	-118.222392	Los Angeles County
112516	Fee-for-Service	1699823674	1699823674	1	1	EL-HASAN, AFIF H MD	12/1/1997	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	55109	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
112538	Fee-for-Service	1134165194	1134165194	1	1	EXCEL CARDIOLOGY GROUP INC	2/8/2015	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	7029	06	Cardiovascular Disease (M.D. only)	0	In state provider	EXCEL CARDIOLOGY GROUP	1505 WILSON TERRACE	STE 320	GLENDALE	CA	91206	4073	19	06037	34.14960934	-118.2313491	Los Angeles County
112540	Fee-for-Service	1740214733	1740214733	2	2	EMERGENCY MEDICINE SPECIALIS	4/7/2020	207PP0204X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	TS OF ORANGE COUNTY	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
112560	Fee-for-Service	1184308223	1184308223	1	1	ELLIOTT, NATALIA BIRTH DOUL	9/25/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	36	06071	0	0	None
112592	Fee-for-Service	1306105721	1306105721	1	2	ENLOE SPECIALTY PHYSICIANS	9/13/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	INC	265 COHASSET RD	None	CHICO	CA	95926	2273	04	06007	39.75090044	-121.8522609	Butte County
112689	Fee-for-Service	1326625237	1326625237	1	1	EVERS, MARISA R MD	7/11/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
112747	Fee-for-Service	1780010595	1780010595	1	1	ERNST, XAVIER J CNP	3/25/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8850 VALLEY VIEW ST	None	BUENA PARK	CA	90620	3562	30	06059	33.833988	-118.0282915	Orange County
112748	Fee-for-Service	1790797835	1790797835	1	1	EZRA, ESHAGH MD INC	4/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	56249	None	None	0	In state provider	None	15424 NORDHOFF ST	STE B	NORTH HILLS	CA	91343	6952	19	06037	34.23550347	-118.468656	Los Angeles County
112783	Fee-for-Service	1558537910	1558537910	1	1	E & S WINESTOCK, INC	2/22/1991	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8920 WILSHIRE BLVD	STE 108	BEVERLY HILLS	CA	90211	2001	19	06037	34.06703599	-118.3863456	Los Angeles County
112786	Fee-for-Service	1689862815	1689862815	1	2	ELITE HOME HEALTH INC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	220 S KENWOOD	SUITE 220	GLENDALE	CA	91205	1671	19	06037	34.14355865	-118.2513018	Los Angeles County
112826	Fee-for-Service	1134165194	1134165194	1	1	EXCEL CARDIOLOGY GROUP INC	2/8/2015	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	7029	41	Internal Medicine	0	In state provider	EXCEL CARDIOLOGY GROUP	1505 WILSON TERRACE	STE 320	GLENDALE	CA	91206	4073	19	06037	34.14960934	-118.2313491	Los Angeles County
112827	Fee-for-Service	1053776906	1053776906	1	1	ELIZABETH TUPTA	2/13/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
112832	Fee-for-Service	1972007235	1972007235	1	1	ERSHADI, SEAN N MD	10/11/2021	390200000X	NA	Other	026	PHYSICIANS	165130	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
112866	Fee-for-Service	1073780938	1073780938	1	1	EDDIN, MONEER J MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	106214	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	43723 20TH ST	None	LANCASTER	CA	93534	4784	19	06037	34.67746837	-118.1657415	Los Angeles County
112886	Fee-for-Service	1881644482	1881644482	1	1	EDRAKI, TANEES I MD	5/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	49624	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	830 SCENIC DR	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
112929	Fee-for-Service	1467554543	1467554543	1	1	EAKIN, COLIN L. MD	6/6/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	76089	20	Orthopedic Surgery	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
113004	Fee-for-Service	1295045532	1295045532	1	1	ELIAS, MIRNA P MD	10/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109620	41	Internal Medicine	0	In state provider	None	354 S VERMONT AVE	None	LOS ANGELES	CA	90020	1807	19	06037	34.06759719	-118.2916018	Los Angeles County
113123	Fee-for-Service	1336594373	1336594373	1	1	ELALA, YOSEPH C MD	3/4/2020	207R00000X	NA	Other	026	PHYSICIANS	162460	41	Internal Medicine	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
113191	Fee-for-Service	1891729653	1891729653	1	1	ETTINGER, VICTOR G MD	10/24/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	23420	67	Endocrinology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
113192	Fee-for-Service	1750701405	1750701405	1	1	ELLIS, ALISSA J PHD	11/17/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8341	19	06037	34.07067	-118.4432445	Los Angeles County
113227	Fee-for-Service	1265926497	1265926497	1	1	EVERROAD, BRITTANY OT	4/6/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9988 HIBERT ST	208	SAN DIEGO	CA	92131	2480	37	06073	32.91387153	-117.1107585	San Diego County
113261	Fee-for-Service	1902288608	1902288608	1	1	EBERLE, DANIELLE N LCSW	5/17/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23815 STUART RANCH ROAD	300	MALIBU	CA	90265	4861	19	06037	34.03957842	-118.6927134	Los Angeles County
113308	Fee-for-Service	1932267150	1932267150	1	1	ELLINGSON, SANDRA L NP	9/10/2009	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
113309	Fee-for-Service	1265451801	1265451801	1	1	ESPINOSA, ROSALIE E MD	4/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51359	40	Pediatrics	0	In state provider	None	7140 INDIANA AVE	None	RIVERSIDE	CA	92504	4544	33	06065	33.93890182	-117.3977958	Riverside County
113416	Fee-for-Service	1376618389	1376618389	1	1	ELSHIRE, HARRY D MD	11/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	40737	None	None	0	In state provider	None	6412 LAUREL AVE	None	LAKE ISABELLA	CA	93240	9529	15	06029	35.63564004	-118.407037	Kern County
113482	Fee-for-Service	1891729653	1891729653	1	1	ETTINGER, VICTOR G MD	10/24/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	23420	41	Internal Medicine	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
113556	Fee-for-Service	1720412612	1720412612	1	1	ENRIGHT, ANDREW N LMFT	5/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
113620	Fee-for-Service	1154730828	1154730828	1	3	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	9140 VAN NUYS BLVD	STE 207	PANORAMA CITY	CA	91402	6763	19	06037	34.236603	-118.4502215	Los Angeles County
113853	Fee-for-Service	1073867958	1073867958	1	1	ERICA A PARRISH	1/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
113899	Fee-for-Service	1689722415	1689722415	1	1	ELLIS, RICHARD K DO	9/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8627	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
113907	Fee-for-Service	1154730828	1154730828	1	3	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	9140 VAN NUYS BLVD	STE 207	PANORAMA CITY	CA	91402	6763	19	06037	34.236603	-118.4502215	Los Angeles County
113925	Fee-for-Service	1437553583	1437553583	2	1	EXCEL REHAB PHYSICAL THERAPY	2/23/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	2000 W KETTLEMAN LN,	SUITE 106	LODI	CA	95242	4334	39	06077	38.1153755	-121.2971355	San Joaquin County
113929	Fee-for-Service	1720667256	1720667256	1	1	EMBRACE THEM	7/19/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
113941	Fee-for-Service	1760491286	1760491286	1	1	ERFANI, MOHAMMAD S MD	1/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	94194	24	Plastic Surgery	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
114022	Fee-for-Service	1871931352	1871931352	1	1	EFTHEMIS, PHILIP J PT	4/6/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
114109	Fee-for-Service	1598952327	1598952327	1	1	EAGAN, MICHAEL J MD	10/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99867	20	Orthopedic Surgery	0	In state provider	None	2400 S FLOWER ST	None	LOS ANGELES	CA	90007	2629	19	06037	34.02861627	-118.273964	Los Angeles County
114113	Fee-for-Service	1407831233	1407831233	1	1	EGU, OBILOH MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83698	15	Obstetrics (D.O. only)	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
114241	Fee-for-Service	1376784207	1376784207	1	1	ERICKSON, DACHELLE A CRNA	8/30/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
114307	Fee-for-Service	1972546166	1972546166	1	1	EVANS, JAMES D III MD	1/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	79671	40	Pediatrics	0	In state provider	None	4 COUNTRY CLUB PLAZA	None	ORINDA	CA	94563	2308	07	06013	37.88568235	-122.1926427	Contra Costa County
114438	Fee-for-Service	1598833303	1598833303	1	1	EARLE, CHARMAINE E MD	7/18/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	80086	None	None	0	In state provider	None	12984 HESPERIA ROAD	SUITE 101	VICTORVILLE	CA	92395	5819	36	06071	34.48716133	-117.2903452	San Bernardino County
114471	Fee-for-Service	1700010030	1700010030	1	1	EL MOKADEM, HESHAM E MD	8/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107687	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1717 3RD ST	None	RIVERSIDE	CA	92507	3435	33	06065	33.98304426	-117.348918	Riverside County
114560	Fee-for-Service	1104052273	1104052273	1	1	ELMUFDI, RAMI S MD	8/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108497	41	Internal Medicine	0	In state provider	None	1150 N INDIAN CYN DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
114646	Fee-for-Service	1205241528	1205241528	1	1	ECHEVESTE, SILVIA NP	12/17/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
114849	Fee-for-Service	1255808440	1255808440	1	1	EMPRESS HEALTHCARE	1/3/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	7100 HAYVENHURST AVE	PENTHOUSE SUITE E	VAN NUYS	CA	91406	3874	19	06037	34.199064	-118.4923845	Los Angeles County
114876	Fee-for-Service	1356503643	1356503643	1	1	EKPO, GERALDINE E MD	7/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120209	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1001 POTRERO AVE	RM 6D	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
114924	Fee-for-Service	1649226242	1649226242	1	1	EAST BAY ANESTHESIOLOGY	1/4/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	MEDICAL GROUP	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
114970	Fee-for-Service	1740629104	1740629104	1	1	EBRAHIM, JOHN L MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142685	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
114980	Fee-for-Service	1962619668	1962619668	1	1	ECKERMANN, JAN M	2/8/2015	207T00000X	NA	General Surgery	026	PHYSICIANS	96203	14	Neurological Surgery	0	In state provider	None	1524 27TH ST	None	BAKERSFIELD	CA	93301	2055	15	06029	35.38387747	-119.0197575	Kern County
115056	Fee-for-Service	1720030570	1720030570	1	1	EARLY, PHILIP W MD	6/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65561	05	Anesthesiology	0	In state provider	None	3800 JANES RD	ROOM 138	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
115091	Fee-for-Service	1285912311	1285912311	1	1	EDWARDS, EMILY R MD	11/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117631	40	Pediatrics	0	In state provider	None	MCMF - 250 E YALE LOOP	SUITE 200	IRVINE	CA	92604	4697	30	06059	33.67473753	-117.7880547	Orange County
115120	Fee-for-Service	1740548734	1740548734	1	1	EGHTEDARI, MOHAMMAD MD	3/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114372	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
115129	Fee-for-Service	1093747396	1093747396	1	1	ENLOE, THOMAS S MD	6/21/2000	204C00000X	NA	Other	026	PHYSICIANS	36115	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1002 N DOUTY ST	None	HANFORD	CA	93230	3723	16	06031	36.335133	-119.646077	Kings County
115140	Fee-for-Service	1912580762	1912580762	1	1	ELI AHDOOT, DO, INC.	5/5/2022	207XS0114X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	191 BUENA VISTA ST	STE 370	BURBANK	CA	91505	4562	19	06037	34.15872557	-118.3283863	Los Angeles County
115174	Fee-for-Service	1922501584	1922501584	1	1	ERIKA BISCHOFF, LICENSED CLI	6/5/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	520 S SEPULVEDA BLVD	305	LOS ANGELES	CA	90049	3536	19	06037	34.06573968	-118.4598268	Los Angeles County
115265	Fee-for-Service	1942206719	1942206719	2	1	EL DORADO PATHOLOGY MEDICAL	8/9/2018	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	1000 FOWLER WAY	STE 4	PLACERVILLE	CA	95667	5738	09	06017	38.72679661	-120.7923668	El Dorado County
115324	Fee-for-Service	1144767211	1144767211	1	1	EL-MOGHRABI, NANCY OD	4/25/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	835 THIRD AVE	SUITE A	CHULA VISTA	CA	91911	1352	37	06073	32.62293517	-117.0726661	San Diego County
115355	Fee-for-Service	1528021854	1528021854	1	1	ENGLANDER, JEFFREY MD	12/1/1990	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	54918	41	Internal Medicine	0	In state provider	BLDG H-12	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
115424	Fee-for-Service	1437103942	1437103942	1	10	EMERGENCY & ACUTE CARE	4/1/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL CORPORATION	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
115440	Fee-for-Service	1245410950	1245410950	1	1	EL-GABALAWY, MOHAMED H	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50305	36	Psychiatry	0	In state provider	MD INC	1111 S ARROYO PKWY	STE 405	PASADENA	CA	91105	3291	19	06037	34.12800981	-118.1473729	Los Angeles County
115578	Fee-for-Service	1407482730	1407482730	1	1	ELITE CLINICAL CARE PHARMACY	9/14/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9103 SEPULVEDA BLVD	None	NORTH HILLS	CA	91343	3920	19	06037	34.235802	-118.467736	Los Angeles County
115591	Fee-for-Service	1619397700	1619397700	1	1	EDISTO DIALYSIS LLC	9/10/2015	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	13054 N HARBOR BLVD	None	GARDEN GROVE	CA	92843	1744	30	06059	33.77484603	-117.919439	Orange County
115643	Fee-for-Service	1528021854	1528021854	1	1	ENGLANDER, JEFFREY MD	12/1/1990	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	54918	25	Physical Medicine and Rehabilitation	0	In state provider	BLDG H-12	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
115712	Fee-for-Service	1437103942	1437103942	1	10	EMERGENCY & ACUTE CARE	12/1/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
115770	Fee-for-Service	1053432054	1053432054	1	1	ELIAS, HUSAM G DMD	1/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113977	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
115899	Fee-for-Service	1831622869	1831622869	1	1	EVANS, MARK W MD	3/31/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162363	None	None	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
115919	Fee-for-Service	1205167491	1205167491	1	3	ENVISION SCHOOLS	7/1/2012	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	325 LA GRANDE STREET	None	SAN FRANCISCO	CA	94112	2866	38	06075	37.71943287	-122.4257434	San Francisco County
116023	Fee-for-Service	1134560477	1134560477	1	1	ENOS, MATTHEW M OD	7/23/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	340 WEST PORTAL AVE	None	SAN FRANCISCO	CA	94127	1412	38	06075	37.73744363	-122.4697471	San Francisco County
116083	Fee-for-Service	1760605513	1760605513	1	1	ERSKINE, MARK P	5/16/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
116249	Fee-for-Service	1679537971	1679537971	1	1	ESSERMAN, LAURA J	3/31/1992	208600000X	NA	General Surgery	026	PHYSICIANS	53346	01	General Practice	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
116267	Fee-for-Service	1043741747	1043741747	1	1	ESCAMILLA, DIANDRA MD	8/2/2021	207P00000X	NA	Other	026	PHYSICIANS	172037	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
116281	Fee-for-Service	1275514325	1275514325	1	1	ENGLISH, DAVID K	6/1/1995	207P00000X	NA	Other	026	PHYSICIANS	60006	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
116283	Fee-for-Service	1720099328	1720099328	1	3	ENLOE MEDICAL CENTER	1/16/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	185 E 7TH AVE	STE A	CHICO	CA	95926	3356	04	06007	39.74473059	-121.8488381	Butte County
116285	Fee-for-Service	1801841051	1801841051	1	1	EAGER, STEVEN E MD	5/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	71271	20	Orthopedic Surgery	0	In state provider	None	333 E ALPINE AVE	None	STOCKTON	CA	95204	3407	39	06077	37.98100681	-121.2957195	San Joaquin County
116343	Fee-for-Service	1881744605	1881744605	1	1	ENG, ROSE MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37850	01	General Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
116439	Fee-for-Service	1447269220	1447269220	1	1	EDGAR SELAUDIN BEKTESHI M.D	3/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3155 E SOUTHERN AVE	STE 201	MESA	AZ	85204	5521	00	None	33.393465	-111.763026	Maricopa County
116492	Fee-for-Service	1417957473	1417957473	1	2	ELADH, LP	6/18/2021	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	EAST LA DOCTORS HOSP	4036 WHITTIER BLVD	STE 201	LOS ANGELES	CA	90023	2561	19	06037	34.02390455	-118.1847825	Los Angeles County
116546	Fee-for-Service	1174005003	1174005003	1	1	EPARTHENOS	9/28/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	23504 LYONS AVE	STE 304	SANTA CLARITA	CA	91321	5776	19	06037	34.37942345	-118.5452006	Los Angeles County
116569	Fee-for-Service	1275514325	1275514325	1	1	ENGLISH, DAVID K	6/1/1995	207P00000X	NA	Other	026	PHYSICIANS	60006	41	Internal Medicine	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
116573	Fee-for-Service	1720099328	1720099328	1	3	ENLOE MEDICAL CENTER	1/16/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	185 E 7TH AVE	STE A	CHICO	CA	95926	3356	04	06007	39.74473059	-121.8488381	Butte County
116602	Fee-for-Service	1467578708	1467578708	1	1	EAKIN, DESIREE R MD	8/19/2009	208M00000X	NA	Other	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
116609	Fee-for-Service	1225695117	1225695117	1	1	EISMAN, ALYSSA LCSW	4/11/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	155 HOSPITALITY LN	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
116706	Fee-for-Service	1760541361	1760541361	1	1	EICHER, MARK S MD	5/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	55756	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
116756	Fee-for-Service	1285793836	1285793836	1	1	EATON, SCOTT D MD	9/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	88621	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	60 FENTON ST	STE 1	LIVERMORE	CA	94550	4196	01	06001	37.67760213	-121.7834094	Alameda County
116797	Fee-for-Service	1366845166	1366845166	1	1	ESHAGHIAN, SHAHROOZ MD INC	6/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	100734	78	Neoplastic Diseases/Oncology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	4504	19	06037	34.07671715	-118.3799413	Los Angeles County
116833	Fee-for-Service	1497765069	1497765069	1	1	EDELSTEIN, HOWARD E MD	4/30/1987	174400000X	NA	Other	026	PHYSICIANS	50259	77	Infectious Disease	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
116876	Fee-for-Service	1942448923	1942448923	1	1	ESCOBAR, ALBERT PT	4/11/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	433 N 4TH STREET	SUITE 216	MONTEBELLO	CA	90640	4309	19	06037	34.01561115	-118.1019888	Los Angeles County
116897	Fee-for-Service	1417957473	1417957473	1	1	ELADH, LP	9/1/1999	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	EAST LA DOCTORS HOSP	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
116902	Fee-for-Service	1114562576	1114562576	1	1	E2 HOSPICE INC	2/18/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5123 W. SUNSET BLVD	SUITE 206	LOS ANGELES	CA	90027	5779	19	06037	34.0981773	-118.3013882	Los Angeles County
116934	Fee-for-Service	1669738290	1669738290	1	1	ENO, JONATHAN-JAMES T MD	12/8/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	126858	20	Orthopedic Surgery	0	In state provider	None	450 6TH AVE	None	SAN FRANCISCO	CA	94118	3010	38	06075	37.7802547	-122.4642049	San Francisco County
116935	Fee-for-Service	1750659306	1750659306	2	1	ENCORE HOSPICE CORP	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	271 W ALAMEDA AVE	None	BURBANK	CA	91502	2559	19	06037	34.16723083	-118.3075057	Los Angeles County
117165	Fee-for-Service	1437103942	1437103942	1	9	EMERGENCY & ACUTE CARE	9/25/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5555 GROSSMONT CENTER	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
117184	Fee-for-Service	1417957473	1417957473	1	1	ELADH, LP	9/1/1999	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	EAST LA DOCTORS HOSP	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
117190	Fee-for-Service	1114562576	1114562576	1	1	E2 HOSPICE INC	2/18/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5123 W. SUNSET BLVD	SUITE 206	LOS ANGELES	CA	90027	5779	19	06037	34.0981773	-118.3013882	Los Angeles County
117208	Fee-for-Service	1437287216	1437287216	1	1	ENG, LYDIA LMFT	10/31/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
117224	Fee-for-Service	1750659306	1750659306	2	1	ENCORE HOSPICE CORP	10/11/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	271 W ALAMEDA AVE	None	BURBANK	CA	91502	2559	19	06037	34.16723083	-118.3075057	Los Angeles County
117232	Fee-for-Service	1619057957	1619057957	1	1	EDWARDS, MORVEN S MD	11/1/2020	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
117239	Fee-for-Service	1376621177	1376621177	1	1	EWING, THOMAS L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	23457	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
117247	Fee-for-Service	1023063914	1023063914	1	1	EL PASO HEALTHCARE SYSTEM	1/1/2000	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LTD	10301 GATEWAY BLVD W	None	EL PASO	TX	79925	7701	00	None	31.75604417	-106.3501944	El Paso County
117364	Fee-for-Service	1295780260	1295780260	1	1	ENGLANOFF, JOSEPH S MD	11/1/1995	207PE0004X	NA	Other	026	PHYSICIANS	77404	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1720 BROOKLYN AVE	None	LOS ANGELES	CA	90033	2462	19	06037	34.040502	-118.191954	Los Angeles County
117395	Fee-for-Service	1477585248	1477585248	1	1	EDELMAN, STEVEN V MD	3/1/1984	207R00000X	NA	Other	026	PHYSICIANS	51578	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
117405	Fee-for-Service	1689663395	1689663395	1	1	ENGSTROM, ROBERT E	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	69965	None	None	0	In state provider	None	5363 BALBOA BLVD	STE 246	ENCINO	CA	91316	2828	19	06037	34.169058	-118.5011265	Los Angeles County
117452	Fee-for-Service	1437103942	1437103942	1	9	EMERGENCY & ACUTE CARE	1/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
117461	Fee-for-Service	1063943629	1063943629	1	1	EVEREST, AMARPREET DO	11/9/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18555	None	None	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
117514	Fee-for-Service	1548249808	1548249808	1	1	ERICKSON, ERINE E MD	4/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55260	01	General Practice	0	In state provider	None	1510 E MAIN ST	STE 104C	SANTA MARIA	CA	93454	4825	42	06083	34.95282793	-120.4100798	Santa Barbara County
117523	Fee-for-Service	1427824796	1427824796	1	1	ERIC WALSH & ASSOCIATES, A M	1/11/2024	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4199 FLAT ROCK DR	147	RIVERSIDE	CA	92505	7115	33	06065	33.90364208	-117.4931242	Riverside County
117536	Fee-for-Service	1023063914	1023063914	1	1	EL PASO HEALTHCARE SYSTEM	1/12/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LTD	10301 GATEWAY BLVD W	None	EL PASO	TX	79925	7701	00	None	31.75604417	-106.3501944	El Paso County
117562	Fee-for-Service	1558658864	1558658864	1	2	EGB HOLDINGS	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4100 LATHAM STREET	SUITE D	RIVERSIDE	CA	92501	1733	33	06065	34.00149667	-117.3721621	Riverside County
117577	Fee-for-Service	1881706521	1881706521	1	1	ELIAZO, MELODIA MD INC	9/30/1991	174400000X	NA	Other	026	PHYSICIANS	42414	08	Family Practice	0	In state provider	None	1045 R ST	None	FRESNO	CA	93721	1312	10	06019	36.74038639	-119.7827527	Fresno County
117587	Fee-for-Service	1285046847	1285046847	1	1	EAST VALLEY COMMUNITY HEALTH	10/1/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	APCC	276 WEST COLLEGE STREET	None	COVINA	CA	91723	1902	19	06037	34.08747441	-117.8941951	Los Angeles County
117616	Fee-for-Service	1831364603	1831364603	1	1	ENG, JESSICA A MD	11/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121501	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
117646	Fee-for-Service	1083637300	1083637300	1	1	EZER, JOSEPH MD AMC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34899	41	Internal Medicine	0	In state provider	None	8500 WILSHIRE BLVD	STE 705	BEVERLY HILLS	CA	90211	3105	19	06037	34.06521956	-118.3764689	Los Angeles County
117877	Fee-for-Service	1285046847	1285046847	1	1	EAST VALLEY COMMUNITY HEALTH	10/1/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	APCC	276 WEST COLLEGE STREET	None	COVINA	CA	91723	1902	19	06037	34.08747441	-117.8941951	Los Angeles County
117884	Fee-for-Service	1619055696	1619055696	1	1	EDMUNDS, KATHLEEN S MD	4/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101151	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7901 WALKER ST	None	LA PALMA	CA	90623	1722	30	06059	33.84755382	-118.0373024	Orange County
117895	Fee-for-Service	1124798624	1124798624	1	1	ESCORT HOME CARE LLC	6/23/2022	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	4781 E GETTSYBURG STREET	STE 106	FRESNO	CA	93726	1814	10	06019	36.80131952	-119.737098	Fresno County
117908	Fee-for-Service	1700668845	1700668845	1	1	EAGLEVIEWPSYCHIATRY	11/14/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	428 J ST	STE 400	SACRAMENTO	CA	95814	2394	34	06067	38.581839	-121.500522	Sacramento County
117918	Fee-for-Service	1881989564	1881989564	1	1	ELITE RX INC	11/21/2011	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5187 N FIRST ST	101	FRESNO	CA	93710	7805	10	06019	36.81193366	-119.7724301	Fresno County
117934	Fee-for-Service	1083637300	1083637300	1	1	EZER, JOSEPH MD AMC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34899	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	8500 WILSHIRE BLVD	STE 705	BEVERLY HILLS	CA	90211	3105	19	06037	34.06521956	-118.3764689	Los Angeles County
118084	Fee-for-Service	1356391130	1356391130	1	1	ENGEL, JOANNE MD	12/1/1985	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	56459	41	Internal Medicine	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
118105	Fee-for-Service	1982852398	1982852398	1	1	EVANS, TECSIA B PHD	1/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
118164	Fee-for-Service	1285046847	1285046847	1	1	EAST VALLEY COMMUNITY HEALTH	12/1/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	APCC	276 WEST COLLEGE STREET	None	COVINA	CA	91723	1902	19	06037	34.08747441	-117.8941951	Los Angeles County
118183	Fee-for-Service	1902587249	1902587249	1	1	EVANGELISTA, SARAH CRNA	3/13/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
118195	Fee-for-Service	1700668845	1700668845	1	1	EAGLEVIEWPSYCHIATRY	11/14/2024	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	428 J ST	STE 400	SACRAMENTO	CA	95814	2394	34	06067	38.581839	-121.500522	Sacramento County
118279	Fee-for-Service	1538247424	1538247424	1	1	ELLSWORTH, GRANT R MD	10/1/1996	207RH0003X	NA	Oncology	026	PHYSICIANS	73084	78	Neoplastic Diseases/Oncology	0	In state provider	AMC	1245 WILSHIRE BLVD	#801	LOS ANGELES	CA	90017	4808	19	06037	34.05362775	-118.2661889	Los Angeles County
118311	Fee-for-Service	1992816631	1992816631	1	1	EBRAHIMI, RAMIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	65016	01	General Practice	0	In state provider	None	100 UCLA MEDICAL PLZ	STE 770	LOS ANGELES	CA	90024	6990	19	06037	34.06544724	-118.4459249	Los Angeles County
118405	Fee-for-Service	1790864213	1790864213	1	1	EAST LOS ANGELES	4/5/2000	193400000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	CARDIOLOGY MEDICAL GROUP	1701 CESAR E CHAVEZ AVE	SUITE 125	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
118433	Fee-for-Service	1225222714	1225222714	1	1	EBENEZER, DAVID S MD	9/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132479	20	Orthopedic Surgery	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
118454	Fee-for-Service	1285046847	1285046847	1	1	EAST VALLEY COMMUNITY HEALTH	4/25/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	APCC	276 WEST COLLEGE STREET	None	COVINA	CA	91723	1902	19	06037	34.08747441	-117.8941951	Los Angeles County
118462	Fee-for-Service	1407443849	1407443849	1	4	ELEONOR'S PLACE INC.	9/23/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	24431 ZANDRA DRIVE	None	MISSION VIEJO	CA	92691	4512	30	06059	33.60734105	-117.6865189	Orange County
118466	Fee-for-Service	1174237135	1174237135	1	1	ERICK MADRIGAL MD, MBA, INC.	12/28/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	FREE STANDING RHC	101 N PALM ST	None	WOODLAKE	CA	93286	1422	54	06107	36.414099	-119.100159	Tulare County
118486	Fee-for-Service	1700668845	1700668845	1	1	EAGLEVIEWPSYCHIATRY	11/14/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	428 J ST	STE 400	SACRAMENTO	CA	95814	2394	34	06067	38.581839	-121.500522	Sacramento County
118501	Fee-for-Service	1518385236	1518385236	1	1	ERIC KIECHLE MD	4/18/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
118565	Fee-for-Service	1538247424	1538247424	1	1	ELLSWORTH, GRANT R MD	10/1/1996	207RH0003X	NA	Oncology	026	PHYSICIANS	73084	68	Hematology	0	In state provider	AMC	1245 WILSHIRE BLVD	#801	LOS ANGELES	CA	90017	4808	19	06037	34.05362775	-118.2661889	Los Angeles County
118596	Fee-for-Service	1558725846	1558725846	1	1	ECHIPARE, LORIGAIL T DO	3/30/2023	207RN0300X	NA	Nephrology	026	PHYSICIANS	19755	None	None	0	In state provider	None	2301 CIRCADIAN WAY	STE A	SANTA ROSA	CA	95407	5457	49	06097	38.421936	-122.7533895	Sonoma County
118598	Fee-for-Service	1992816631	1992816631	1	1	EBRAHIMI, RAMIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	65016	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	100 UCLA MEDICAL PLZ	STE 770	LOS ANGELES	CA	90024	6990	19	06037	34.06544724	-118.4459249	Los Angeles County
118622	Fee-for-Service	1801833678	1801833678	1	1	EARLE, KAREN E MD	8/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70980	01	General Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
118683	Fee-for-Service	1548576705	1548576705	1	1	ELTON, DANIEL CRNA	8/31/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	465 W PUTNUM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
118692	Fee-for-Service	1790864213	1790864213	1	1	EAST LOS ANGELES	4/5/2000	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CARDIOLOGY MEDICAL GROUP	1701 CESAR E CHAVEZ AVE	SUITE 125	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
118740	Fee-for-Service	1518497304	1518497304	1	1	ESKANDER, DANIEL MD	8/29/2023	207L00000X	NA	Other	026	PHYSICIANS	178175	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
118754	Fee-for-Service	1174237135	1174237135	1	1	ERICK MADRIGAL MD, MBA, INC.	12/28/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	FREE STANDING RHC	101 N PALM ST	None	WOODLAKE	CA	93286	1422	54	06107	36.414099	-119.100159	Tulare County
118896	Fee-for-Service	1578727871	1578727871	1	1	ELIAS, MARVIN L MD	11/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120834	41	Internal Medicine	0	In state provider	None	11370 ANDERSON	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
118910	Fee-for-Service	1801833678	1801833678	1	1	EARLE, KAREN E MD	8/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70980	67	Endocrinology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
118923	Fee-for-Service	1760011795	1760011795	1	1	EHRET, ZACHARY MD	8/1/2023	207P00000X	NA	Other	026	PHYSICIANS	184754	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
119030	Fee-for-Service	1790763118	1790763118	1	1	ENGALLA, APRILLE T	11/1/2002	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3460 E LA PALMA AVE	None	ANAHEIM	CA	92806	2020	30	06059	33.85429451	-117.8446551	Orange County
119035	Fee-for-Service	1255812780	1255812780	1	2	ENLOE MEDICAL CENTER	6/30/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1427 MAGNOLIA AVE	None	CHICO	CA	95926	3310	04	06007	39.74063543	-121.8499003	Butte County
119038	Fee-for-Service	1720099328	1720099328	1	4	ENLOE MEDICAL CENTER	2/24/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	181 7TH AVE	None	CHICO	CA	95926	3304	04	06007	39.74456693	-121.8491874	Butte County
119224	Fee-for-Service	1477581262	1477581262	1	1	ELLINGSON, JAMES J MD	3/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76851	30	Radiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
119275	Fee-for-Service	1801168471	1801168471	1	1	EBNESHAHIDI, MOHSEN MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121681	41	Internal Medicine	0	In state provider	None	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.2206967	-118.5342638	Los Angeles County
119276	Fee-for-Service	1255812780	1255812780	1	3	ENLOE MEDICAL CENTER	2/26/2024	207V00000X	NA	Obstetrics & Gynecology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1427 MAGNOLIA AVE	None	CHICO	CA	95926	3226	04	06007	39.74063543	-121.8499003	Butte County
119304	Fee-for-Service	1346769965	1346769965	1	1	ELLIOTT-MENDOZA, MARIA	5/11/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ARLENE C	901 NEVIN AVENUE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
119324	Fee-for-Service	1720099328	1720099328	1	4	ENLOE MEDICAL CENTER	2/24/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	181 7TH AVE	None	CHICO	CA	95926	3304	04	06007	39.74456693	-121.8491874	Butte County
119350	Fee-for-Service	1346427861	1346427861	1	1	EL RAMAH, MOHSEN M MD	3/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134718	45	Nephrology (Renal-Kidney)	0	In state provider	None	608 E ORANGEBURG AVE	None	MODESTO	CA	95350	5513	50	06099	37.66359354	-120.985569	Stanislaus County
119389	Fee-for-Service	1295359610	1295359610	1	1	EVANS, NIKI L	6/18/2021	172A00000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	L TRANSPORTATION	1168 ORO DAM BLVD W	None	OROVILLE	CA	95965	4346	04	06007	39.49807952	-121.5913365	Butte County
119405	Fee-for-Service	1578014494	1578014494	1	1	ELEVADO, GAYLE NP	11/27/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
119410	Fee-for-Service	1134226020	1134226020	1	1	EISENBERG, SUSAN J MD	5/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	65056	None	None	0	In state provider	None	110 LA CASA VIA	STE 200	WALNUT CREEK	CA	94598	3017	07	06013	37.91241987	-122.0425768	Contra Costa County
119459	Fee-for-Service	1023481496	1023481496	1	1	EYECHECK OPTOMETRY INC	3/3/2016	193400000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7743 WEST LN	STE A2	STOCKTON	CA	95210	3350	39	06077	38.01951553	-121.2949841	San Joaquin County
119536	Fee-for-Service	1740064161	1740064161	1	1	ELHAJJAOUI, NADEEN OT	6/25/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9900 INDIANA AVE	8	RIVERSIDE	CA	92503	5498	33	06065	33.90939848	-117.4496843	Riverside County
119563	Fee-for-Service	1255812780	1255812780	1	3	ENLOE MEDICAL CENTER	5/5/2022	207V00000X	NA	Obstetrics & Gynecology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1427 MAGNOLIA AVE	None	CHICO	CA	95926	3226	04	06007	39.74063543	-121.8499003	Butte County
119572	Fee-for-Service	1013048412	1013048412	1	1	EDMONDS, ERIC W MD	5/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86165	20	Orthopedic Surgery	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
119618	Fee-for-Service	1477614170	1477614170	1	1	EDWARDS, CHERYL Y MD	3/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1505 SOQUEL DR	STE 5A	SANTA CRUZ	CA	95065	1716	44	06087	36.98803429	-121.9848045	Santa Cruz County
119654	Fee-for-Service	1346218278	1346218278	1	1	EFFRON, MARC K MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40964	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	351 SANTA FE DR	STE 100	ENCINITAS	CA	92024	5137	37	06073	33.03617853	-117.2843775	San Diego County
119664	Fee-for-Service	1467530634	1467530634	1	1	EVERGREEN MEDICAL SUPPLY	10/2/2001	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	9442 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92844	1453	30	06059	33.77387251	-117.9675315	Orange County
119756	Fee-for-Service	1437103942	1437103942	1	2	EMERGENCY & ACUTE CARE	2/6/1992	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
119826	Fee-for-Service	1265655237	1265655237	1	1	ESPENSHADE, BRUCE M MD	6/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139297	01	General Practice	0	In state provider	None	ONE MEDICAL PLAZA DRIVE	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
119850	Fee-for-Service	1255812780	1255812780	1	3	ENLOE MEDICAL CENTER	3/3/2021	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	None	1427 MAGNOLIA AVE	None	CHICO	CA	95926	3226	04	06007	39.74063543	-121.8499003	Butte County
119912	Fee-for-Service	1083103725	1083103725	1	1	ESSAPOOR, SHAYAN H DPM	12/11/2020	213EP1101X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3801 MIRANDA AVE	None	PALO ALTO	CA	94304	1207	43	06085	37.404162	-122.1395085	Santa Clara County
119938	Fee-for-Service	1689618746	1689618746	1	1	EDWARDS, DIANA M MD	1/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88405	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
119944	Fee-for-Service	1346218278	1346218278	1	1	EFFRON, MARC K MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40964	66	Emergency Medicine (Urgent Care)	0	In state provider	None	351 SANTA FE DR	STE 100	ENCINITAS	CA	92024	5137	37	06073	33.03617853	-117.2843775	San Diego County
119951	Fee-for-Service	1902851918	1902851918	1	1	ETEMADI, ALIREZA MD	9/25/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67093	01	General Practice	0	In state provider	None	23401 EL TORO RD	STE 100	LAKE FOREST	CA	92630	6923	30	06059	33.62343549	-117.6971029	Orange County
120041	Fee-for-Service	1437103942	1437103942	1	2	EMERGENCY & ACUTE CARE	1/27/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
120080	Fee-for-Service	1568845261	1568845261	1	1	ENCINITAS HOSPICE CARE INC	8/19/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	410 S SANTA FE AVE	SUITE 202	VISTA	CA	92084	6101	37	06073	33.19839241	-117.240681	San Diego County
120083	Fee-for-Service	1659443067	1659443067	1	1	ELITE, ANTHONY E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	33418	36	Psychiatry	0	In state provider	None	70 ST GERMAIN AVENUE	None	SAN FRANCISCO	CA	94114	2130	38	06075	37.75755781	-122.4495146	San Francisco County
120143	Fee-for-Service	1215472048	1215472048	1	1	EJW INC	4/3/2017	193400000X	NA	Other	026	PHYSICIANS	97838	01	General Practice	0	In state provider	None	18331 GRIDLEY RD	SUITE A	CERRITOS	CA	90703	5438	19	06037	33.86506541	-118.0911068	Los Angeles County
120169	Fee-for-Service	1316003635	1316003635	1	1	EDWARD L RICEBERG MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	22329	41	Internal Medicine	0	In state provider	None	9400 BRIGHTON WAY	STE 410	BEVERLY HILLS	CA	90210	4711	19	06037	34.07043476	-118.4011952	Los Angeles County
120186	Fee-for-Service	1447446752	1447446752	1	1	EHRLICH, JASON S MD	8/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92211	18	Ophthalmology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
120238	Fee-for-Service	1902851918	1902851918	1	1	ETEMADI, ALIREZA MD	9/25/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67093	08	Family Practice	0	In state provider	None	23401 EL TORO RD	STE 100	LAKE FOREST	CA	92630	6923	30	06059	33.62343549	-117.6971029	Orange County
120261	Fee-for-Service	1144553769	1144553769	1	1	ERICKSON, JON A MD INC	5/14/2009	174400000X	NA	Other	026	PHYSICIANS	56879	07	Dermatology	0	In state provider	None	3257 PROFESSIONAL DR	STE B	AUBURN	CA	95602	2460	31	06061	38.943405	-121.1008195	Placer County
120365	Fee-for-Service	1568845261	1568845261	1	1	ENCINITAS HOSPICE CARE INC	8/19/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	410 S SANTA FE AVE	SUITE 202	VISTA	CA	92084	6101	37	06073	33.19839241	-117.240681	San Diego County
120374	Fee-for-Service	1821655481	1821655481	1	1	ESCOBAR, MARCOS O MD	9/27/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178164	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
120502	Fee-for-Service	1518657535	1518657535	1	1	EL MIRADOR MEDICAL PLAZA PHA	12/26/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2658	33	06065	33.94354395	-117.394926	Riverside County
120510	Fee-for-Service	1033614706	1033614706	1	1	ELLISON MEDICAL GROUP VEIN T	5/6/2021	207LP2900X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	5330 CARROLL CANYON RD	140	SAN DIEGO	CA	92121	3758	37	06073	32.8917216	-117.1927751	San Diego County
120523	Fee-for-Service	1043375561	1043375561	1	1	EAST BAY NEWBORN	9/27/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	SPECIALISTS, INC	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
120526	Fee-for-Service	1629678420	1629678420	1	1	EASE OF MIND HOSPICE CARE	12/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	19634 VENTURA BLVD	STE 220	TARZANA	CA	91356	7139	19	06037	34.17264197	-118.5613482	Los Angeles County
120608	Fee-for-Service	1205975513	1205975513	1	1	ESKWITT, DONNA L	1/16/2019	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
120723	Fee-for-Service	1023039948	1023039948	1	1	ENDICOTT, THYRA J MD	6/1/1998	2085R0001X	NA	Other	026	PHYSICIANS	61316	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 MEDICAL PLAZA	STE B265	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
120800	Fee-for-Service	1851979058	1851979058	1	1	ESTRADA, BESS MICHELLE B MD	5/17/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21141	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
120812	Fee-for-Service	1043375561	1043375561	1	1	EAST BAY NEWBORN	9/27/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	SPECIALISTS, INC	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
120814	Fee-for-Service	1629678420	1629678420	1	1	EASE OF MIND HOSPICE CARE	12/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	19634 VENTURA BLVD	STE 220	TARZANA	CA	91356	7139	19	06037	34.17264197	-118.5613482	Los Angeles County
120858	Fee-for-Service	1518955996	1518955996	1	1	EMERSON, SCOTT S OD	9/22/1995	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1030 W I ST	None	LOS BANOS	CA	93635	3954	24	06047	37.06178287	-120.8627266	Merced County
120871	Fee-for-Service	1205379559	1205379559	1	1	ELZBY, LAURA A	6/19/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	12062 VALLEY VIEW STREET	137	GARDEN GROVE	CA	92845	1741	30	06059	33.78720885	-118.028413	Orange County
120910	Fee-for-Service	1164991683	1164991683	1	1	ELIZABETH RAMIREZ CHILD & FA	11/18/2018	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MILY COUNSELING INC.	9 W GABILAN STREET	SUITE 18	SALINAS	CA	93901	2723	27	06053	36.67556101	-121.6556155	Monterey County
120942	Fee-for-Service	1730115239	1730115239	1	1	ESCALANTE, PATRICIO MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67280	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1355 SAN PABLO ST	None	LOS ANGELES	CA	90033	1035	19	06037	34.06080447	-118.203734	Los Angeles County
120956	Fee-for-Service	1417901091	1417901091	1	14	ENLOE MEDICAL CENTER-	10/13/2023	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1555 SPRINGFIELD DRIVE	None	CHICO	CA	95928	6398	04	06007	39.73089101	-121.8089267	Butte County
120998	Fee-for-Service	1942272075	1942272075	1	1	EL-BEBLAWI, IHAB E MD	2/1/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	48946	01	General Practice	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
121019	Fee-for-Service	1023039948	1023039948	1	1	ENDICOTT, THYRA J MD	6/1/1998	2085R0001X	NA	Other	026	PHYSICIANS	61316	30	Radiology	0	In state provider	None	200 MEDICAL PLAZA	STE B265	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
121081	Fee-for-Service	1437191996	1437191996	1	1	ERLICH, VICTOR M MD	7/1/2017	2084N0400X	NA	Neurology	026	PHYSICIANS	65668	13	Neurology (M.D. only)	0	In state provider	None	515 FAIRCHILD CT	None	WOODLAND	CA	95695	5164	57	06113	38.66569664	-121.7925341	Yolo County
121129	Fee-for-Service	1609955749	1609955749	1	1	EBERHARD, LAURA W MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	71839	41	Internal Medicine	0	In state provider	None	2450 ASHBY AVE	RM 1002	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
121134	Fee-for-Service	1003889247	1003889247	1	1	ESTWICK, BRIAN K MD INC	11/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	41775	18	Ophthalmology	0	In state provider	None	12524 W WASHINGTON BLVD	None	LOS ANGELES	CA	90066	5506	19	06037	33.99678514	-118.4309642	Los Angeles County
121147	Fee-for-Service	1295141562	1295141562	1	1	EL DORADO HILLS VISION	12/11/2014	193400000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	3955 PARK DR	SUITE 1	EL DORADO HILLS	CA	95762	4569	09	06017	38.65493069	-121.0697725	El Dorado County
121316	Fee-for-Service	1104879089	1104879089	1	1	EDELSOHN, DAVID A MD	9/28/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	37480	05	Anesthesiology	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
121422	Fee-for-Service	1003889247	1003889247	1	1	ESTWICK, BRIAN K MD INC	11/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	41775	01	General Practice	0	In state provider	None	12524 W WASHINGTON BLVD	None	LOS ANGELES	CA	90066	5506	19	06037	33.99678514	-118.4309642	Los Angeles County
121479	Fee-for-Service	1316209158	1316209158	1	1	ESTREMERA, HEIDI D	1/23/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	12062 VALLEY VIEW ST	STE 137	GARDEN GROVE	CA	92845	1741	30	06059	33.78720885	-118.028413	Orange County
121480	Fee-for-Service	1568021988	1568021988	1	1	EMOJONG, JACQUELINE N NP	9/20/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
121582	Fee-for-Service	1881678217	1881678217	1	1	EXCELLENT CARE HOME HLTH	2/9/2015	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES, INC	9037 ARROW RTE	STE 140	RANCHO CUCAMONGA	CA	91730	4448	36	06071	34.09930232	-117.6082094	San Bernardino County
121780	Fee-for-Service	1588124143	1588124143	1	1	EDARA, DHARMAKARUNA S MD	9/29/2022	207R00000X	NA	Other	026	PHYSICIANS	178882	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
121784	Fee-for-Service	1649265968	1649265968	1	1	EIDELWEIN, ALEXANDRA P MD	4/2/2018	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	72380	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
121804	Fee-for-Service	1245398882	1245398882	2	1	ENG AND CHANG PARTNERSHIP	10/7/2013	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	625 S FAIR OAKS AVE	SUITE 235	PASADENA	CA	91105	2664	19	06037	34.134894	-118.1504155	Los Angeles County
121840	Fee-for-Service	1649519380	1649519380	1	1	ESCOTO, KARLA P LMFT	8/21/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	RAPIST	5150 E. PACIFIC COAST HW	200	LONG BEACH	CA	90804	3312	19	06037	33.7831762	-118.1333125	Los Angeles County
121853	Fee-for-Service	1265466213	1265466213	1	1	EDMUNDS, KENNETH O MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
121880	Fee-for-Service	1588126866	1588126866	1	1	EMAMIAN, ANAHITA MD	6/29/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	178966	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
121896	Fee-for-Service	1780970079	1780970079	1	1	ETUDO, OGECHUKWU MD	1/17/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	154546	08	Family Practice	0	In state provider	None	2505 W HAMMER LN	None	STOCKTON	CA	95209	2839	39	06077	38.02139448	-121.347738	San Joaquin County
121911	Fee-for-Service	1437103942	1437103942	1	3	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	1000 NUT TREE RD	None	VACAVILLE	CA	95687	4100	48	06095	38.35581953	-121.9530257	Solano County
121924	Fee-for-Service	1891266193	1891266193	1	1	EVILLA, ZITA RCP	1/22/2019	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
121974	Fee-for-Service	1124608872	1124608872	1	1	ERVIL, CONCIANA OT	1/9/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 W HOSPITALITY LN	103	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
122094	Fee-for-Service	1447344270	1447344270	1	1	EDES, ELLIOTT MD	1/31/1987	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	59464	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INLAND EMPIRE FERTILITY	69265 RAMON RD	STE B1	CATHEDRAL CITY	CA	92234	3391	33	06065	33.81584651	-116.4560805	Riverside County
122124	Fee-for-Service	1205881331	1205881331	1	1	ERMER,DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1621 MINNESOTA AVE	None	SIOUX FALLS	SD	57105	0000	00	None	43.530615	-96.731694	Minnehaha County
122183	Fee-for-Service	1780970079	1780970079	1	1	ETUDO, OGECHUKWU MD	1/17/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	154546	70	Clinic (mixed specialty)	0	In state provider	None	2505 W HAMMER LN	None	STOCKTON	CA	95209	2839	39	06077	38.02139448	-121.347738	San Joaquin County
122200	Fee-for-Service	1437103942	1437103942	1	3	EMERGENCY & ACUTE CARE	10/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	1000 NUT TREE RD	None	VACAVILLE	CA	95687	4100	48	06095	38.35581953	-121.9530257	Solano County
122230	Fee-for-Service	1215200258	1215200258	1	1	ESQUIBEL, MARISSA S LMFT	2/20/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	250 W FIRST ST	SUITE 346	CLAREMONT	CA	91711	4742	19	06037	34.09450024	-117.7183344	Los Angeles County
122234	Fee-for-Service	1023157724	1023157724	1	1	ESPINOZA, ANGELICA B MD	6/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73920	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
122548	Fee-for-Service	1356910053	1356910053	1	2	EL CAMINO ANESTHESIA	8/19/2021	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
122678	Fee-for-Service	1972516714	1972516714	1	1	EDELSTEIN, MARK D MD	11/24/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	41340	-	NOT APPLICABLE	0	In state provider	None	232 EAST GISH ROAD	None	SAN JOSE	CA	95112	4706	43	06085	37.36411044	-121.9052075	Santa Clara County
122682	Fee-for-Service	1538395983	1538395983	1	1	ELLISON, MILANA MD	7/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118011	08	Family Practice	0	In state provider	None	525 WEST ACACIA STREET	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
122748	Fee-for-Service	1417668062	1417668062	1	1	EL DORADO COUNTY COMMUNITY H	6/29/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	, PLACERVILLE	4212 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6269	09	06017	38.706228	-120.834891	El Dorado County
122762	Fee-for-Service	1447308499	1447308499	1	1	ERMSHAR, STANLEY R MD	10/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	36028	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
122777	Fee-for-Service	1801672209	1801672209	1	1	ELDERCARE HOMES, INC.	10/24/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7754 COLDWATER CANYON AV	None	NORTH HOLLYWOOD	CA	91605	2010	19	06037	34.211781	-118.414362	Los Angeles County
122802	Fee-for-Service	1093133506	1093133506	1	1	EDMONDS, SHEENA M DO	3/12/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	14393	None	None	0	In state provider	None	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	54	06107	36.332757	-119.288682	Tulare County
122822	Fee-for-Service	1659429967	1659429967	1	1	EAST WHITTIER CITY ESD	3/11/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	14535 WHITTIER BLVD	None	WHITTIER	CA	90605	2130	19	06037	33.9531254	-118.0149338	Los Angeles County
122948	Fee-for-Service	1316936990	1316936990	1	1	EL PASO COUNTY HOSPITAL DIST	6/4/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4815 ALAMEDA AVE	None	EL PASO	TX	79905	2705	00	None	31.7712078	-106.4360134	El Paso County
122969	Fee-for-Service	1538395983	1538395983	1	1	ELLISON, MILANA MD	7/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118011	01	General Practice	0	In state provider	None	525 WEST ACACIA STREET	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
123002	Fee-for-Service	1891292801	1891292801	1	1	EBADI, FARHA N DO	9/27/2024	207R00000X	NA	Other	026	PHYSICIANS	20673	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
123015	Fee-for-Service	1689793911	1689793911	1	1	EL PROYECTO DEL BARRIO, INC	2/11/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	9140 VAN NUYS BLVD	SUITE 211	PANORAMA CITY	CA	91402	6764	19	06037	34.236603	-118.4502215	Los Angeles County
123068	Fee-for-Service	1083200943	1083200943	1	1	EDEN HOSPICE INC	6/14/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	25 WHEELER AVE	STE M	ARCADIA	CA	91006	3208	19	06037	34.14120547	-118.0301953	Los Angeles County
123070	Fee-for-Service	1003426479	1003426479	1	1	EGORYAN, GOAR MD	5/8/2023	207R00000X	NA	Other	026	PHYSICIANS	184640	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
123161	Fee-for-Service	1235189093	1235189093	1	1	EMLEIN, GEORG MD	10/30/1990	207R00000X	NA	Other	026	PHYSICIANS	61360	41	Internal Medicine	0	In state provider	None	500 UNIVERSITY AVE	STE 530	SACRAMENTO	CA	95825	6504	34	06067	38.568402	-121.418019	Sacramento County
123192	Fee-for-Service	1699894808	1699894808	1	1	EVANS, SCOTT R MD	7/28/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	100151	08	Family Practice	0	In state provider	None	6699 ALVARADO RD	STE 2100	SAN DIEGO	CA	92120	5238	37	06073	32.77665383	-117.0540279	San Diego County
123238	Fee-for-Service	1316936990	1316936990	1	1	EL PASO COUNTY HOSPITAL DIST	6/4/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4815 ALAMEDA AVE	None	EL PASO	TX	79905	2705	00	None	31.7712078	-106.4360134	El Paso County
123355	Fee-for-Service	1083200943	1083200943	1	1	EDEN HOSPICE INC	6/14/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	25 WHEELER AVE	STE M	ARCADIA	CA	91006	3208	19	06037	34.14120547	-118.0301953	Los Angeles County
123475	Fee-for-Service	1821090150	1821090150	1	1	EMERY, SHAWN C MD	10/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	22	Pathology (M.D. only)	1	Border provider	None	1350 STARDUST ST	STE D	RENO	NV	89503	4264	00	None	39.52858204	-119.8347915	Washoe County
123506	Fee-for-Service	1720099328	1720099328	1	5	ENLOE MEDICAL CENTER	3/20/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1430 ESPLANADE	6	CHICO	CA	95926	3366	04	06007	39.74156774	-121.8480966	Butte County
123520	Fee-for-Service	1982651071	1982651071	1	1	ENSIGN,MARGARET MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 HILLAND AVE	None	BURLEY	ID	83318	0000	00	None	42.53489313	-113.7833899	Cassia County
123596	Fee-for-Service	1477921443	1477921443	1	2	ELIZABETH SARKIS	5/21/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1567 W MAGILL AVE	None	FRESNO	CA	93711	1434	10	06019	36.83477268	-119.8210828	Fresno County
123656	Fee-for-Service	1003249525	1003249525	1	1	EHLERS, JESSICA K LCSW	11/4/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	327 E REDWOOD AVE	C	FORT BRAGG	CA	95437	3550	23	06045	39.4442763	-123.80293	Mendocino County
123662	Fee-for-Service	1417122128	1417122128	1	1	ELLISON-COLE, L LOUANNE	6/2/2016	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1421 CHANTICLEER AVE	None	SANTA CRUZ	CA	95062	3174	44	06087	36.97249114	-121.9808712	Santa Cruz County
123670	Fee-for-Service	1831528363	1831528363	1	1	ENG, ANDERSON D DO	2/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13400	01	General Practice	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
123740	Fee-for-Service	1801059894	1801059894	1	1	ERCOLANI, MATTHEW C MD	9/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155626	34	Urology and Urological Surgery	0	In state provider	None	2767 OLIVE HIGHWAY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
123793	Fee-for-Service	1720099328	1720099328	1	5	ENLOE MEDICAL CENTER	3/20/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1430 ESPLANADE	6	CHICO	CA	95926	3366	04	06007	39.74156774	-121.8480966	Butte County
123822	Fee-for-Service	1942890660	1942890660	1	1	EZEOFOR, IJEOMA N PHD	5/30/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
123919	Fee-for-Service	1033875109	1033875109	1	1	ESSENBERG, SAMANTHA H	8/26/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8325 BRIMHALL RD	STE 100	BAKERSFIELD	CA	93312	2244	15	06029	35.36875951	-119.0959206	Kern County
123948	Fee-for-Service	1730243940	1730243940	1	1	ESPIL, BRET A	2/26/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
123956	Fee-for-Service	1275791436	1275791436	1	1	EHRENBURG, MENASHE DO	4/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11076	15	Obstetrics (D.O. only)	0	In state provider	None	200 S WELLS RD	SUITE 100	VENTURA	CA	93004	1302	56	06111	34.29321532	-119.1597424	Ventura County
123979	Fee-for-Service	1619157831	1619157831	1	1	ESTERS, LATAVIA PA-C	6/10/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	19444	-	NOT APPLICABLE	0	In state provider	None	135 CARMEN LANE	None	SANTA MARIA	CA	93458	7729	42	06083	34.92484952	-120.4374645	Santa Barbara County
123992	Fee-for-Service	1104302678	1104302678	1	1	ESHTEHARDI, SIMIN LMFT	8/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2115 BEVERLY BLVD	None	LOS ANGELES	CA	90057	2203	19	06037	34.06694463	-118.2708859	Los Angeles County
124013	Fee-for-Service	1184923336	1184923336	1	1	ENGORN, KRISTIN M MD	10/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146465	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
124063	Fee-for-Service	1457506305	1457506305	1	1	ENNIS, PATRICK S LCSW	12/15/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
124090	Fee-for-Service	1477551489	1477551489	1	1	ELKHART GENERAL HOSPITAL INC	3/22/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	600 EAST BLVD	None	ELKHART	IN	46514	2499	00	None	41.67924431	-85.99202423	Elkhart County
124193	Fee-for-Service	1366156549	1366156549	1	1	EYECONIC EYE GROUP	10/2/2023	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	20072 SW BIRCH ST	SUITE 210	NEWPORT BEACH	CA	92660	0794	30	06059	33.65980961	-117.874611	Orange County
124240	Fee-for-Service	1295733434	1295733434	1	1	EUGENIO M ARMENDARIZ, MD	5/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3280 JOE BATTLE BLVD	None	EL PASO	TX	79938	2622	00	None	31.790412	-106.2643545	El Paso County
124246	Fee-for-Service	1275791436	1275791436	1	1	EHRENBURG, MENASHE DO	4/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11076	09	Gynecology (D.O. only)	0	In state provider	None	200 S WELLS RD	SUITE 100	VENTURA	CA	93004	1302	56	06111	34.29321532	-119.1597424	Ventura County
124431	Fee-for-Service	1780917989	1780917989	1	1	EL DEEB, MOKHTAR M MD	8/20/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	156019	15	Obstetrics (D.O. only)	0	In state provider	None	2210 E ILLINOIS AVE	SUITE 408	FRESNO	CA	93701	2168	10	06019	36.74500687	-119.7846885	Fresno County
124472	Fee-for-Service	1659442622	1659442622	1	1	EVANS, CINDY J MD	12/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	64026	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
124475	Fee-for-Service	1841369295	1841369295	1	1	ENGDAHL,ANDERS MD	6/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	310 SUNNYVIEW LANE	None	KALISPELL	MT	59901	3129	00	None	48.214773	-114.3236925	Flathead County
124503	Fee-for-Service	1245597517	1245597517	1	1	EASY LIFT TRANSPORTATION INC	7/20/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1522 COOK PL	333	SANTA BARBARA	CA	93117	3124	42	06083	34.43021569	-119.8448098	Santa Barbara County
124516	Fee-for-Service	1396753281	1396753281	1	2	ENLOE MEDICAL CENTER	12/19/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	560 COHASSET ROAD	None	CHICO	CA	95926	2212	04	06007	39.7519137	-121.8477606	Butte County
124518	Fee-for-Service	1487686069	1487686069	1	1	EILBERT, MICHAEL J MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64951	41	Internal Medicine	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
124543	Fee-for-Service	1669541041	1669541041	1	1	ENRIQUEZ, LINDA B MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29487	22	Pathology (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
124575	Fee-for-Service	1336776343	1336776343	1	1	EZIKE, OGECHUKWU F MD	11/8/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8700 BEVERLY BLVD	# 3611	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
124595	Fee-for-Service	1417901091	1417901091	1	3	ENLOE MEDICAL CENTER-	12/1/1991	282N00000X	NEMT Provider	Hospitals	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
124639	Fee-for-Service	1346389483	1346389483	1	1	EDWARDS, KELLY R PT	2/16/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1150 MORTON	B	PORTERVILLE	CA	93257	1940	54	06107	36.07332205	-119.0428201	Tulare County
124694	Fee-for-Service	1700918430	1700918430	1	1	EVANS, JOANNE F LMFT	5/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
124762	Fee-for-Service	1285622258	1285622258	1	1	EBENHOECH, ADELHEID T	6/4/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	66115	None	None	0	In state provider	None	17615 MORO RD	None	SALINAS	CA	93907	8541	27	06053	36.80320219	-121.663727	Monterey County
124857	Fee-for-Service	1548725310	1548725310	1	1	EDWARDS, NAKIA A CNP	6/3/2022	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1524 MCHENRY AVE	STE 135	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
124866	Fee-for-Service	1992269583	1992269583	1	1	EXPATIATE COMMUNICATIONS INC	7/1/2018	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	155 N LAKE AVE	STE 800	PASADENA	CA	91101	1857	19	06037	34.148538	-118.132407	Los Angeles County
124907	Fee-for-Service	1356910053	1356910053	1	1	EL CAMINO ANESTHESIA	8/19/2021	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	2500 GRANT ROAD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
124959	Fee-for-Service	1396814893	1396814893	1	1	EL DORADO COMM SVCS CTR	8/8/1997	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	VAN NUYS MED & MNTL HLTH	6265 SEPULVEDA BLVD	STE 9	VAN NUYS	CA	91411	1126	19	06037	34.18438377	-118.4662174	Los Angeles County
124977	Fee-for-Service	1770536120	1770536120	1	1	EL PASO HEALTHCARE SYSTEM	8/1/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LTD	1801 N OREGON ST	None	EL PASO	TX	79902	3524	00	None	31.77022741	-106.4985745	El Paso County
125017	Fee-for-Service	1659494664	1659494664	1	1	ERDELAC, SANDRA L LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
125092	Fee-for-Service	1164226395	1164226395	1	1	EHRENFRIED, PETER LMFT	4/10/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
125097	Fee-for-Service	1609965797	1609965797	1	1	EBAUGH, MICHAEL J MD	5/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	65845	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	254 N KESSING ST	None	PORTERVILLE	CA	93257	3424	54	06107	36.07048847	-119.025139	Tulare County
125099	Fee-for-Service	1417199340	1417199340	1	1	EL CAMINO HOSP	12/31/1992	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4378	43	06085	37.36893518	-122.0779448	Santa Clara County
125135	Fee-for-Service	1811997828	1811997828	1	1	ENG, KRISTINE M	11/1/1998	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3980 SAN PABLO DAM RD	STE 101	EL SOBRANTE	CA	94803	2816	07	06013	37.96546353	-122.3118407	Contra Costa County
125182	Fee-for-Service	1518044809	1518044809	1	1	EDRALIN, GERALD G MD	9/30/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	40545	40	Pediatrics	0	In state provider	None	1037 W AVENUE N	STE 202	PALMDALE	CA	93551	2002	19	06037	34.63124053	-118.149021	Los Angeles County
125265	Fee-for-Service	1770536120	1770536120	1	1	EL PASO HEALTHCARE SYSTEM	8/1/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LTD	1801 N OREGON ST	None	EL PASO	TX	79902	3524	00	None	31.77022741	-106.4985745	El Paso County
125311	Fee-for-Service	1083103725	1083103725	1	2	ESSAPOOR, SHAYAN H DPM	9/1/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2637 SHADELANDS DR	None	WALNUT CREEK	CA	94598	2512	07	06013	37.925712	-122.021856	Contra Costa County
125364	Fee-for-Service	1902132376	1902132376	1	1	EITHUN, BENJAMIN L NP	12/26/2024	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
125386	Fee-for-Service	1417199340	1417199340	1	1	EL CAMINO HOSP	12/31/1992	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4378	43	06085	37.36893518	-122.0779448	Santa Clara County
125618	Fee-for-Service	1952023103	1952023103	1	1	ELYSIAN PSYCHOLOGICAL SERVIC	8/1/2024	193400000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ES	11240 MAGNOLIA BLVD	# 204	NORTH HOLLYWOOD	CA	91601	3975	19	06037	34.16490451	-118.375965	Los Angeles County
125623	Fee-for-Service	1609312149	1609312149	1	1	ESPINOZA, CHOLENE D MD	8/9/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	151099	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8631 W THIRD STREET	None	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
125666	Fee-for-Service	1326303736	1326303736	1	1	ELGUINDY, YEHIA M MD	5/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	141563	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
125710	Fee-for-Service	1104821537	1104821537	1	2	EVERGREEN HOME HEALTH	6/1/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	17215 STUDEBAKER RD	STE 270	CERRITOS	CA	90703	2522	19	06037	33.874686	-118.0998595	Los Angeles County
125720	Fee-for-Service	1417901091	1417901091	1	8	ENLOE MEDICAL CENTER-	10/5/2011	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	RADIOLOGY	251 COHASSET ROAD	SUITE 150	CHICO	CA	95926	2275	04	06007	39.75090044	-121.8522609	Butte County
125730	Fee-for-Service	1942799283	1942799283	1	1	EISNER, DAVID L MD	10/3/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	164456	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
125759	Fee-for-Service	1396113726	1396113726	1	1	ELYSIUM HOSPICE CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	709 BREA CANYON	STE 1	WALNUT	CA	91789	3041	19	06037	34.0052163	-117.8466001	Los Angeles County
125784	Fee-for-Service	1124344858	1124344858	1	1	ERICA MARTIN-MACINTOSH M.D.	7/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 BROADWAY N	None	FARGO	ND	58102	3641	00	None	46.885068	-96.7872375	Cass County
125786	Fee-for-Service	1154839264	1154839264	1	2	ELITE CBAS CENTER INC	5/18/2020	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	SERVICES CENTER	12825 VANOWEN ST	None	NORTH HOLLYWOOD	CA	91605	5219	19	06037	34.19397047	-118.412802	Los Angeles County
125811	Fee-for-Service	1255812780	1255812780	1	1	ENLOE MEDICAL CENTER	6/30/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1425 MAGNOLIA AVE	None	CHICO	CA	95926	3310	04	06007	39.74063551	-121.8499048	Butte County
125821	Fee-for-Service	1619280294	1619280294	1	1	EDWARDS, JEREMY K OD	12/28/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1160 LIVE OAK BLVD	None	YUBA CITY	CA	95991	3407	51	06101	39.14528537	-121.6208248	Sutter County
125906	Fee-for-Service	1407443849	1407443849	1	3	ELEONOR'S PLACE INC.	9/23/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	26711 VALPARISO DRIVE	None	MISSION VIEJO	CA	92691	3428	30	06059	33.61618953	-117.6646447	Orange County
126052	Fee-for-Service	1396113726	1396113726	1	1	ELYSIUM HOSPICE CARE INC	7/24/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	709 BREA CANYON	STE 1	WALNUT	CA	91789	3041	19	06037	34.0052163	-117.8466001	Los Angeles County
126078	Fee-for-Service	1093353195	1093353195	1	1	EAST SACRAMENTO PEDIATRIC ME	5/29/2020	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	DICAL GROUP INC	5030 J STREET	301	SACRAMENTO	CA	95819	3800	34	06067	38.566359	-121.442094	Sacramento County
126089	Fee-for-Service	1194188193	1194188193	1	1	ELIZA J FOLEY	8/6/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	601 CHILDRENS LN	None	NORFOLK	VA	23507	1910	00	None	36.8619664	-76.30130371	Norfolk city
126103	Fee-for-Service	1477921443	1477921443	1	1	ELIZABETH SARKIS	5/21/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	787 E MINARETS AVE	None	FRESNO	CA	93720	3309	10	06019	36.84250648	-119.770614	Fresno County
126136	Fee-for-Service	1952798373	1952798373	1	1	EMBRACE ORTHOTICS LLC	5/7/2015	335E00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	2710 TELEGRAPH AVE	SUITE 230	OAKLAND	CA	94612	1771	01	06001	37.81647593	-122.2677965	Alameda County
126481	Fee-for-Service	1841252178	1841252178	1	1	EICHORST, DELPHINE M MD	8/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	501 EAST HAMPDEN AVENUE	None	ENGLEWOOD	CO	80013	2702	00	None	39.6531952	-104.9810967	Arapahoe County
126624	Fee-for-Service	1801514468	1801514468	1	1	ESTELLE, KIRA PT	10/8/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	27699 JEFFERSON AVENUE	SUITE 202	TEMECULA	CA	92590	0000	33	06065	33.51449799	-117.1593524	Riverside County
126664	Fee-for-Service	1417988668	1417988668	1	1	EAST COUNTY URGENT CARE	7/22/1987	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	INDUSTRIAL & MED CLINIC	1625 E MAIN ST	STE 100	EL CAJON	CA	92021	5240	37	06073	32.80969963	-116.9203429	San Diego County
126691	Fee-for-Service	1891582417	1891582417	1	1	ERAZO, LIGIA	5/2/2025	No Taxonomy Provided	NA	None	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
126721	Fee-for-Service	1003064353	1003064353	1	1	ERIKSEN, NIKLAUS V MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119080	04	Otology, Laryngology, Rhinology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
126736	Fee-for-Service	1457915639	1457915639	1	1	ECHIPARE, LORNA JOY DO	12/27/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19595	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
126765	Fee-for-Service	1790777878	1790777878	1	1	ENGEL, RICHARD C MD	9/20/2007	207L00000X	NA	Other	026	PHYSICIANS	50383	05	Anesthesiology	0	In state provider	ANESTH CONS OF ESCONDIDO	332 S JUNIPER ST	STE 108	ESCONDIDO	CA	92025	4941	37	06073	33.12066536	-117.0770413	San Diego County
126863	Fee-for-Service	1023190550	1023190550	1	1	EMERGENCY & ACUTE CARE	6/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
126951	Fee-for-Service	1417988668	1417988668	1	1	EAST COUNTY URGENT CARE	7/22/1987	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	INDUSTRIAL & MED CLINIC	1625 E MAIN ST	STE 100	EL CAJON	CA	92021	5240	37	06073	32.80969963	-116.9203429	San Diego County
127005	Fee-for-Service	1003064353	1003064353	1	1	ERIKSEN, NIKLAUS V MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119080	02	General Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
127229	Fee-for-Service	1568868479	1568868479	1	1	EHRLICH, ANNIKA W	5/30/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
127312	Fee-for-Service	1235320185	1235320185	1	1	ESFANDIARI, RAHELEH MD	9/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100932	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	37	06073	33.14066871	-117.156095	San Diego County
127414	Fee-for-Service	1184187247	1184187247	1	1	ERWIN, SCOTT MD	8/8/2023	207L00000X	NA	Other	026	PHYSICIANS	177367	None	None	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
127448	Fee-for-Service	1992989263	1992989263	1	1	ELLIOTT, DAVID T	4/17/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
127564	Fee-for-Service	1952835332	1952835332	1	1	ESCOBAR, EDDY R MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150110	01	General Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
127616	Fee-for-Service	1346418225	1346418225	1	1	ELLERBROCK, KATIE R MD	5/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105335	05	Anesthesiology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
127657	Fee-for-Service	1356928279	1356928279	1	1	ESTERWOOD, EMILY	9/10/2024	208M00000X	NA	Other	026	PHYSICIANS	192513	41	Internal Medicine	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
127717	Fee-for-Service	1326392168	1326392168	1	1	ERICKSON, JOEL S MD INC	9/25/2013	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54218	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	165 ROWLAND WAY	SUITE 212	NOVATO	CA	94945	5055	21	06041	38.09824386	-122.559872	Marin County
127778	Fee-for-Service	1366043580	1366043580	1	1	ERNST, HALEY M CNM	6/22/2022	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
127877	Fee-for-Service	1336249713	1336249713	1	1	EATON PEDIATRICS AND MEDICAL	10/28/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	CORPORATION	518 WEST EATON AVE	None	TRACY	CA	95376	3422	39	06077	37.74328555	-121.433589	San Joaquin County
127983	Fee-for-Service	1902936081	1902936081	2	1	EXPRESS MEDICAL TRANSPORT IN	10/20/2009	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	EXPRESS MEDICAL TRANSPOR	10630 TOWN CENTER DR	STE 128B	RANCHO CUCAMONGA	CA	91730	6805	36	06071	34.11112305	-117.5729644	San Bernardino County
128002	Fee-for-Service	1326392168	1326392168	1	1	ERICKSON, JOEL S MD INC	9/25/2013	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54218	41	Internal Medicine	0	In state provider	None	165 ROWLAND WAY	SUITE 212	NOVATO	CA	94945	5055	21	06041	38.09824386	-122.559872	Marin County
128087	Fee-for-Service	1992763114	1992763114	1	1	ELLIS, RONALD J MD	2/28/1992	2084N0400X	NA	Neurology	026	PHYSICIANS	70658	13	Neurology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
128113	Fee-for-Service	1366051120	1366051120	1	2	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	77 CADILLAC DR	SUITE 200	SACRAMENTO	CA	95825	8337	34	06067	38.572551	-121.4181585	Sacramento County
128400	Fee-for-Service	1366051120	1366051120	1	6	ELICA HEALTH CENTERS	2/20/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2400 GLENDALE LANE	None	SACRAMENTO	CA	95825	2431	34	06067	38.597355	-121.405212	Sacramento County
128440	Fee-for-Service	1295035905	1295035905	1	1	EVANS, JENNIFER LMFT	8/25/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28100 BOUQUET CANYON RD.	SUITE 218	SANTA CLARITA	CA	91350	2009	19	06037	34.45052733	-118.497654	Los Angeles County
128605	Fee-for-Service	1851927800	1851927800	1	1	ENGELHART, SHAWN MD	4/3/2024	207L00000X	NA	Other	026	PHYSICIANS	181193	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
128651	Fee-for-Service	1205167491	1205167491	1	4	ENVISION SCHOOLS	7/1/2012	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1195 HUDSON AVENUE	None	SAN FRANCISCO	CA	94124	2488	38	06075	37.73275954	-122.3812862	San Francisco County
128691	Fee-for-Service	1366051120	1366051120	1	6	ELICA HEALTH CENTERS	2/20/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2400 GLENDALE LANE	None	SACRAMENTO	CA	95825	2431	34	06067	38.597355	-121.405212	Sacramento County
128699	Fee-for-Service	1093874703	1093874703	1	1	EVERETT, JOHN M CRNA	4/5/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
128979	Fee-for-Service	1366051120	1366051120	1	6	ELICA HEALTH CENTERS	2/20/2023	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2400 GLENDALE LANE	None	SACRAMENTO	CA	95825	2431	34	06067	38.597355	-121.405212	Sacramento County
129006	Fee-for-Service	1932322112	1932322112	1	1	ERMAKOVA, ELENA V MD	8/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92215	08	Family Practice	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
129021	Fee-for-Service	1710757851	1710757851	1	1	EMERGENCY PHYSICIANS URGENT	9/10/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	29400 RANCHO CALIFORNIA	None	TEMECULA	CA	92591	5204	33	06065	33.50315094	-117.1482943	Riverside County
129119	Fee-for-Service	1568628329	1568628329	1	1	EATON, PATRICIA J LMFT	6/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 E HACIENDA AVE	None	CAMPBELL	CA	95008	6617	43	06085	37.26846327	-121.9547306	Santa Clara County
129136	Fee-for-Service	1184778656	1184778656	1	1	EWING, CATHERINE LCSW	10/25/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	630 DRAKE AVE	None	SAUSALITO	CA	94965	1107	21	06041	37.87340883	-122.515085	Marin County
129184	Fee-for-Service	1992449490	1992449490	1	1	EMAMIAN, SOFIA MSW LCSW	12/6/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	520 N MAIN ST	SUITE 120	SANTA ANA	CA	92701	4623	30	06059	33.749316	-117.868123	Orange County
129189	Fee-for-Service	1619203668	1619203668	1	1	EDMUNDS, MAGDALEN M MD	1/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	110258	01	General Practice	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
129266	Fee-for-Service	1366051120	1366051120	1	2	ELICA HEALTH CENTERS	9/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	77 CADILLAC DR	SUITE 200	SACRAMENTO	CA	95825	8337	34	06067	38.572551	-121.4181585	Sacramento County
129286	Fee-for-Service	1093769390	1093769390	1	1	EDELMAN,STEVEN MD	7/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MCMINNVILLE IMAGING ASS	2700 STRATUS AVE SE	None	MCMINNVILLE	OR	97128	0000	00	None	45.20010494	-123.1656951	Yamhill County
129307	Fee-for-Service	1710757851	1710757851	1	1	EMERGENCY PHYSICIANS URGENT	7/2/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	29400 RANCHO CALIFORNIA	None	TEMECULA	CA	92591	5204	33	06065	33.50315094	-117.1482943	Riverside County
129321	Fee-for-Service	1558653600	1558653600	1	1	EL-FTESI, SAMYRA MD	8/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129765	05	Anesthesiology	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
129406	Fee-for-Service	1194822262	1194822262	1	1	EDRICH, LESLIE H MD	12/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	48000	02	General Surgery	0	In state provider	None	701 E 28TH ST	STE 400	LONG BEACH	CA	90806	2778	19	06037	33.80803441	-118.1847137	Los Angeles County
129469	Fee-for-Service	1417993429	1417993429	1	1	EGHRARI, HALEH	2/8/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1314 WESTWOOD BLVD	STE 206	LOS ANGELES	CA	90024	4928	19	06037	34.05653136	-118.4424884	Los Angeles County
129553	Fee-for-Service	1366051120	1366051120	1	2	ELICA HEALTH CENTERS	1/31/2023	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	77 CADILLAC DR	SUITE 200	SACRAMENTO	CA	95825	8337	34	06067	38.572551	-121.4181585	Sacramento County
129620	Fee-for-Service	1346567617	1346567617	1	1	EKEJIUBA, JANE U MD	6/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123455	08	Family Practice	0	In state provider	None	21501 S AVALON BLVD	SUITE 100	CARSON	CA	90745	2210	19	06037	33.833421	-118.2637985	Los Angeles County
129632	Fee-for-Service	1720167851	1720167851	1	1	ENG, BILL WUN MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45305	08	Family Practice	0	In state provider	None	2615 I ST	None	SACRAMENTO	CA	95816	4395	34	06067	38.575656	-121.470867	Sacramento County
129660	Fee-for-Service	1225415714	1225415714	1	1	ELCHAKI, RIM MD	8/17/2022	2080P0210X	NA	Nephrology	026	PHYSICIANS	154545	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
129692	Fee-for-Service	1831508019	1831508019	1	1	EDWARDS, ELENA G CCC-SLP	8/3/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	41689 ENTERPRISE CR. NO.	SUITE 118	TEMECULA	CA	92590	5630	33	06065	33.51953516	-117.1693891	Riverside County
129702	Fee-for-Service	1093096000	1093096000	1	2	EXCELLENT HOME CARE LLC	1/31/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	37208 27TH STREET EAST	None	PALMDALE	CA	93550	6411	19	06037	34.55850692	-118.0809113	Los Angeles County
129723	Fee-for-Service	1669654380	1669654380	1	1	ESPITIA, DENNIS MD	2/25/2008	207P00000X	NA	Other	026	PHYSICIANS	98307	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
129724	Fee-for-Service	1306853403	1306853403	1	1	ENO, MARY MD	3/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	87606	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
129776	Fee-for-Service	1659399558	1659399558	2	1	ELITE HOME MED & RESPIRATORY	2/3/2009	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ELITE HOME MED & RESP	326 W KATELLA AVE	STE 4M	ORANGE	CA	92867	4756	30	06059	33.80902447	-117.856116	Orange County
129836	Fee-for-Service	1225329840	1225329840	1	1	ERIDON, JAMIE M MD	1/17/2023	208G00000X	NA	General Surgery	026	PHYSICIANS	183854	None	None	0	In state provider	None	3828 SCHAUFELE AVE	STE 340	LONG BEACH	CA	90808	1793	19	06037	33.8283	-118.1479725	Los Angeles County
129843	Fee-for-Service	1699331439	1699331439	1	1	ESQUIVEL, CHRISTINE LMFT	4/22/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
129846	Fee-for-Service	1245331743	1245331743	1	1	ESPINOZA, SARA E MD	1/17/2024	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	191718	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
129869	Fee-for-Service	1457735789	1457735789	1	1	ENGEL, DELPHINE MD INC	8/17/2015	2086S0102X	NA	General Surgery	026	PHYSICIANS	97052	02	General Surgery	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
129910	Fee-for-Service	1346567617	1346567617	1	1	EKEJIUBA, JANE U MD	6/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123455	01	General Practice	0	In state provider	None	21501 S AVALON BLVD	SUITE 100	CARSON	CA	90745	2210	19	06037	33.833421	-118.2637985	Los Angeles County
130002	Fee-for-Service	1750869574	1750869574	1	1	ESCOBAR, JOHN A RCP	9/6/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
130017	Fee-for-Service	1821356692	1821356692	1	1	ELBOUDWAREJ, OMEED MD	12/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128861	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
130058	Fee-for-Service	1659600112	1659600112	1	1	EISA, NASEEM MD	5/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137168	67	Endocrinology	0	In state provider	None	311 WEST I ST	None	LOS BANOS	CA	93635	3479	24	06047	37.06343055	-120.8570545	Merced County
130102	Fee-for-Service	1710089974	1710089974	1	1	EVERS, AMY R MD	5/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82780	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
130103	Fee-for-Service	1194835330	1194835330	1	1	ELBASSIR, MAGDI MD	6/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	86654	08	Family Practice	0	In state provider	None	12408 HESPERIA ROAD	STE 1	HESPERIA	CA	92395	4786	36	06071	34.47685861	-117.291289	San Bernardino County
130112	Fee-for-Service	1689176356	1689176356	1	1	EASTGATE PHARMACY INC	4/16/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11741 VALLEY VIEW ST	SUITE L	CYPRESS	CA	90630	5500	30	06059	33.79210447	-118.0287769	Orange County
130124	Fee-for-Service	1063498616	1063498616	1	1	ENENSTEIN, HARRY E	10/8/1993	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CTR OF ENCINO	17310 VENTURA BLVD	None	ENCINO	CA	91316	3904	19	06037	34.16093637	-118.5106255	Los Angeles County
130159	Fee-for-Service	1457735789	1457735789	1	1	ENGEL, DELPHINE MD INC	8/17/2015	2086S0102X	NA	General Surgery	026	PHYSICIANS	97052	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
130195	Fee-for-Service	1285681874	1285681874	1	1	E&M MULTI SPECIALTY	1/18/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CAL GROUP INC	1300 N VERMONT AVE	STE 60	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
130309	Fee-for-Service	1376834697	1376834697	1	1	EBEL, NOELLE H MD	8/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	123789	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
130320	Fee-for-Service	1508132457	1508132457	1	1	ELBERS, JORINA M MD	5/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120454	13	Neurology (M.D. only)	0	In state provider	None	725 WELCH RD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
130343	Fee-for-Service	1659600112	1659600112	1	1	EISA, NASEEM MD	5/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137168	41	Internal Medicine	0	In state provider	None	311 WEST I ST	None	LOS BANOS	CA	93635	3479	24	06047	37.06343055	-120.8570545	Merced County
130361	Fee-for-Service	1356358121	1356358121	1	2	EMILIA TALAMAS M.D	8/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2001 N OREGON ST	None	EL PASO	TX	79902	3320	00	None	31.77138005	-106.4995755	El Paso County
130436	Fee-for-Service	1770558678	1770558678	1	1	ECOFF, STEVEN A DO	3/4/2008	207L00000X	NA	Other	026	PHYSICIANS	5497	05	Anesthesiology	0	In state provider	None	1000 TRANCAS ST	None	NAPA	CA	94558	2906	28	06055	38.32349768	-122.2963137	Napa County
130439	Fee-for-Service	1497787642	1497787642	1	1	ELGHOUL, ZIAD M. MD	8/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1960 W FRYE RD	SUITE 5	CHANDLER	AZ	85224	6238	00	None	33.299361	-111.875625	Maricopa County
130455	Fee-for-Service	1902023989	1902023989	1	1	ESANI, NAHID N MD	6/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74583	None	None	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
130484	Fee-for-Service	1285681874	1285681874	1	1	E&M MULTI SPECIALTY	1/18/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	CAL GROUP INC	1300 N VERMONT AVE	STE 60	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
130583	Fee-for-Service	1598362568	1598362568	1	1	ENCINITAS EMERGENCY MEDICINE	11/24/2020	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	, INC.	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
130586	Fee-for-Service	1912020181	1912020181	1	1	ENLOE MEDICAL CENTER	4/14/2017	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
130607	Fee-for-Service	1790706646	1790706646	1	1	ELSIBAI, AMGAD R MD	1/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	52784	05	Anesthesiology	0	In state provider	None	18321 CLARK ST	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
130661	Fee-for-Service	1831438399	1831438399	1	1	ELAKABAWI, AMY F CNM	4/23/2015	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	12100 EUCLID ST	None	GARDEN GROVE	CA	92840	3304	30	06059	33.786882	-117.9410535	Orange County
130756	Fee-for-Service	1790833697	1790833697	1	1	EASTMAN, JOHN S MD	1/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	42388	01	General Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
130835	Fee-for-Service	1689905952	1689905952	1	1	EDWARD J GONZALEZ	11/18/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4300 BARTLETT ST	None	HOMER	AK	99603	7005	00	None	59.65210843	-151.5501715	Kenai Peninsula Borough
130859	Fee-for-Service	1538135694	1538135694	1	1	EYE PHYSICIANS MED/SUR	6/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	CTR, INC.	681 3RD AVE	None	CHULA VISTA	CA	91910	5703	37	06073	32.6284656	-117.0748498	San Diego County
130873	Fee-for-Service	1568127579	1568127579	1	1	ELDER, CODY D LMFT	4/15/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
130912	Fee-for-Service	1669758918	1669758918	1	1	EL-SAYED, DENA MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127060	41	Internal Medicine	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
130924	Fee-for-Service	1083945653	1083945653	1	1	EVANS, CARLA M NP	7/19/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	19230	-	NOT APPLICABLE	0	In state provider	None	625 STEELE LANE	STE B	SANTA ROSA	CA	95403	3127	49	06097	38.460366	-122.7242565	Sonoma County
131059	Fee-for-Service	1023112554	1023112554	1	1	ELARDO, THOMAS J DPM	8/9/2023	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	400 CARLTON AVE	SUITE 200	LOS GATOS	CA	95032	2629	43	06085	37.24728836	-121.9514527	Santa Clara County
131089	Fee-for-Service	1578509667	1578509667	1	1	EAST BAY RETINA CONSULT	1/1/1995	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL GROUP INC	5401 NORRIS CANYON RD	STE 200	SAN RAMON	CA	94583	5406	07	06013	37.77752374	-121.9579277	Contra Costa County
131148	Fee-for-Service	1538135694	1538135694	1	1	EYE PHYSICIANS MED/SUR	9/20/2024	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CTR, INC.	681 3RD AVE	None	CHULA VISTA	CA	91910	5703	37	06073	32.6284656	-117.0748498	San Diego County
131172	Fee-for-Service	1932530193	1932530193	1	1	EL HOGAR COMMUNITY SERVICES,	6/7/2024	261QM0850X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	INC.	3780 ROSIN CT	SUITE 110	SACRAMENTO	CA	95834	1646	34	06067	38.636478	-121.473081	Sacramento County
131179	Fee-for-Service	1255812780	1255812780	1	5	ENLOE MEDICAL CENTER	1/12/2022	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	277 COHASSET ROAD	None	CHICO	CA	95926	2242	04	06007	39.75152348	-121.8511763	Butte County
131186	Fee-for-Service	1528445202	1528445202	1	1	ERIC ROOT	4/19/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	355 N MAIN ST	None	KANAB	UT	84741	3260	00	None	37.054485	-112.5286185	Kane County
131190	Fee-for-Service	1508935230	1508935230	1	1	EL DORADO COMM SVS CTR	12/1/1995	261QP2300X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARITA MED & MNTL	24625 ARCH ST	None	NEWHALL	CA	91321	1111	19	06037	34.38498366	-118.5292907	Los Angeles County
131217	Fee-for-Service	1225125602	1225125602	1	1	ENLOE MEDICAL	10/3/1995	282N00000X	NA	Hospitals	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CENTER HOSPICE	1390 E LASSEN AVE	None	CHICO	CA	95973	7823	04	06007	39.77300289	-121.8389237	Butte County
131235	Fee-for-Service	1376597443	1376597443	1	1	EHRENBERG, DOUGLAS A DPM	5/1/1999	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	52 MOHAWK AVE	None	CORTE MADERA	CA	94925	1033	21	06041	37.92829769	-122.5216959	Marin County
131291	Fee-for-Service	1689384067	1689384067	1	1	EVANS, SARAH CRNA	10/12/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	7417 N CEDAR AVE	None	FRESNO	CA	93720	3637	10	06019	36.844227	-119.7568975	Fresno County
131370	Fee-for-Service	1497035083	1497035083	1	1	EXPRESS HEALTH PHARMACY INC	3/28/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	650 F STREET	None	WASCO	CA	93280	2018	15	06029	35.59467435	-119.3336739	Kern County
131383	Fee-for-Service	1417002635	1417002635	1	1	ECONOMIDIS, MEGAN A MD	10/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	75842	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
131404	Fee-for-Service	1871249821	1871249821	1	1	ENDOW, WESLEY K PT	4/17/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1900 DRESDEN	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
131470	Fee-for-Service	1255812780	1255812780	1	5	ENLOE MEDICAL CENTER	1/12/2022	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	277 COHASSET ROAD	None	CHICO	CA	95926	2242	04	06007	39.75152348	-121.8511763	Butte County
131493	Fee-for-Service	1275688558	1275688558	1	1	EVERGREEN CERRITOS	2/5/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GROUP	18403 PIONEER BLVD	STE 200	CERRITOS	CA	90701	4608	19	06037	33.86480298	-118.0822253	Los Angeles County
131506	Fee-for-Service	1225125602	1225125602	1	1	ENLOE MEDICAL	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CENTER HOSPICE	1390 E LASSEN AVE	None	CHICO	CA	95973	7823	04	06007	39.77300289	-121.8389237	Butte County
131513	Fee-for-Service	1821026816	1821026816	1	1	EAST COOPER COMMUNITY	9/2/2004	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	1200 JOHNNIE DODDS BLVD	None	MT PLEASANT	SC	29464	3231	00	None	32.81417996	-79.85713567	Charleston County
131567	Fee-for-Service	1124875380	1124875380	1	1	EASE THE JOINTS PHYSICAL THE	8/22/2024	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	RAPY A PROFESSIOAL COR	18181 BUTTERFIELD BLVD	SUITE 170	MORGAN HILL	CA	95037	8108	43	06085	37.13904584	-121.6547035	Santa Clara County
131604	Fee-for-Service	1437293446	1437293446	1	1	EVANS, EDWARD B MD	9/12/1985	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	43785	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	161 THUNDER DR	STE 105	VISTA	CA	92083	6051	37	06073	33.18638925	-117.2882216	San Diego County
131610	Fee-for-Service	1154377109	1154377109	1	1	EDOUARD, PHILIPPE R MD	4/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	51257	41	Internal Medicine	0	In state provider	INC	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
131753	Fee-for-Service	1649512427	1649512427	1	1	EGNER, STEVEN M	5/5/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3460 E LA PALMA AVE	None	ANAHEIM	CA	92806	2020	30	06059	33.85429451	-117.8446551	Orange County
131761	Fee-for-Service	1255812780	1255812780	1	5	ENLOE MEDICAL CENTER	2/26/2024	207V00000X	NA	Obstetrics & Gynecology	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	277 COHASSET ROAD	None	CHICO	CA	95926	2242	04	06007	39.75152348	-121.8511763	Butte County
131764	Fee-for-Service	1861258105	1861258105	1	1	ETOAMAIHE, DAVIDSON	12/27/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8329 BRIMHALL RD	804	BAKERSFIELD	CA	93312	2243	15	06029	35.366706	-119.0959425	Kern County
131801	Fee-for-Service	1821026816	1821026816	1	1	EAST COOPER COMMUNITY	9/2/2004	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL INC	1200 JOHNNIE DODDS BLVD	None	MT PLEASANT	SC	29464	3231	00	None	32.81417996	-79.85713567	Charleston County
131852	Fee-for-Service	1184172520	1184172520	1	1	EASTMAN, ASHLEE H	1/30/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
131861	Fee-for-Service	1821137522	1821137522	1	1	EUBANY,LORRAINE A MD	10/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	71206	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
131900	Fee-for-Service	1154377109	1154377109	1	1	EDOUARD, PHILIPPE R MD	4/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	51257	45	Nephrology (Renal-Kidney)	0	In state provider	INC	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
131916	Fee-for-Service	1073775110	1073775110	1	1	ELMESALLATI, HUSAMEDDIN M MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
131954	Fee-for-Service	1922354240	1922354240	1	1	ENGLISH, DAVID W MD	5/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128610	01	General Practice	0	In state provider	None	1001 POTRERO AVE	RM 4F	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
132045	Fee-for-Service	1255812780	1255812780	1	5	ENLOE MEDICAL CENTER	5/5/2022	207V00000X	NA	Obstetrics & Gynecology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	277 COHASSET ROAD	None	CHICO	CA	95926	2242	04	06007	39.75152348	-121.8511763	Butte County
132086	Fee-for-Service	1629044342	1629044342	1	1	ERIC CHRISTIANSON	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2450 RIVERSIDE AVE	None	MINNEAPOLIS	MN	55454	1450	00	None	44.96613258	-93.23756795	Hennepin County
132090	Fee-for-Service	1023196649	1023196649	1	1	ELKEEB, LAILA M MD	6/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85384	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
132167	Fee-for-Service	1336250851	1336250851	1	1	ELLIOTT, BRIAN K. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	555 S 70TH ST	None	LINCOLN	NE	68510	2462	00	None	40.808151	-96.62516802	Lancaster County
132181	Fee-for-Service	1437226313	1437226313	1	1	EWIN, LEON H MD	3/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	48003	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
132199	Fee-for-Service	1063441293	1063441293	1	2	EMANATE HEALTH MEDICAL	3/10/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1135 S SUNSET AVE	SUITE 401	WEST COVINA	CA	91790	3921	19	06037	34.06215064	-117.9453997	Los Angeles County
132316	Fee-for-Service	1235864406	1235864406	1	1	ELSAYED, NORA NP	7/22/2022	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	555 E HARDY ST	IRA KAUFMAN PAVILION	INGLEWOOD	CA	90301	4106	19	06037	33.94909549	-118.3481595	Los Angeles County
132396	Fee-for-Service	1295837177	1295837177	1	1	ESQUIVEL-AGUILAR, G MD	4/30/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	35880	40	Pediatrics	0	In state provider	None	3748 E SHIELDS AVE	None	FRESNO	CA	93726	7028	10	06019	36.77950149	-119.7622755	Fresno County
132410	Fee-for-Service	1285662775	1285662775	1	1	EATON, LAURA J MD	5/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93978	08	Family Practice	0	In state provider	None	350 PARNASSUS AVE	None	SAN FRANCISCO	CA	94117	3608	38	06075	37.76403932	-122.4561371	San Francisco County
132433	Fee-for-Service	1043317068	1043317068	1	1	EYE MAX OPTOMETRY WILSHIRE	6/1/2001	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INC	3359 WILSHIRE BLVD	None	LOS ANGELES	CA	90010	1803	19	06037	34.0618263	-118.296969	Los Angeles County
132471	Fee-for-Service	1437226313	1437226313	1	1	EWIN, LEON H MD	3/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	48003	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
132556	Fee-for-Service	1306576103	1306576103	1	1	EVANS, KIMBERLY BIRTH DOULA	3/14/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
132563	Fee-for-Service	1962755298	1962755298	1	1	EMI, MICHELLE L MD	8/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	73265	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLZ	STE 365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
132600	Fee-for-Service	1255636130	1255636130	1	1	ESCORCIA, CLAUDIA E LMFT	3/15/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6809 INDIANA AVE	131	RIVERSIDE	CA	92506	4221	33	06065	33.94312844	-117.3918196	Riverside County
132668	Fee-for-Service	1598723801	1598723801	1	1	ENZMANN, DIETER R MD	1/1/1982	2085N0700X	NA	MRI Provider	026	PHYSICIANS	26559	None	None	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
132682	Fee-for-Service	1437103942	1437103942	1	22	EMERGENCY & ACUTE CARE	9/27/2023	324500000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	31872 COAST HWY	None	LAGUNA BEACH	CA	92651	6773	30	06059	33.49961197	-117.7420867	Orange County
132688	Fee-for-Service	1841483427	1841483427	1	1	EAG PROFESSIONAL MEDICAL COR	11/18/2022	2084P0800X	NA	Psychiatry	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	P.	809 SYLVAN AVE	SUITE 500A	MODESTO	CA	95350	1500	50	06099	37.68900616	-120.9836976	Stanislaus County
132743	Fee-for-Service	1922558220	1922558220	1	1	ECONOMOU, NICOLE MD	6/12/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	145438	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
132825	Fee-for-Service	1164762399	1164762399	1	1	EMMERT, LISHANNA T LAC	11/8/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	5617 SCOTTS VALLEY DR	SUITE 180	SCOTTS VALLEY	CA	95066	3452	44	06087	37.06204883	-122.0069319	Santa Cruz County
132836	Fee-for-Service	1891930673	1891930673	1	2	EAST BAY RHEUMATOLOGY MEDICA	5/7/2022	174400000X	NA	Other	022	PHYSICIANS GROUP	-	83	Rheumatology	0	In state provider	L GROUP, INC.	13851 E 14TH ST	STE 102A	SAN LEANDRO	CA	94578	2630	01	06001	37.71458918	-122.1418781	Alameda County
132883	Fee-for-Service	1124886882	1124886882	1	1	EXPRESS CARE MEDICAL GROUP,	9/13/2024	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	A PROFESSIONAL CORPORA	2131 HERNDON AVE	STE 103	CLOVIS	CA	93611	6304	10	06019	36.83752991	-119.6766888	Fresno County
132977	Fee-for-Service	1841483427	1841483427	1	1	EAG PROFESSIONAL MEDICAL COR	11/18/2022	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	None	None	0	In state provider	P.	809 SYLVAN AVE	SUITE 500A	MODESTO	CA	95350	1500	50	06099	37.68900616	-120.9836976	Stanislaus County
133000	Fee-for-Service	1306906839	1306906839	1	1	ELITE MEDICAL TRANSPORT, LLC	4/8/2008	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1500 S 8TH ST	None	DEMING	NM	88030	4939	00	None	32.25377462	-107.7686529	Luna County
133031	Fee-for-Service	1679544084	1679544084	1	1	EL-TAYEB, HISHAM N MD	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	52244	05	Anesthesiology	0	In state provider	None	400 E MAIN ST	None	STOCKTON	CA	95202	3000	39	06077	37.95344497	-121.2852303	San Joaquin County
133111	Fee-for-Service	1699748830	1699748830	1	1	EISENMANN, ULRIKE B MD	8/26/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80035	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
133174	Fee-for-Service	1346761236	1346761236	1	1	ELTAYEB, MOHAMED A MD	9/13/2021	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
133247	Fee-for-Service	1720178817	1720178817	1	1	ELBALALESY, NASER M MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	73709	40	Pediatrics	0	In state provider	None	12751 HARBOR BLVD	None	GARDEN GROVE	CA	92840	5800	30	06059	33.77746612	-117.9151381	Orange County
133269	Fee-for-Service	1871608992	1871608992	1	1	ENGLANDER, DAVID M MD	7/13/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	33805	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4500 W 116TH ST	None	HAWTHORNE	CA	90250	2209	19	06037	33.92906042	-118.3548882	Los Angeles County
133350	Fee-for-Service	1609383835	1609383835	1	1	EPPINETTE, MEGHAN L CCC-SLP	4/19/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	410 E MERCED AVE	STE. D	WEST COVINA	CA	91790	5058	19	06037	34.05493113	-117.9381152	Los Angeles County
133359	Fee-for-Service	1629407069	1629407069	1	1	EXACT SCIENCES LABORATORIES,	2/18/2019	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	LLC	145 E BADGER RD	STE 100	MADISON	WI	53713	2723	00	None	43.03830469	-89.38309034	Dane County
133408	Fee-for-Service	1396548889	1396548889	1	1	ESPER TREML, RICARDO MD	4/1/2025	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
133466	Fee-for-Service	1942249388	1942249388	1	1	EDRAKI, BABAK	11/3/2008	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	67092	None	None	0	In state provider	None	1455 MONTEGO	STE 100	WALNUT CREEK	CA	94598	2952	07	06013	37.91046956	-122.0418669	Contra Costa County
133488	Fee-for-Service	1003994831	1003994831	1	1	ERICKSON, DONN MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	84627	01	General Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
133534	Fee-for-Service	1720178817	1720178817	1	1	ELBALALESY, NASER M MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	73709	13	Neurology (M.D. only)	0	In state provider	None	12751 HARBOR BLVD	None	GARDEN GROVE	CA	92840	5800	30	06059	33.77746612	-117.9151381	Orange County
133598	Fee-for-Service	1376731208	1376731208	1	1	EUN JUNG YI MD	3/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2312 NE 129TH ST	None	VANCOUVER	WA	98686	3236	00	None	45.715383	-122.6477565	Clark County
133643	Fee-for-Service	1629407069	1629407069	1	2	EXACT SCIENCES LABORATORIES,	12/1/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	LLC	650 FORWARD DR.	None	MADISON	WI	53711	2441	00	None	43.05095044	-89.48819706	Dane County
133725	Fee-for-Service	1225112204	1225112204	1	1	EISENBERG, STEPHEN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	18081	30	Radiology	0	In state provider	None	7011 SHOUP AVE	None	CANOGA PARK	CA	91307	2335	19	06037	34.19773728	-118.6146715	Los Angeles County
133844	Fee-for-Service	1295139632	1295139632	1	1	ELIM HEALTHCARE INC	1/17/2015	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1126 S WESTMORELAND AVE	None	LOS ANGELES	CA	90006	3400	19	06037	34.04986368	-118.2890787	Los Angeles County
134081	Fee-for-Service	1316342579	1316342579	1	2	ENCINO SURGICAL CENTER, LLC	7/5/2023	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	NTER, LLC	16260 VENTURA BOULEVARD	800	ENCINO	CA	91436	2203	19	06037	34.15687678	-118.4876342	Los Angeles County
134107	Fee-for-Service	1134244635	1134244635	1	1	EHRLICH, MICHELLE MD	7/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85530	07	Dermatology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
134196	Fee-for-Service	1912176884	1912176884	1	1	EKANAYAKE, MANORIE T MD	11/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102613	08	Family Practice	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
134233	Fee-for-Service	1215128988	1215128988	1	1	ELDER, MAHR DDS MD APC	1/4/2018	1223S0112X	NA	Dental Provider	022	PHYSICIANS GROUP	-	84	Surgery-Head and Neck	0	In state provider	None	1805 NOVATO BLVD	STE 1	NOVATO	CA	94947	2934	21	06041	38.10838371	-122.5838215	Marin County
134235	Fee-for-Service	1205274545	1205274545	1	1	ERICKSON-RIDOUT, KATHRYN MD	12/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150034	36	Psychiatry	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
134240	Fee-for-Service	1922620939	1922620939	1	1	EL-SAIED, MOHAMMAD MD	9/15/2023	207R00000X	NA	Other	026	PHYSICIANS	189029	None	None	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
134599	Fee-for-Service	1811009525	1811009525	1	1	ENOCH, RUSSELL E DO	10/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	8019	41	Internal Medicine	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
134722	Fee-for-Service	1902227788	1902227788	1	1	EVANS, CHRISTOPHER S DO	11/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
134762	Fee-for-Service	1669442182	1669442182	1	1	ERICKSON, LISA NP	4/22/2021	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
134864	Fee-for-Service	1851378392	1851378392	1	1	ENGWALL, SCOTT A MD	1/31/1990	207L00000X	NA	Other	026	PHYSICIANS	64211	05	Anesthesiology	0	In state provider	None	780 E GILBERT ST	None	SAN BERNARDINO	CA	92415	1003	36	06071	34.1268333	-117.2705634	San Bernardino County
134916	Fee-for-Service	1821300989	1821300989	1	1	EUREKA UNION SCHOOL DIST	8/10/2009	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	5455 EUREKA RD	None	GRANITE BAY	CA	95746	8808	31	06061	38.73632752	-121.1993415	Placer County
134922	Fee-for-Service	1790500288	1790500288	1	1	ELIS, JULIE M NP	1/22/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
134999	Fee-for-Service	1578584678	1578584678	1	1	ELLIS, BANDT, BIRKIN,	1/12/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	1	Border provider	KOLLINS, & WONG APC	2020 PALOMINO LN	STE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
135076	Fee-for-Service	1720212210	1720212210	1	1	ESMAIL, FARIHA MD	1/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123389	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
135090	Fee-for-Service	1366680449	1366680449	1	1	EHRLICH, ETHAN CRNA	11/5/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
135184	Fee-for-Service	1477605665	1477605665	1	1	ECKERT, WILLIAM M CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
135190	Fee-for-Service	1205053865	1205053865	1	1	ELLIS, WENDY D MD	8/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	157478	30	Radiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
135236	Fee-for-Service	1043657802	1043657802	1	1	ETEHAD, SIAMAK MD INC AMC	1/3/2014	207R00000X	NA	Other	026	PHYSICIANS	43714	41	Internal Medicine	0	In state provider	None	17075 DEVONSHIRE ST	SUITE 100	NORTHRIDGE	CA	91325	5405	19	06037	34.25755945	-118.50471	Los Angeles County
135279	Fee-for-Service	1417075094	1417075094	1	1	EDWARDS, CURTIS J PHD	12/3/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVENUE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
135291	Fee-for-Service	1922206283	1922206283	1	2	EASTWEST PHYSICAL THERAPY	1/21/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	1234 S GARFIELD AVE	STE 205	ALHAMBRA	CA	91801	5079	19	06037	34.0796013	-118.1229688	Los Angeles County
135339	Fee-for-Service	1407443849	1407443849	1	2	ELEONOR'S PLACE INC.	2/28/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	24772 ARGUS DRIVE	None	MISSION VIEJO	CA	92691	4614	30	06059	33.60238275	-117.6796507	Orange County
135388	Fee-for-Service	1295716363	1295716363	1	1	EVANS, DOUGLAS MD	10/31/1991	207P00000X	NA	Other	026	PHYSICIANS	67166	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1688 E MAIN ST	None	EL CAJON	CA	92021	5204	37	06073	32.81173156	-116.9190219	San Diego County
135400	Fee-for-Service	1518622695	1518622695	1	1	ESTRADA, SANDRA LMFT	11/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1307 6TH ST	108	CORONA	CA	92882	3294	33	06065	33.87790309	-117.589666	Riverside County
135437	Fee-for-Service	1265079685	1265079685	1	1	ELARA HOSPICE INC	9/16/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14640 VICTORY BLVD	STE 226	VAN NUYS	CA	91411	1623	19	06037	34.18663255	-118.452402	Los Angeles County
135502	Fee-for-Service	1588298442	1588298442	1	1	EIJEAN WU, MD, MPP, A PROFES	7/22/2020	207VX0201X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1300 N VERMONT AVE	1001	LOS ANGELES	CA	90027	6098	19	06037	34.0956033	-118.2916918	Los Angeles County
135577	Fee-for-Service	1750706800	1750706800	1	1	ELLIS, SUSAN NP	8/2/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1908 SWEETWATER RD	None	NATIONAL CITY	CA	91950	7628	37	06073	32.66119079	-117.0786584	San Diego County
135599	Fee-for-Service	1689360760	1689360760	1	1	ESTANQUE, ESTHER L NP	4/16/2025	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
135627	Fee-for-Service	1609067735	1609067735	1	1	ESCALANTE, MIRNA X MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120922	67	Endocrinology	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
135628	Fee-for-Service	1033782826	1033782826	1	1	EPIC HOME HEALTH CARE INC	2/27/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	9900 LAKEWOOD BLVD	SUITE 103	DOWNEY	CA	90240	4039	19	06037	33.94958507	-118.1158116	Los Angeles County
135725	Fee-for-Service	1265079685	1265079685	1	1	ELARA HOSPICE INC	9/16/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14640 VICTORY BLVD	STE 226	VAN NUYS	CA	91411	1623	19	06037	34.18663255	-118.452402	Los Angeles County
135757	Fee-for-Service	1811021405	1811021405	1	1	EAST BAY PERINATAL CENTER	8/28/2007	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	PERINATAL CENTER	350 30TH ST	None	OAKLAND	CA	94609	3424	01	06001	37.81892183	-122.2640154	Alameda County
135772	Fee-for-Service	1386675288	1386675288	1	1	ESSENTIAL MEDICAL SUPPLY	5/24/2006	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	INC	1283 S LA BREA AVE	None	LOS ANGELES	CA	90019	1627	19	06037	34.05106397	-118.3446118	Los Angeles County
135815	Fee-for-Service	1821543455	1821543455	1	1	ELLIS, SHERRY	5/30/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
135848	Fee-for-Service	1265774665	1265774665	1	1	ESKANDAR-AFSHARI, FATIMA DO	6/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14583	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
135918	Fee-for-Service	1609067735	1609067735	1	1	ESCALANTE, MIRNA X MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120922	40	Pediatrics	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
135926	Fee-for-Service	1396753281	1396753281	1	3	ENLOE MEDICAL CENTER	1/16/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	888 LAKESIDE VILLAGE COM	None	CHICO	CA	95926	2281	04	06007	39.750084	-121.7934327	Butte County
136061	Fee-for-Service	1306204318	1306204318	2	1	EDS-I PRACTICES OF CALIFORNI	1/12/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
136084	Fee-for-Service	1356361885	1356361885	1	1	ETHERIDGE, ARI U MD	11/24/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	80762	-	NOT APPLICABLE	0	In state provider	None	982 MISSION STREET	None	SAN FRANCISCO	CA	94103	2911	38	06075	37.7813638	-122.4082438	San Francisco County
136110	Fee-for-Service	1205932555	1205932555	1	1	EAST BAY SLEEP MEDICAL	4/22/2004	261QS1200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CENTER	27001 CALAROGA AVE	STE 1	HAYWARD	CA	94545	4345	01	06001	37.63388965	-122.0898396	Alameda County
136171	Fee-for-Service	1700464302	1700464302	1	1	ETCHEVERRY, ADRIANA M DO	11/5/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	22537	40	Pediatrics	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
136194	Fee-for-Service	1063060812	1063060812	1	1	EDWARDS, CANDACE M PT	5/17/2023	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2660 W COVELL BLVD	None	DAVIS	CA	95616	5645	57	06113	38.56101005	-121.7821776	Yolo County
136231	Fee-for-Service	1942607668	1942607668	1	1	ERICKSON, LAUREN A LMFT	5/13/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
136270	Fee-for-Service	1407934557	1407934557	1	1	ERWIN, RODNEY J MD	10/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67950	26	Psychiatry (child)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
136279	Fee-for-Service	1437103942	1437103942	1	12	EMERGENCY & ACUTE CARE	12/19/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
136289	Fee-for-Service	1437103942	1437103942	1	21	EMERGENCY & ACUTE CARE	5/12/2017	324500000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
136351	Fee-for-Service	1558553958	1558553958	1	1	ESKANDER, RAMY N MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	96649	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
136418	Fee-for-Service	1295742120	1295742120	1	1	ENNIS, GRAIG A MD	6/30/1991	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	72693	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
136434	Fee-for-Service	1730104498	1730104498	1	1	EMERGENCY DEPT PHYSICIAN	1/1/1985	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MED GRP INC	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
136452	Fee-for-Service	1750451159	1750451159	1	1	ESQUEDA, NICOLE D OD	7/16/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	115 N IRWIN ST	None	HANFORD	CA	93230	4537	16	06031	36.32604929	-119.6471886	Kings County
136569	Fee-for-Service	1437103942	1437103942	1	12	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
136581	Fee-for-Service	1437103942	1437103942	1	21	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
136673	Fee-for-Service	1194087155	1194087155	1	1	ELIAS, RANI MD	1/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121684	40	Pediatrics	0	In state provider	None	742 W HIGHLAND AVE	None	SAN BERNARDINO	CA	92405	3839	36	06071	34.13604853	-117.29952	San Bernardino County
136726	Fee-for-Service	1982606992	1982606992	2	1	EUROFINS ASCEND CLINICAL, LL	11/18/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	C	435 OAKMEAD PKWY	None	SUNNYVALE	CA	94085	4709	43	06085	37.38285143	-121.9882213	Santa Clara County
136739	Fee-for-Service	1134365679	1134365679	1	1	EYE AND VISION CENTRAL CALIF	3/15/2005	193400000X	NA	Other	026	PHYSICIANS	80829	18	Ophthalmology	0	In state provider	ORNIA INC	2325 W CLEVELAND AVE	STE 103	MADERA	CA	93637	8753	20	06039	36.97466953	-120.0853215	Madera County
136802	Fee-for-Service	1255011672	1255011672	1	1	EDWIN AMIRIANFAR DO PSC	5/16/2024	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	25	Physical Medicine and Rehabilitation	0	In state provider	None	1600 ROSE AVE	None	OXNARD	CA	93030	3722	56	06111	34.21700406	-119.1582582	Ventura County
136823	Fee-for-Service	1508886359	1508886359	1	1	EPSTEIN, DAVID MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71756	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
136858	Fee-for-Service	1467273060	1467273060	1	1	ESQUEDA - ZAPIEN, DEYANIRA	2/25/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	44	06087	0	0	None
136903	Fee-for-Service	1326322306	1326322306	1	1	EICHNER, LORA K MD	12/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	80320	40	Pediatrics	0	In state provider	None	765 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43983678	-122.162757	Santa Clara County
136940	Fee-for-Service	1720055791	1720055791	1	1	E DUQUE, RICARDO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2200 OSPREY BLVD	None	BARTOW	FL	33830	3308	00	None	27.91780517	-81.84341515	Polk County
136944	Fee-for-Service	1235586959	1235586959	1	1	ELIAS, PETRA MD	1/17/2025	207L00000X	NA	Other	026	PHYSICIANS	150670	05	Anesthesiology	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
136982	Fee-for-Service	1932239159	1932239159	1	2	EARLES, KERISHA N LMFT	6/16/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41593 WINCHESTER RD	122	TEMECULA	CA	92590	4857	33	06065	33.52030169	-117.1659061	Riverside County
137030	Fee-for-Service	1548265267	1548265267	1	1	EWING, ROBERT H	9/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	40089	18	Ophthalmology	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
137087	Fee-for-Service	1710395777	1710395777	2	1	EAGLE GLEN CARE HOME INC	9/1/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1697 HONORS CIRCLE	None	CORONA	CA	92883	0759	33	06065	33.8171638	-117.5416948	Riverside County
137114	Fee-for-Service	1508886359	1508886359	1	1	EPSTEIN, DAVID MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71756	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
137220	Fee-for-Service	1003890229	1003890229	1	1	EDDOW, CHRISTINE M PT	3/27/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2815 MAIN ST.,	SUITE 205	CORONA	CA	92882	0000	33	06065	33.84741266	-117.570694	Riverside County
137222	Fee-for-Service	1598366841	1598366841	1	1	EVERCLEAR HOSPICE AND	6/19/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	25835 NARBONNE AVE	SUITE 277	LOMITA	CA	90717	3074	19	06037	33.788529	-118.3200155	Los Angeles County
137244	Fee-for-Service	1043653413	1043653413	1	1	ESKANDARI, ARMEN MD DO	7/3/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	139303	10	Gastroenterology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
137245	Fee-for-Service	1376620294	1376620294	1	1	EVANS, JOHN C MD	8/14/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	108412	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
137267	Fee-for-Service	1023022092	1023022092	2	1	EAST COUNTY FAMILY MEDICAL C	3/19/2020	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	NTER	330 S MAGNOLIA AVE	101	EL CAJON	CA	92020	5290	37	06073	32.79218212	-116.9623617	San Diego County
137480	Fee-for-Service	1922749027	1922749027	1	1	EDELSBERG, KIMBERLY DO	11/22/2024	207R00000X	NA	Other	026	PHYSICIANS	21635	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
137510	Fee-for-Service	1598366841	1598366841	1	1	EVERCLEAR HOSPICE AND	6/19/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	25835 NARBONNE AVE	SUITE 277	LOMITA	CA	90717	3074	19	06037	33.788529	-118.3200155	Los Angeles County
137535	Fee-for-Service	1376620294	1376620294	1	1	EVANS, JOHN C MD	8/14/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	108412	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
137543	Fee-for-Service	1881218782	1881218782	1	1	ESPINOZA, SABRINA PSYD	12/17/2023	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	520 CHADBOURNE RD	None	FAIRFIELD	CA	94534	0000	48	06095	38.235248	-122.0817079	Solano County
137681	Fee-for-Service	1467694745	1467694745	1	1	EMILY GERSTMAN M.D.	11/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	939 HARLOW RD	STE 110	SPRINGFIELD	OR	97477	1190	00	None	44.06977851	-123.0418746	Lane County
137743	Fee-for-Service	1225187099	1225187099	1	1	ETIWANDA ELEMENTARY SD	11/4/2002	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	6061 EAST AVE	None	ETIWANDA	CA	91739	2218	36	06071	34.14421719	-117.514554	San Bernardino County
137779	Fee-for-Service	1467442897	1467442897	1	1	ENGINEER, DAIZY MD	8/1/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	80913	40	Pediatrics	0	In state provider	None	26991 CROWN VALLEY PKWY	None	MISSION VIEJO	CA	92691	6528	30	06059	33.56210341	-117.6694207	Orange County
137832	Fee-for-Service	1962448795	1962448795	1	1	ERIK PENNER MD	10/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	413 LILLY RD NE	None	OLYMPIA	WA	98506	0000	00	None	47.052801	-122.847462	Thurston County
137835	Fee-for-Service	1962907840	1962907840	1	1	ETCHISON, ASHLEY R MD	5/22/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184419	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
137903	Fee-for-Service	1235231598	1235231598	1	1	EYE PHYSICIANS OF LONG	2/15/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	BEACH A MED GROUP INC	3325 PALO VERDE AVE	STE 103	LONG BEACH	CA	90808	4132	19	06037	33.81701249	-118.1078791	Los Angeles County
137953	Fee-for-Service	1124461322	1124461322	1	1	ECK, IVAN N DO	2/2/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	20041	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
138088	Fee-for-Service	1700274743	1700274743	1	1	ESQUENAZI, JACOB MD	6/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
138122	Fee-for-Service	1558522094	1558522094	1	1	ECKROTH-BERNARD, KAMELL R MD	7/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102660	02	General Surgery	0	In state provider	None	1247 EAST ALLUVIAL AVE	STE 101	FRESNO	CA	93720	2686	10	06019	36.84470048	-119.7606195	Fresno County
138164	Fee-for-Service	1437103942	1437103942	1	4	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
138168	Fee-for-Service	1528032562	1528032562	1	1	ETEMAD, HOSSEIN A MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50563	20	Orthopedic Surgery	0	In state provider	None	200 MEDICAL PLAZA STE 14	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
138181	Fee-for-Service	1821262858	1821262858	1	1	ETHNASIOS, RAMEZ, A MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111125	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
138201	Fee-for-Service	1891209813	1891209813	1	1	ETCHER, KATIE M PT	3/8/2023	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
138285	Fee-for-Service	1013335355	1013335355	1	1	EMERUWA, IHEANACHO O MD	4/29/2021	207RP1001X	NA	Pulmonology	026	PHYSICIANS	154224	None	None	0	In state provider	None	200 MEDICAL PLAZA	265	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
138297	Fee-for-Service	1063441293	1063441293	1	1	EMANATE HEALTH MEDICAL	12/1/1977	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
138298	Fee-for-Service	1689872418	1689872418	1	1	ENGEL, LINDA L LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
138458	Fee-for-Service	1437103942	1437103942	1	4	EMERGENCY & ACUTE CARE	10/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
138528	Fee-for-Service	1922206283	1922206283	1	1	EASTWEST PHYSICAL THERAPY	1/21/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	5153 HOLT BLVD	A-1	MONTCLAIR	CA	91763	4837	36	06071	34.0631015	-117.692694	San Bernardino County
138547	Fee-for-Service	1043996069	1043996069	1	1	ELEVATED TRANSPORT SERVICES	11/10/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC	155 E. CAMPBELL AVE	SUITE 100	CAMPBELL	CA	95008	3016	43	06085	37.28709998	-121.9470958	Santa Clara County
138584	Fee-for-Service	1063441293	1063441293	1	1	EMANATE HEALTH MEDICAL	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
138669	Fee-for-Service	1285820316	1285820316	1	1	ESPINOZA, TOMAS R MD	3/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101529	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
138677	Fee-for-Service	1659934974	1659934974	1	1	EL MONTE SNF LLC	5/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3111 SANTA ANITA AVE	None	EL MONTE	CA	91733	1357	19	06037	34.06446511	-118.0427563	Los Angeles County
138698	Fee-for-Service	1184332892	1184332892	1	1	ELITE HOME CARE GROUP LLC	12/15/2022	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	9655 GRANITE RIDGE DR	STE 200	SAN DIEGO	CA	92123	2676	37	06073	32.80652495	-117.1200582	San Diego County
138702	Fee-for-Service	1427694512	1427694512	1	1	EAGLE CARE LLC	10/26/2021	172A00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	9245 LAGUNA SPRINGS DR	200	ELK GROVE	CA	95758	7987	34	06067	38.422494	-121.3965495	Sacramento County
138722	Fee-for-Service	1265611362	1265611362	1	1	EBILANE ANANIAS E MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34021	01	General Practice	0	In state provider	None	13429 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5803	19	06037	33.91025923	-118.352777	Los Angeles County
138732	Fee-for-Service	1710037353	1710037353	1	1	ERIC MICHAEL PAUL	3/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	None	LITTLE ROCK	AR	72205	6321	00	None	34.744437	-92.3813595	Pulaski County
138773	Fee-for-Service	1912023037	1912023037	1	1	EDDO, LINDA B MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42166	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
138839	Fee-for-Service	1376937821	1376937821	1	1	EILERS, JONATHAN MD	3/1/2024	207R00000X	NA	Other	026	PHYSICIANS	145062	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
138862	Fee-for-Service	1437103942	1437103942	1	8	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	23625 HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
138876	Fee-for-Service	1629556758	1629556758	1	1	EDINBURGH-TAYLOR, MAYA	2/13/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
138889	Fee-for-Service	1821579681	1821579681	1	1	ELATION HOME HEALTH INC	7/10/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	333 N SANTA ANITA AVE	SUITE 15	ARCADIA	CA	91006	2812	19	06037	34.14447	-118.031608	Los Angeles County
138909	Fee-for-Service	1497151633	1497151633	1	1	ED & AR HOSPICE CARE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	16933 PARTHENIA ST	SUITE 205	NORTHRIDGE	CA	91343	4552	19	06037	34.22853041	-118.5017033	Los Angeles County
138931	Fee-for-Service	1750587887	1750587887	1	1	ECKLUND, KIER J MD	8/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84117	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
139018	Fee-for-Service	1205006012	1205006012	1	1	ESTELLA, JOEY A LMFT	7/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	219 N. INDIAN HILL BLVD.	SUITE 202A	CLAREMONT	CA	91711	0121	19	06037	34.09604729	-117.71934	Los Angeles County
139053	Fee-for-Service	1093478554	1093478554	1	1	EVANGELISTA, TRISHA NOREEN	5/24/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1301 E BIDWELL ST	#101	FOLSOM	CA	95630	3452	34	06067	38.66841	-121.151025	Sacramento County
139058	Fee-for-Service	1184272759	1184272759	1	1	EVANGELISTA, EDIL NP	11/25/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25470 MEDICAL CENTER DR	SUITE 201	MURRIETA	CA	92562	4900	33	06065	33.55723646	-117.1859554	Riverside County
139067	Fee-for-Service	1851631642	1851631642	1	1	EMMONS, DEBI M LMFT	8/30/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3559 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	1763	49	06097	38.47813376	-122.7279674	Sonoma County
139109	Fee-for-Service	1740238278	1740238278	1	1	EASLEY, ARTHUR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
139152	Fee-for-Service	1437103942	1437103942	1	8	EMERGENCY & ACUTE CARE	10/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	23625 HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
139194	Fee-for-Service	1497151633	1497151633	1	1	ED & AR HOSPICE CARE, INC	2/10/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	16933 PARTHENIA ST	SUITE 205	NORTHRIDGE	CA	91343	4552	19	06037	34.22853041	-118.5017033	Los Angeles County
139229	Fee-for-Service	1235395682	1235395682	1	1	EMERY UNIFIED SD	4/1/2007	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	4727 SAN PABLO AVE	None	EMERYVILLE	CA	94608	3035	01	06001	37.83602155	-122.2815649	Alameda County
139230	Fee-for-Service	1477846186	1477846186	1	1	ELLIS, CHRISTINE L LCSW	12/21/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
139280	Fee-for-Service	1568036366	1568036366	1	1	EMERGENCY PHYSICIANS URGENT	10/15/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	761 WEST SHAW AVE	None	CLOVIS	CA	93612	3217	10	06019	36.80859652	-119.7268065	Fresno County
139331	Fee-for-Service	1316462724	1316462724	1	1	EZEAMAMA, UJU P MD	10/19/2020	207R00000X	NA	Other	026	PHYSICIANS	163353	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
139366	Fee-for-Service	1538555255	1538555255	1	1	EVERLASTING HEALTHCARE	6/19/2015	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1603 ROYWOOD DRIVE	None	LANCASTER	CA	93535	6731	19	06037	34.6889729	-118.1013275	Los Angeles County
139374	Fee-for-Service	1720244601	1720244601	1	1	EDWARDS, MONTESSA L MD	4/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111214	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
139405	Fee-for-Service	1790826394	1790826394	1	1	ESCHE, CLEMENS MD	1/10/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	163030	None	None	0	In state provider	None	57463 29 PALMS HWY	201	YUCCA VALLEY	CA	92284	2925	36	06071	34.12447835	-116.4106891	San Bernardino County
139549	Fee-for-Service	1861409823	1861409823	1	1	EL CENTRO REGIONAL MEDICAL	12/1/1977	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
139594	Fee-for-Service	1437103942	1437103942	1	14	EMERGENCY & ACUTE CARE	2/12/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
139615	Fee-for-Service	1982905055	1982905055	1	2	EIDE, MICHAEL LMFT	2/13/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
139669	Fee-for-Service	1033411434	1033411434	1	1	EMMERT, MELISSA A PHD	8/21/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5755 COTTLE ROAD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
139690	Fee-for-Service	1205988656	1205988656	1	1	EM, MAKKASEN OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12501 IMPERIAL HWY	STE 400	NORWALK	CA	90650	1419	19	06037	33.91723852	-118.065834	Los Angeles County
139693	Fee-for-Service	1689849945	1689849945	1	1	EVANS, AKE S MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103068	25	Physical Medicine and Rehabilitation	0	In state provider	None	135 CARMEN LANE	None	SANTA MARIA	CA	93458	7729	42	06083	34.92484952	-120.4374645	Santa Barbara County
139730	Fee-for-Service	1629020755	1629020755	1	2	EZRA, JOSEPH MD	1/8/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	31354	36	Psychiatry	0	In state provider	None	18646 OXNARD ST	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
139738	Fee-for-Service	1275093221	1275093221	1	1	ERICKSON, JESSICA D MD	9/21/2022	207R00000X	NA	Other	026	PHYSICIANS	177327	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
139814	Fee-for-Service	1992781843	1992781843	1	1	EVERHART,FLOYD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12605 E 16TH AVE	None	AURORA	CO	80045	0000	00	None	39.742182	-104.8408515	Adams County
139826	Fee-for-Service	1114371481	1114371481	1	2	EMAD IBRAHIM MD INC	5/2/2019	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	255 TERRACINA BLVD	SUITE 104-B	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
139835	Fee-for-Service	1972138584	1972138584	1	1	EQUINOX HOSPICE INC	1/12/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6621 VAN NUYS BLVD	STE 115	VAN NUYS	CA	91405	4673	19	06037	34.19138471	-118.4487668	Los Angeles County
139836	Fee-for-Service	1861409823	1861409823	1	1	EL CENTRO REGIONAL MEDICAL	12/1/1977	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
139881	Fee-for-Service	1437103942	1437103942	1	14	EMERGENCY & ACUTE CARE	9/23/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
139893	Fee-for-Service	1255494506	1255494506	1	1	EPSTEIN, ELIZABETH S LCSW	12/11/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE AVENUE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
139926	Fee-for-Service	1114923919	1114923919	1	1	EASTERN PLUMAS HEALTH CARE	12/4/1995	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	PORTOLA	480 1ST AVE	None	PORTOLA	CA	96122	9405	32	06063	39.80603471	-120.463888	Plumas County
139940	Fee-for-Service	1194954677	1194954677	1	1	ELIASIEH, KASRA MD	3/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132513	None	None	0	In state provider	None	400 29TH STREET	SUITE 315	OAKLAND	CA	94609	3522	01	06001	37.81784861	-122.2652263	Alameda County
139944	Fee-for-Service	1861471385	1861471385	1	1	EWERT, TODD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5633 N LIDGERWOOD ST	None	SPOKANE	WA	99208	1224	00	None	47.709423	-117.406944	Spokane County
140002	Fee-for-Service	1972091353	1972091353	1	1	EDMOND, KELLI OT	2/7/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	848 LANCASTER BLVD	STE 102	LANCASTER	CA	93534	2347	19	06037	34.69727236	-118.1462398	Los Angeles County
140050	Fee-for-Service	1487659637	1487659637	1	1	ESLAMI-FARSANI, MAHMOUD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62348	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	700 N TUSTIN AVE	None	SANTA ANA	CA	92705	3602	30	06059	33.75128487	-117.834205	Orange County
140070	Fee-for-Service	1093715542	1093715542	1	1	EGGERT, JOAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	544 S 400 E	None	ST GEORGE	UT	84770	3705	00	None	37.09902122	-113.5748483	Washington County
140114	Fee-for-Service	1780043224	1780043224	1	1	EGWU, JOY CNP	12/22/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8491 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90069	4218	19	06037	34.08988507	-118.3757716	Los Angeles County
140122	Fee-for-Service	1588808927	1588808927	1	1	EXPERT CARE HOSPICE INC	5/10/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7617 LOUISE AVE	SUITE A	NORTHRIDGE	CA	91325	4523	19	06037	34.208946	-118.509866	Los Angeles County
140123	Fee-for-Service	1972138584	1972138584	1	1	EQUINOX HOSPICE INC	1/12/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6621 VAN NUYS BLVD	STE 115	VAN NUYS	CA	91405	4673	19	06037	34.19138471	-118.4487668	Los Angeles County
140161	Fee-for-Service	1518112606	1518112606	1	1	ESLAO, OMAR A MD	4/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	116494	36	Psychiatry	0	In state provider	None	43112 15TH STREET WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
140184	Fee-for-Service	1285712257	1285712257	1	1	EBADI, MOJGAN MD	8/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	61584	41	Internal Medicine	0	In state provider	None	1186 BRITTAN AVE	None	SAN CARLOS	CA	94070	3929	41	06081	37.5001262	-122.253359	San Mateo County
140193	Fee-for-Service	1841700010	1841700010	1	1	EVANS, SYDNEY	2/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
140215	Fee-for-Service	1114923919	1114923919	1	1	EASTERN PLUMAS HEALTH CARE	12/4/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	PORTOLA	480 1ST AVE	None	PORTOLA	CA	96122	9405	32	06063	39.80603471	-120.463888	Plumas County
140218	Fee-for-Service	1316043177	1316043177	1	1	EVELYN AND FLICKINGER	2/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
140274	Fee-for-Service	1053869073	1053869073	1	1	EDWARDS, ADA R NP	5/16/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
140309	Fee-for-Service	1326158247	1326158247	1	1	EZE CORDELIA	2/27/2007	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	UJ MEDICAL SUPPLY	1315 N BULLIS RD	STE 12 RM E F	COMPTON	CA	90221	1650	19	06037	33.90520155	-118.2072299	Los Angeles County
140339	Fee-for-Service	1487659637	1487659637	1	1	ESLAMI-FARSANI, MAHMOUD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62348	41	Internal Medicine	0	In state provider	None	700 N TUSTIN AVE	None	SANTA ANA	CA	92705	3602	30	06059	33.75128487	-117.834205	Orange County
140363	Fee-for-Service	1306623913	1306623913	1	1	EVANS, ALEXANDRA L DOULA	9/13/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
140396	Fee-for-Service	1386696466	1386696466	1	1	ELIZONDO, MARGARET V MD	3/31/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	71918	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
140408	Fee-for-Service	1588808927	1588808927	1	1	EXPERT CARE HOSPICE INC	5/10/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7617 LOUISE AVE	SUITE A	NORTHRIDGE	CA	91325	4523	19	06037	34.208946	-118.509866	Los Angeles County
140410	Fee-for-Service	1790990752	1790990752	1	1	ELLIOTT, BRIAN J DO	10/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	101 CIVIC CENTER LN	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
140502	Fee-for-Service	1265498729	1265498729	1	1	EICHLER, CHARLES M MD	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	39626	02	General Surgery	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
140530	Fee-for-Service	1831888684	1831888684	1	1	EUROFINS DIATHERIX LABORATOR	11/10/2023	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	IES LLC	12701 PLANTSIDE DR	None	LOUISVILLE	KY	40299	6388	00	None	38.21099563	-85.52270182	Jefferson County
140546	Fee-for-Service	1023039815	1023039815	1	1	EUBANKS, HAYWARD L MD	10/19/2010	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	54388	04	Otology, Laryngology, Rhinology	0	In state provider	None	4477 W 118TH ST	SUITE 205	HAWTHORNE	CA	90250	2257	19	06037	33.92734752	-118.354221	Los Angeles County
140591	Fee-for-Service	1063441293	1063441293	1	5	EMANATE HEALTH MEDICAL	3/10/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1135 S SUNSET AVE	SUITE 401	WEST COVINA	CA	91790	3921	19	06037	34.06215064	-117.9453997	Los Angeles County
140635	Fee-for-Service	1760630669	1760630669	1	1	ELLISON, JON G MD	4/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117199	30	Radiology	0	In state provider	None	8881 FLETCHER PARKWAY	SUITE 102	LA MESA	CA	91942	3129	37	06073	32.78442148	-117.0073814	San Diego County
140726	Fee-for-Service	1386813103	1386813103	1	2	EL-BERSHAWI MEDICAL CORP	6/29/2009	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4234 RIVERWALK PKWY	SUITE 230	RIVERSIDE	CA	92505	3312	33	06065	33.90290859	-117.4941562	Riverside County
140767	Fee-for-Service	1801834312	1801834312	1	1	EASTLAKE SLEEP CTR INC	7/11/2007	261QS1200X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	841 KUHN DR	STE 201	CHULA VISTA	CA	91914	4523	37	06073	32.65289649	-116.9665862	San Diego County
140787	Fee-for-Service	1467742213	1467742213	1	1	EVERSON, RICHARD G MD	11/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	115786	14	Neurological Surgery	0	In state provider	None	300 STEIN PLAZA	STE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06482846	-118.4443432	Los Angeles County
140898	Fee-for-Service	1407457658	1407457658	1	1	ELLIS, MEGAN M LMFT	12/28/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
140934	Fee-for-Service	1548342157	1548342157	1	1	EDMONDS, HARVEY L MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	24725	13	Neurology (M.D. only)	0	In state provider	FRESNO NEUROLOGICAL	728 E BULLARD AVE	STE 104	FRESNO	CA	93710	5475	10	06019	36.82313167	-119.7742743	Fresno County
140994	Fee-for-Service	1801560180	1801560180	1	1	EDYBURN, KELLY L PHD	8/7/2023	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
141125	Fee-for-Service	1801946116	1801946116	1	1	EMMRICH, AIMEE M LPCC	11/4/2024	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
141135	Fee-for-Service	1699886903	1699886903	1	1	EDELMAN, ALAN S MD	8/31/1989	207T00000X	NA	General Surgery	026	PHYSICIANS	46751	14	Neurological Surgery	0	In state provider	BLDG C, SUITE 2	821 E CHAPEL ST	STE 204	SANTA MARIA	CA	93545	4619	42	06083	34.95428347	-120.4236585	Santa Barbara County
141140	Fee-for-Service	1720187800	1720187800	1	1	EPNER, STEVEN L MD	6/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	78907	None	None	0	In state provider	None	1940 EL CAJON BLVD	None	SAN DIEGO	CA	92104	1005	37	06073	32.75537745	-117.1446525	San Diego County
141159	Fee-for-Service	1548248776	1548248776	1	1	EDWARDS, JOSEPH T MD	1/6/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	35955	09	Gynecology (D.O. only)	0	In state provider	None	2888 LONG BEACH BLVD	STE 400	LONG BEACH	CA	90806	1530	19	06037	33.809706	-118.189343	Los Angeles County
141215	Fee-for-Service	1609954296	1609954296	1	1	EASTER, WAYNE L	12/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	52086	40	Pediatrics	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
141229	Fee-for-Service	1477632750	1477632750	1	1	EL BAZOUNI, HADI MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	325 N STATE OF FRANKLIN	None	JOHNSON CITY	TN	37604	6062	00	None	36.306585	-82.3877955	Washington County
141411	Fee-for-Service	1689890808	1689890808	1	1	EDRIS, AHMAD MD	9/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98251	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
141416	Fee-for-Service	1104596170	1104596170	1	1	EXTENSIVE HOME HEALTH CARE	7/19/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	9602 LAS TUNAS DR	STE 201	TEMPLE CITY	CA	91780	2150	19	06037	34.10664097	-118.0607679	Los Angeles County
141447	Fee-for-Service	1548248776	1548248776	1	1	EDWARDS, JOSEPH T MD	1/6/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	35955	15	Obstetrics (D.O. only)	0	In state provider	None	2888 LONG BEACH BLVD	STE 400	LONG BEACH	CA	90806	1530	19	06037	33.809706	-118.189343	Los Angeles County
141457	Fee-for-Service	1871830364	1871830364	1	1	ESQUIVEL, SVETLANA M LCSW	9/11/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	777 DAVIS ST	None	SAN LEANDRO	CA	94577	6923	01	06001	37.72317409	-122.162925	Alameda County
141591	Fee-for-Service	1356600688	1356600688	1	1	ESTRADA-GONZALEZ, JOEL	6/21/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	550 FESLER STREET	SUITE G1 G2	EL CAJON	CA	92020	1901	37	06073	32.8088283	-116.9686057	San Diego County
141605	Fee-for-Service	1215968409	1215968409	1	1	ELLIS, ERIC L MD	7/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86317	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
141729	Fee-for-Service	1780635268	1780635268	1	1	ELLMAN,MARK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SOUTHWEST EYE INSTITUTE	1324 NORTH YARBROUGH	DRIVE	EL PASO	TX	79925	0000	00	None	31.75933229	-106.3396901	El Paso County
141829	Fee-for-Service	1164988119	1164988119	1	1	EKTEFAIE, JORDAN	8/1/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	19239 GOLDEN VALLEY RD	None	SANTA CLARITA	CA	91387	1472	19	06037	34.3922042	-118.4672521	Los Angeles County
141933	Fee-for-Service	1144200932	1144200932	1	1	ENDRES, JONATHAN M MD	12/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109415	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
142051	Fee-for-Service	1285812024	1285812024	1	1	ELK GROVE URGENT CARE INC	3/19/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9045 BRUCEVILLE RD	SUITE 100	ELK GROVE	CA	95758	5948	34	06067	38.429289	-121.4169885	Sacramento County
142075	Fee-for-Service	1700073103	1700073103	1	1	EDILLON, EDWIN L MD	2/22/1982	193400000X	NA	Other	026	PHYSICIANS	38045	01	General Practice	0	In state provider	SUNSET MEDICAL CLINIC	222 N SUNSET AVE	STE F	WEST COVINA	CA	91790	3400	19	06037	34.07397524	-117.9354429	Los Angeles County
142086	Fee-for-Service	1508909557	1508909557	1	1	ESCUE, ANN C PSYD	3/4/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2401 E KATELLA AVE	625	ANAHEIM	CA	92806	5995	30	06059	33.80588529	-117.8828675	Orange County
142137	Fee-for-Service	1427016120	1427016120	1	2	EYECARE MEDICAL CORP	7/16/2018	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	PORATION	19038 NORWALK BLVD	None	ARTESIA	CA	90701	7032	19	06037	33.85727707	-118.0722655	Los Angeles County
142241	Fee-for-Service	1881869741	1881869741	1	1	ESCALONA, MARIA E MD	5/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	100986	15	Obstetrics (D.O. only)	0	In state provider	None	1617 N CALIFORNIA ST	STE 2A	STOCKTON	CA	95204	6617	39	06077	37.9697906	-121.2890104	San Joaquin County
142278	Fee-for-Service	1205877156	1205877156	1	1	ENLOE PRIMARY PHYSICIANS	8/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	5TH & ESPLANADE	None	CHICO	CA	95926	3226	04	06007	39.741948	-121.848921	Butte County
142301	Fee-for-Service	1891322483	1891322483	1	1	ELDEAN, KATHERINE J LMFT	3/27/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
142372	Fee-for-Service	1457879744	1457879744	2	1	ELIJAH, CHERRISE L LCSW	11/21/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ELLNESS	12204 CEDAR AVENUE	None	HAWTHORNE	CA	90250	4043	19	06037	33.92174801	-118.3492518	Los Angeles County
142420	Fee-for-Service	1144315896	1144315896	2	1	EMJ PHARMACY CORPORATION	6/1/2018	3336C0004X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	665 CAMINO DE LOS MARES	STE 101	SAN CLEMENTE	CA	92673	2840	30	06059	33.45730192	-117.6483252	Orange County
142428	Fee-for-Service	1427016120	1427016120	1	2	EYECARE MEDICAL CORP	7/25/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PORATION	19038 NORWALK BLVD	None	ARTESIA	CA	90701	7032	19	06037	33.85727707	-118.0722655	Los Angeles County
142431	Fee-for-Service	1023207594	1023207594	1	1	ENVUE OPTOMETRY INC	3/18/1994	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8450 VALLEY BLVD	STE 110	ROSEMEAD	CA	91770	1680	19	06037	34.08038284	-118.0848722	Los Angeles County
142443	Fee-for-Service	1376508366	1376508366	1	1	EMERGENCY AMBULANCE SCV	1/1/1979	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3200 E BIRCH ST	STE A	BREA	CA	92821	6287	30	06059	33.91829149	-117.852966	Orange County
142468	Fee-for-Service	1154585883	1154585883	1	1	ESTRELLITA OLEA	9/15/2008	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	ESTRELLITA OLEA	8830 JERIDA LANE	None	FAIR OAKS	CA	95628	5470	34	06067	38.659032	-121.229433	Sacramento County
142517	Fee-for-Service	1528465028	1528465028	1	1	E.Z. LIFE MEDICAL SUPPLY INC	4/28/2016	332B00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	18149 VENTURA BLVD	None	TARZANA	CA	91356	3616	19	06037	34.16606244	-118.5291524	Los Angeles County
142535	Fee-for-Service	1780186817	1780186817	1	1	ENGELSKIRGER, JACOB F PSYD	4/14/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
142541	Fee-for-Service	1386160810	1386160810	1	1	EASYACCESS MEDICAL GROUP, IN	6/3/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	C	222 E COLE BLVD	B	CALEXICO	CA	92231	3211	13	06025	32.69391949	-115.495038	Imperial County
142728	Fee-for-Service	1508905266	1508905266	1	1	EBONY COUNSELING CENTER	12/16/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1301 & 1315 CALIFORNIA A	None	BAKERSFIELD	CA	93304	1405	15	06029	35.36838609	-119.0169895	Kern County
142739	Fee-for-Service	1255992731	1255992731	1	1	EVERSON, REECE A DPM	6/17/2022	208600000X	NA	General Surgery	027	PODIATRISTS	-	None	None	0	In state provider	None	299 W FOOTHILL BLVD	124	UPLAND	CA	91786	3854	36	06071	34.10706753	-117.6550335	San Bernardino County
142835	Fee-for-Service	1750842076	1750842076	1	2	ERSNO EROMO, MD INC	11/3/2023	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	None	1400 S GRAND AVE	STE 707	LOS ANGELES	CA	90015	2881	19	06037	34.03692236	-118.2655238	Los Angeles County
142864	Fee-for-Service	1437315108	1437315108	1	1	EXPRESS SERVICES HEALTHCARE	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14429 VENTURA BLVD	STE 103	SHERMAN OAKS	CA	91423	2676	19	06037	34.15069547	-118.4471619	Los Angeles County
142999	Fee-for-Service	1497057152	1497057152	1	1	ELDRIDGE, ALAN D	4/12/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
143098	Fee-for-Service	1598156895	1598156895	1	1	ESPIRITU, MAECHELLE D NP	4/27/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
143110	Fee-for-Service	1386853323	1386853323	1	1	ESPIRITU, CHERYL E MD	9/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119326	01	General Practice	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
143126	Fee-for-Service	1750842076	1750842076	1	2	ERSNO EROMO, MD INC	11/3/2023	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	1400 S GRAND AVE	STE 707	LOS ANGELES	CA	90015	2881	19	06037	34.03692236	-118.2655238	Los Angeles County
143153	Fee-for-Service	1417901091	1417901091	1	7	ENLOE MEDICAL CENTER-	9/3/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	MOTHER BABY EDUC CENTER	251 COHASSET ROAD	STE 120	CHICO	CA	95926	2274	04	06007	39.75090044	-121.8522609	Butte County
143272	Fee-for-Service	1518930627	1518930627	1	1	ELLIOTT, SEAN P. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
143304	Fee-for-Service	1144486929	1144486929	1	1	ESKANDER, RAMEZ N MD	5/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102482	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITH DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
143337	Fee-for-Service	1689963845	1689963845	1	2	EMERGENCY PHYSICIANS URGENT	9/29/2020	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	15	06029	35.3687456	-119.1106561	Kern County
143399	Fee-for-Service	1386853323	1386853323	1	1	ESPIRITU, CHERYL E MD	9/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119326	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
143411	Fee-for-Service	1750842076	1750842076	1	2	ERSNO EROMO, MD INC	11/3/2023	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	None	1400 S GRAND AVE	STE 707	LOS ANGELES	CA	90015	2881	19	06037	34.03692236	-118.2655238	Los Angeles County
143610	Fee-for-Service	1437450400	1437450400	1	1	EMERGENCY MEDICINE PHYSICIAN	1/1/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS OF SACRAMENTO	7500 HOSPITAL DRIVE	None	SACRAMENTO	CA	95823	5403	34	06067	38.463381	-121.416183	Sacramento County
143613	Fee-for-Service	1952698078	1952698078	1	1	EXECUTIVE SURGERY CENTER, IN	8/26/2020	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	C.	1320 EL CAPITAN DR	SUITE 100	DANVILLE	CA	94526	6258	07	06013	37.78476866	-121.9658691	Contra Costa County
143619	Fee-for-Service	1316092794	1316092794	1	1	ESPINOSA, ARLENE LMFT	9/28/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4221 WILSHIRE BLVD	STE 230	LOS ANGELES	CA	90010	3519	19	06037	34.06177566	-118.320844	Los Angeles County
143624	Fee-for-Service	1689963845	1689963845	1	2	EMERGENCY PHYSICIANS URGENT	4/9/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	15	06029	35.3687456	-119.1106561	Kern County
143642	Fee-for-Service	1184600108	1184600108	1	1	ENSMINGER, JENNIFER L MD	3/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102699	18	Ophthalmology	0	In state provider	None	6283 CLARK ROAD	STE 10	PARADISE	CA	95969	4100	04	06007	39.7674117	-121.6005321	Butte County
143791	Fee-for-Service	1740716521	1740716521	1	1	EDER, ANKE Z MD	12/21/2019	207P00000X	NA	Other	026	PHYSICIANS	158119	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95242	3635	39	06077	38.12188356	-121.285872	San Joaquin County
143804	Fee-for-Service	1366051120	1366051120	1	1	ELICA HEALTH CENTERS	9/8/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	AFFILIATE	4815 WATT AVE	None	NORTH HIGHLANDS	CA	95660	5108	34	06067	38.653245	-121.3836075	Sacramento County
143838	Fee-for-Service	1427672351	1427672351	1	1	EPPS, MICHELLE T MD	8/20/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
143860	Fee-for-Service	1134731383	1134731383	1	1	EISA, AMA OD	11/30/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
143954	Fee-for-Service	1720462468	1720462468	1	1	ELTON, JENNIFER NP	8/26/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
144081	Fee-for-Service	1275028110	1275028110	1	1	ELUL-JONES, RACHELLE Y NP	12/13/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
144090	Fee-for-Service	1639120827	1639120827	1	1	EKANEY, IRENE M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4911 SANDHILL DR	None	SUGAR LAND	TX	77479	5320	00	None	29.59948264	-95.68213887	Fort Bend County
144091	Fee-for-Service	1366051120	1366051120	1	1	ELICA HEALTH CENTERS	9/8/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATE	4815 WATT AVE	None	NORTH HIGHLANDS	CA	95660	5108	34	06067	38.653245	-121.3836075	Sacramento County
144127	Fee-for-Service	1538545702	1538545702	1	1	ESPINOSA, ARIAM M	2/24/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	522 BROADWAY ST	STE. D	KING CITY	CA	93930	3243	27	06053	36.21109736	-121.1298997	Monterey County
144128	Fee-for-Service	1780781609	1780781609	1	1	EKHOLM, ROBERTA A DO	8/24/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	4668	01	General Practice	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
144353	Fee-for-Service	1043388085	1043388085	1	1	ENGELHARDT, CALE	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
144368	Fee-for-Service	1730250598	1730250598	1	1	EVANS, MARVA L MD	6/21/2000	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	47390	40	Pediatrics	0	In state provider	None	8001 FROST ST	None	SAN DIEGO	CA	92123	2746	37	06073	32.802147	-117.151371	San Diego County
144379	Fee-for-Service	1366051120	1366051120	1	1	ELICA HEALTH CENTERS	9/8/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	AFFILIATE	4815 WATT AVE	None	NORTH HIGHLANDS	CA	95660	5108	34	06067	38.653245	-121.3836075	Sacramento County
144384	Fee-for-Service	1780068213	1780068213	1	1	EL-GABALAWY, FADY M MD	8/16/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	173123	None	None	0	In state provider	None	4640 ADMIRALTY WAY	STE 102	MARINA DEL REY	CA	90292	6629	19	06037	33.98120707	-118.4409729	Los Angeles County
144453	Fee-for-Service	1639103898	1639103898	1	1	ENAD, TERESITA S MD	12/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	49631	41	Internal Medicine	0	In state provider	None	3605 HOSPITAL RD	STE F	ATWATER	CA	95301	5173	24	06047	37.36678073	-120.576731	Merced County
144468	Fee-for-Service	1619278660	1619278660	2	3	EMERGENCY MEDICINE PHYSICIAN	2/4/2025	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	PARTNERS OF EL DORADO C	1100 MARSHALL WAY	None	PLACERVILLE	CA	95667	6533	09	06017	38.72453536	-120.7921649	El Dorado County
144503	Fee-for-Service	1508049297	1508049297	1	2	EXCEED HOME HEALTH INC	2/8/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	20121 VENTURA BLVD	STE 317	WOODLAND HILLS	CA	91364	2559	19	06037	34.17068268	-118.5718406	Los Angeles County
144565	Fee-for-Service	1992871578	1992871578	1	1	ENGBRETSON, MICHAEL R	3/8/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2321 COURT ST	None	REDDING	CA	96001	2527	45	06089	40.57520454	-122.3925566	Shasta County
144614	Fee-for-Service	1093279622	1093279622	1	1	EARTHLY, DEMETRIUS D RCP	7/26/2020	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
144628	Fee-for-Service	1184152613	1184152613	1	1	ERLANDSON, AMANDA C LCSW	5/16/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
144657	Fee-for-Service	1912227125	1912227125	1	1	EVANS, TYLER B MD	2/16/2021	2083P0901X	NA	Adult Primary Care	026	PHYSICIANS	148240	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
144658	Fee-for-Service	1366051120	1366051120	1	8	ELICA HEALTH CENTERS	3/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1750 WRIGHT STREET	STE 1	SACRAMENTO	CA	95825	4041	34	06067	38.597742	-121.4057385	Sacramento County
144761	Fee-for-Service	1699394809	1699394809	1	1	EMONT, JORDAN	6/14/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	192120	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
144860	Fee-for-Service	1497969638	1497969638	1	1	EAST VALLEY ADULT DAY HEALTH	2/17/2014	251S00000X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	CARE CENTER INC	8612 VAN NUYS BLVD	None	PANORAMA CITY	CA	91402	2913	19	06037	34.22647917	-118.4494624	Los Angeles County
144882	Fee-for-Service	1841403029	1841403029	1	1	ENAYATI, PEDRAM MD	8/13/2011	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	91106	10	Gastroenterology (M.D. only)	0	In state provider	None	6222 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90048	5123	19	06037	34.06325771	-118.3641574	Los Angeles County
144915	Fee-for-Service	1336266493	1336266493	1	1	ELNACHEF, NAJWA MD	4/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102803	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94123	2202	38	06075	37.76344756	-122.4581992	San Francisco County
144947	Fee-for-Service	1366051120	1366051120	1	8	ELICA HEALTH CENTERS	3/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1750 WRIGHT STREET	STE 1	SACRAMENTO	CA	95825	4041	34	06067	38.597742	-121.4057385	Sacramento County
144981	Fee-for-Service	1043387996	1043387996	1	1	EVANS, JAMES R MD	3/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	53027	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
144997	Fee-for-Service	1174853832	1174853832	1	1	ELDRED, ALYSE A LMFT	8/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5150 E PACIFIC COAST HWY	SUITE 200	LONG BEACH	CA	90804	3399	19	06037	33.7831762	-118.1333125	Los Angeles County
145097	Fee-for-Service	1114371481	1114371481	1	1	EMAD IBRAHIM MD INC	5/2/2019	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	350 TERRACINA BLVD.	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
145115	Fee-for-Service	1184342099	1184342099	1	1	EXCELLENCE COMMUNITY	10/25/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION PROGRAM	37025 LA CONTEMPO AVE	None	PALMDALE	CA	93550	7351	19	06037	34.55495656	-118.1007888	Los Angeles County
145170	Fee-for-Service	1225587074	1225587074	1	1	EASTVALE ACUPUNCTURE AND HER	1/14/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	BS, INC.	800 MAGNOLIA AVE.	SUITE 114	CORONA	CA	92879	3123	33	06065	33.85979137	-117.5527252	Riverside County
145172	Fee-for-Service	1841403029	1841403029	1	1	ENAYATI, PEDRAM MD	8/13/2011	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	91106	41	Internal Medicine	0	In state provider	None	6222 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90048	5123	19	06037	34.06325771	-118.3641574	Los Angeles County
145203	Fee-for-Service	1336266493	1336266493	1	1	ELNACHEF, NAJWA MD	4/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102803	10	Gastroenterology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94123	2202	38	06075	37.76344756	-122.4581992	San Francisco County
145250	Fee-for-Service	1023125788	1023125788	1	1	EAST BAY WOMEN'S HEALTH	2/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	INC	3300 WEBSTER ST	STE 1200	OAKLAND	CA	94609	3126	01	06001	37.82132826	-122.2621843	Alameda County
145268	Fee-for-Service	1043387996	1043387996	1	1	EVANS, JAMES R MD	3/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	53027	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
145282	Fee-for-Service	1205940657	1205940657	1	1	EL-SIOUFI, SHERENE M DO	12/22/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	17349	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
145362	Fee-for-Service	1700240249	1700240249	1	1	EDELMAN, ALEXANDRA B MD	6/15/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	167597	None	None	0	In state provider	None	955 W IMPERIAL HWY	SUITE 110	BREA	CA	92821	3812	30	06059	33.91745451	-117.9133065	Orange County
145494	Fee-for-Service	1952399602	1952399602	1	1	EDDINS, PAUL E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	87769	08	Family Practice	0	In state provider	None	400 E OAK AVE	None	VISALIA	CA	93291	5034	54	06107	36.332253	-119.288691	Tulare County
145504	Fee-for-Service	1063713600	1063713600	1	1	EXPRESS DRUGS	1/15/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9802 STOCKDALE HWY	STE 106B	BAKERSFIELD	CA	93311	3653	15	06029	35.3544067	-119.1113372	Kern County
145539	Fee-for-Service	1023125788	1023125788	1	1	EAST BAY WOMEN'S HEALTH	2/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	INC	3300 WEBSTER ST	STE 1200	OAKLAND	CA	94609	3126	01	06001	37.82132826	-122.2621843	Alameda County
145574	Fee-for-Service	1457558884	1457558884	1	1	EISLEY, KARI M MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125376	18	Ophthalmology	0	In state provider	None	3553 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
145608	Fee-for-Service	1437473063	1437473063	1	1	ELENA P GABRIEL & APOLONIO	7/28/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	GABRIEL	1701 W ELM STREET	None	LODI	CA	95242	2916	39	06077	38.13626931	-121.2944139	San Joaquin County
145794	Fee-for-Service	1063441293	1063441293	1	6	EMANATE HEALTH MEDICAL	3/10/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1135 S SUNSET AVE	SUITE 200	WEST COVINA	CA	91790	3921	19	06037	34.06215064	-117.9453997	Los Angeles County
145833	Fee-for-Service	1003249368	1003249368	1	1	EDANO, LOTIS G NP	5/13/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	1750 EAST DESERT INN RD	SUITE 200	LAS VEGAS	NV	89169	3202	00	None	36.12989452	-115.1278065	Clark County
145851	Fee-for-Service	1245276591	1245276591	1	1	ESKER, ALEC H MD	1/25/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	10	Gastroenterology (M.D. only)	1	Border provider	None	1025 W 24TH ST	STE 17	YUMA	AZ	85364	8371	00	None	32.683824	-114.631668	Yuma County
145920	Fee-for-Service	1619093168	1619093168	1	1	EAST VALLEY COMM HLTH CT	5/1/1997	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	680 FAIRPLEX DR	None	POMONA	CA	91768	1100	19	06037	34.06233587	-117.7874742	Los Angeles County
145952	Fee-for-Service	1891990628	1891990628	1	1	EVANS, CHRISTOPHER S PHD	7/16/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
145969	Fee-for-Service	1174010888	1174010888	1	1	EKE, UCHENNA NP	12/20/2024	363LG0600X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	30	06059	33.62609529	-117.7293191	Orange County
146016	Fee-for-Service	1417901091	1417901091	1	13	ENLOE MEDICAL CENTER-	1/10/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1430 ESPLANADE	SUITE 6	CHICO	CA	95926	3366	04	06007	39.74156774	-121.8480966	Butte County
146046	Fee-for-Service	1164502365	1164502365	1	1	EL-GOHARY, HUSSAM MD INC	6/28/1995	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	37602	25	Physical Medicine and Rehabilitation	0	In state provider	None	2001 DWIGHT WAY	# 2350	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
146059	Fee-for-Service	1275793937	1275793937	1	1	ESPEJO, JAY B MD	10/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111413	08	Family Practice	0	In state provider	None	6041 CADILLAC AVENUE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
146090	Fee-for-Service	1508850652	1508850652	1	1	ENG, RICHARD S MD	1/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	42226	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2360 MCKEE RD	STE 7	SAN JOSE	CA	95116	1618	43	06085	37.36657971	-121.8479925	Santa Clara County
146097	Fee-for-Service	1346655396	1346655396	1	1	ESTRADA, DANIEL K MD	7/3/2023	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	140441	None	None	0	In state provider	None	13855 14TH ST	None	SAN LEANDRO	CA	94578	2611	01	06001	37.712385	-122.143428	Alameda County
146105	Fee-for-Service	1861409823	1861409823	1	2	EL CENTRO REGIONAL MEDICAL	1/17/2019	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	1271 ROSS AVE	None	EL CENTRO	CA	92243	4304	13	06025	32.78145047	-115.5673098	Imperial County
146138	Fee-for-Service	1124345376	1124345376	1	1	ERMENTROUT, ROBERT M MD	1/20/2025	2085R0204X	NA	Other	026	PHYSICIANS	118012	30	Radiology	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
146157	Fee-for-Service	1548553233	1548553233	1	1	EDWARDS, CAROLYN LMFT	12/3/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
146352	Fee-for-Service	1831828920	1831828920	1	1	ELIAS, TYLER J LMFT	5/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	128 AUBURN CT	STE 206	WESTLAKE VILLAGE	CA	91362	3652	19	06037	34.16587447	-118.8305499	Ventura County
146378	Fee-for-Service	1508850652	1508850652	1	1	ENG, RICHARD S MD	1/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	42226	04	Otology, Laryngology, Rhinology	0	In state provider	None	2360 MCKEE RD	STE 7	SAN JOSE	CA	95116	1618	43	06085	37.36657971	-121.8479925	Santa Clara County
146526	Fee-for-Service	1821191966	1821191966	1	1	ELLIS, ANNETTE D CRNA	9/19/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	2	Out of state provider	None	EMILE @ 42ND	None	OMAHA	NE	68198	0001	00	None	41.254236	-95.97573	Douglas County
146548	Fee-for-Service	1245233147	1245233147	2	1	ESTRELLA-ITCHON, RHODA G MD	2/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55570	01	General Practice	0	In state provider	None	25495 MEDICAL CENTER DR	SUITE 301	MURRIETA	CA	92562	4904	33	06065	33.55804188	-117.1834064	Riverside County
146779	Fee-for-Service	1275906323	1275906323	1	1	ESCALERA, LAURA LMFT	4/1/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
146827	Fee-for-Service	1982708202	1982708202	1	1	EVAN MAHL	12/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MMC EMERGENCY PHYSICIAN	4802 TENTH AVE	None	BROOKLYN	NY	11219	2916	00	None	40.639365	-73.9986705	Kings County
146931	Fee-for-Service	1801964747	1801964747	1	1	EMOND, CHARLES G JR DO	10/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10377	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
146942	Fee-for-Service	1558855817	1558855817	1	1	EPLER, KATHARINE MD	8/1/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	177414	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
146979	Fee-for-Service	1528277233	1528277233	1	1	ESKANDARI, NAHID MD	2/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102766	08	Family Practice	0	In state provider	None	450 N GREENFIELD AVE	None	HANFORD	CA	93230	0000	16	06031	36.328968	-119.6582195	Kings County
146986	Fee-for-Service	1023340312	1023340312	1	1	ECHIGHIAN, ARSINE MD	7/13/2010	207R00000X	NA	Other	026	PHYSICIANS	110891	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
147104	Fee-for-Service	1508179649	1508179649	1	1	ELECTROMED INC	1/17/2012	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	4590 ISH DR	#150	SIMI VALLEY	CA	93063	7686	56	06111	34.26879842	-118.7062744	Ventura County
147124	Fee-for-Service	1861650756	1861650756	1	1	EMERTON, MIHAL L MD	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116879	08	Family Practice	0	In state provider	None	2200 O'FARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
147171	Fee-for-Service	1356517213	1356517213	1	1	ESHWAR, REENA MD	3/11/2024	207R00000X	NA	Other	026	PHYSICIANS	192451	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
147249	Fee-for-Service	1437645108	1437645108	1	1	ETAEE, FARSHID MD	11/16/2023	207R00000X	NA	Other	026	PHYSICIANS	191349	None	None	0	In state provider	None	800 S CENTRAL AVE	STE 305A	GLENDALE	CA	91204	4644	19	06037	34.13654729	-118.2578243	Los Angeles County
147273	Fee-for-Service	1194385898	1194385898	1	1	ELMES, RUSSELL MD	6/6/2024	207P00000X	NA	Other	026	PHYSICIANS	-	70	Clinic (mixed specialty)	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
147294	Fee-for-Service	1780946863	1780946863	1	1	EWERT, ANDREA MARIE	12/5/2013	332BX2000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	4049 N FREEWAY BLVD	None	SACRAMENTO	CA	95834	1253	34	06067	38.64283491	-121.4788462	Sacramento County
147351	Fee-for-Service	1174682835	1174682835	1	1	EXUME, AMILCAR A MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	55133	02	General Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
147384	Fee-for-Service	1972064798	1972064798	1	1	ENAMANDRAM, SHEILA S MD	4/2/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	181155	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
147560	Fee-for-Service	1679830285	1679830285	1	1	EK PHARMACY SOLUTIONS INC	5/21/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	420 E 3RD ST	SUITE 106	LOS ANGELES	CA	90013	1645	19	06037	34.04702011	-118.241912	Los Angeles County
147600	Fee-for-Service	1518456896	1518456896	1	1	ESPIRITU, HERSCHEL ANGELA M	2/17/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17717	None	None	0	In state provider	MD	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
147638	Fee-for-Service	1255411609	1255411609	1	1	ENG, GILBERT P MD	1/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87470	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
147672	Fee-for-Service	1811973902	1811973902	1	1	ELSAYED, M. HANY MD	8/8/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	50101	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
147735	Fee-for-Service	1407465529	1407465529	1	1	ER HOSPICE CARE INC	8/3/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5301 LAUREL CANYON BLVD	SUITE 128	VALLEY VILLAGE	CA	91607	2770	19	06037	34.166907	-118.396546	Los Angeles County
147754	Fee-for-Service	1992117592	1992117592	1	1	ENLOE MEDICAL CENTER	10/23/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	COLORECTAL SURGERY	2 GOVERNOR'S LANE	STE A	CHICO	CA	95926	6300	04	06007	39.75567003	-121.8588553	Butte County
147814	Fee-for-Service	1205053733	1205053733	1	1	EYER, BENJAMIN A MD	8/19/2009	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	95046	30	Radiology	0	In state provider	None	1516 COTNER AVE	None	LOS ANGELES	CA	90025	3303	19	06037	34.04905416	-118.4477438	Los Angeles County
147830	Fee-for-Service	1750533212	1750533212	1	1	EHRESMANN, SONYA M MD	11/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	100206	None	None	0	In state provider	None	3056 FLETCHER DRIVE	None	LOS ANGELES	CA	90065	3753	19	06037	34.11590478	-118.2443234	Los Angeles County
147947	Fee-for-Service	1306445903	1306445903	1	1	ENERJE WELLNESS LICENSED CLI	2/12/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NICAL SOCIAL WORKER, INC	7121 MAGNOLIA AVE	STE O	RIVERSIDE	CA	92504	3805	33	06065	33.9455319	-117.4027101	Riverside County
147971	Fee-for-Service	1164891131	1164891131	1	1	ERIGUEL, JENNIFER M OT	6/4/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
148022	Fee-for-Service	1407465529	1407465529	1	1	ER HOSPICE CARE INC	8/3/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5301 LAUREL CANYON BLVD	SUITE 128	VALLEY VILLAGE	CA	91607	2770	19	06037	34.166907	-118.396546	Los Angeles County
148034	Fee-for-Service	1194283606	1194283606	1	1	E-CARE PHARMACY CORP	11/5/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13063 EUCLID ST	None	GARDEN GROVE	CA	92843	1333	30	06059	33.77287939	-117.9380083	Orange County
148090	Fee-for-Service	1982600920	1982600920	1	1	EASTERN PLUMAS HOSP-	7/1/1989	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PORTOLA CAMPUS	500 1ST AVE	None	PORTOLA	CA	96122	9406	32	06063	39.80595392	-120.4626723	Plumas County
148112	Fee-for-Service	1699981951	1699981951	1	1	ESAU, ANGELA J W MFT	10/24/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	47740	-	NOT APPLICABLE	0	In state provider	None	1885 LUNDY AVENUE	#223	SAN JOSE	CA	95131	1888	43	06085	37.39329538	-121.8907367	Santa Clara County
148128	Fee-for-Service	1679803134	1679803134	1	1	EXPLORER 1 AMBULANCE	7/19/2010	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	SERVICES LLC	1040 E COMPTON BLVD	None	COMPTON	CA	90221	3306	19	06037	33.8959587	-118.2118419	Los Angeles County
148145	Fee-for-Service	1841273752	1841273752	1	1	EL-QOUSY, TAREQ M MD	4/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81776	None	None	0	In state provider	None	847 W CHILDS AVE	None	MERCED	CA	95340	0000	24	06047	37.28825369	-120.4963159	Merced County
148241	Fee-for-Service	1538374160	1538374160	1	1	EDWARDS, ELIJAH M MD	7/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129425	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
148363	Fee-for-Service	1588956916	1588956916	1	1	ELITE PHYSICAL THERAPY AND W	7/1/2011	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ELLNESS CENTER, INC	13637 BURBANK BLVD	None	VAN NUYS	CA	91401	1735	19	06037	34.17215452	-118.4303475	Los Angeles County
148385	Fee-for-Service	1396167813	1396167813	1	1	ELSAYED, MOHAMMED K A	11/7/2013	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	100765	None	None	0	In state provider	PROFESSIONAL CORPORATION	330 OXFORD ST	STE 106	CHULA VISTA	CA	91911	3118	37	06073	32.60985611	-117.0691868	San Diego County
148463	Fee-for-Service	1326135922	1326135922	1	1	EDEN, KATHRYN E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5121 COTTONWOOD ST	None	MURRAY	UT	84107	5701	00	None	40.659588	-111.891798	Salt Lake County
148543	Fee-for-Service	1689011322	1689011322	1	1	EZEKWE, CHIOMA MD	4/8/2025	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
148586	Fee-for-Service	1689975021	1689975021	1	1	ESOTERIX GENETIC LAB	4/5/2011	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	3400 COMPUTER DRIVE	None	WESTBOROUGH	MA	01581	1771	00	None	42.289605	-71.5764555	Worcester County
148595	Fee-for-Service	1588899512	1588899512	1	2	ERICK H ALAYO MC	2/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107506	10	Gastroenterology (M.D. only)	0	In state provider	None	841 KUHN DR	None	CHULA VISTA	CA	91914	4523	37	06073	32.65289649	-116.9665862	San Diego County
148610	Fee-for-Service	1558403733	1558403733	1	1	ETESSAM, ALI PT	4/5/2022	174400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3 CORPORATE PARK	SUITE #165	IRVINE	CA	92606	5161	30	06059	33.69055394	-117.8260389	Orange County
148674	Fee-for-Service	1033759329	1033759329	1	1	EDUARTE, EVA LMFT	5/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
148703	Fee-for-Service	1639429640	1639429640	1	1	ELMI, MITRA H LMFT	7/25/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4701 VON KARMAN AVE	STE 324	NEWPORT BEACH	CA	92660	8145	30	06059	33.66894215	-117.8600003	Orange County
148711	Fee-for-Service	1881856227	1881856227	1	1	ELMORE, PAULLA J MFT	11/7/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	46569	-	NOT APPLICABLE	0	In state provider	None	12420 VENICE BLVD	SUITE 200	LOS ANGELES	CA	90066	3841	19	06037	34.0031666	-118.4344118	Los Angeles County
148715	Fee-for-Service	1023005196	1023005196	1	1	EDWIN RODRIGUEZ-REYES MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	23900 KATY FWY	None	KATY	TX	77494	1323	00	None	29.78594112	-95.78613398	Harris County
148801	Fee-for-Service	1144353384	1144353384	1	1	ELAHI, RASHID MD INC	7/23/2007	261QM2500X	NA	Other	026	PHYSICIANS	54268	45	Nephrology (Renal-Kidney)	0	In state provider	None	200 JOSE FIGUERES AVENUE	SUITE 270	SAN JOSE	CA	95116	1590	43	06085	37.36122014	-121.8505998	Santa Clara County
148884	Fee-for-Service	1588899512	1588899512	1	2	ERICK H ALAYO MC	2/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107506	41	Internal Medicine	0	In state provider	None	841 KUHN DR	None	CHULA VISTA	CA	91914	4523	37	06073	32.65289649	-116.9665862	San Diego County
148906	Fee-for-Service	1750351771	1750351771	1	1	ELLIS, JOHN G MD	2/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	70713	20	Orthopedic Surgery	0	In state provider	None	802 MAGNOLIA AVE	STE 106	CORONA	CA	92879	3125	33	06065	33.8596449	-117.5529774	Riverside County
148924	Fee-for-Service	1154944510	1154944510	1	1	ENCOURAGE HOMES	8/27/2024	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9227 CAYUGA AVE	None	SUN VALLEY	CA	91352	6364	19	06037	34.23726751	-118.399207	Los Angeles County
148972	Fee-for-Service	1588943815	1588943815	1	1	EITZMANN, ANGELA Z LMFT	8/31/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2680 BAYSHORE PARKWAY	411	MOUNTAIN VIEW	CA	94043	1011	43	06085	37.42974564	-122.1003474	Santa Clara County
149005	Fee-for-Service	1265863179	1265863179	1	1	ENLOE MEDICAL CENTER	5/31/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	SPECIALISTS	135 MISSION RANCH BLVD	STE 100	CHICO	CA	95926	2175	04	06007	39.75330715	-121.8611016	Butte County
149036	Fee-for-Service	1033135256	1033135256	1	1	ERHLICH, CARL F MD	5/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55187	04	Otology, Laryngology, Rhinology	0	In state provider	None	12462 PUTNAM STREET	SUITE 303	WHITTIER	CA	90602	1049	19	06037	33.9709236	-118.0460596	Los Angeles County
149088	Fee-for-Service	1144353384	1144353384	1	1	ELAHI, RASHID MD INC	7/23/2007	261QM2500X	NA	Other	026	PHYSICIANS	54268	01	General Practice	0	In state provider	None	200 JOSE FIGUERES AVENUE	SUITE 270	SAN JOSE	CA	95116	1590	43	06085	37.36122014	-121.8505998	Santa Clara County
149217	Fee-for-Service	1184712531	1184712531	1	1	EBERHARDT, WENDY A MD	7/30/2007	2084P0800X	NA	Psychiatry	026	PHYSICIANS	49305	36	Psychiatry	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
149257	Fee-for-Service	1306199898	1306199898	1	1	ELLIOTT, JOHN T MD	2/4/2022	207P00000X	NA	Other	026	PHYSICIANS	123316	None	None	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
149275	Fee-for-Service	1386618304	1386618304	1	1	ESPENAN, PIERRE A MD	9/30/1989	207R00000X	NA	Other	026	PHYSICIANS	42025	01	General Practice	0	In state provider	None	2675 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2926	19	06037	33.9892055	-118.2228885	Los Angeles County
149321	Fee-for-Service	1831624691	1831624691	1	1	ERIC DONAHUE	2/22/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1717 ARLINGTON AVE	None	CALDWELL	ID	83605	4802	00	None	43.654374	-116.694738	Canyon County
149390	Fee-for-Service	1679737795	1679737795	1	1	EVANS, LINDA M PT	2/19/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	425 DIAMOND DR.,	101	LAKE ELSINORE	CA	92530	0000	33	06065	33.65802263	-117.3002985	Riverside County
149399	Fee-for-Service	1144301300	1144301300	1	1	EATON, MARK A MD	5/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	OREGON SURGICAL SPEC PC	520 MEDICAL CENTER DR	STE 300	MEDFORD	OR	97504	4316	00	None	42.318801	-122.831728	Jackson County
149409	Fee-for-Service	1659906790	1659906790	1	1	ESPERANZA RANCH PSYCHOLOGY S	6/25/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	S	3200 E GUASTI RD	SUITE 100	ONTARIO	CA	91761	8660	36	06071	34.06518	-117.5822055	San Bernardino County
149506	Fee-for-Service	1063441293	1063441293	1	4	EMANATE HEALTH MEDICAL	3/10/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1135 S SUNSET AVE	SUITE 401	WEST COVINA	CA	91790	3921	19	06037	34.06215064	-117.9453997	Los Angeles County
149542	Fee-for-Service	1588863716	1588863716	1	1	ELA, THOMAS W MD INC	10/27/2008	2084N0400X	NA	Neurology	026	PHYSICIANS	65793	13	Neurology (M.D. only)	0	In state provider	None	2282 N STATE COLLEGE BL	None	FULLERTON	CA	92831	1362	30	06059	33.897177	-117.891811	Orange County
149650	Fee-for-Service	1265863179	1265863179	1	2	ENLOE MEDICAL CENTER	5/31/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	251 COHASSET ROAD	STE 330	CHICO	CA	95926	2276	04	06007	39.75090044	-121.8522609	Butte County
149665	Fee-for-Service	1861908386	1861908386	1	1	ENNEDY, ASHLEY J DO	8/3/2020	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	17045	None	None	0	In state provider	None	10243 GENETIC CENTER DR	None	SAN DIEGO	CA	92121	6310	37	06073	32.90618683	-117.1814064	San Diego County
149773	Fee-for-Service	1386718609	1386718609	1	1	ELIA, REBECCA L MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	44117	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
149776	Fee-for-Service	1649358359	1649358359	1	1	ERNST, MICHELLE M MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64702	40	Pediatrics	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
149788	Fee-for-Service	1568671774	1568671774	1	1	EDWARD P. & DIANE M. HERNAND	10/28/2009	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	DIANE M OD	15330 AMAR RD	STE A	LA PUENTE	CA	91744	2001	19	06037	34.03714077	-117.9509701	Los Angeles County
149804	Fee-for-Service	1871203273	1871203273	1	1	EDWARDS, TARA E LMFT	7/24/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	135840	-	NOT APPLICABLE	0	In state provider	None	1316 S COAST HWY	None	LAGUNA BEACH	CA	92651	3118	30	06059	33.53236667	-117.7755797	Orange County
149842	Fee-for-Service	1245548700	1245548700	1	1	EUNGDAMRONG, NARAT J MD	5/15/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	147593	None	None	0	In state provider	None	99 N LA CIENEGA BLVD	None	BEVERLY HILLS	CA	90211	2222	19	06037	34.06736471	-118.3763201	Los Angeles County
149851	Fee-for-Service	1578046595	1578046595	1	1	EHFAD, BAHAR PHD	11/26/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	31194 LA BAYA DR	STE 100	WESTLAKE VILLAGE	CA	91362	6420	19	06037	34.15643887	-118.8025233	Los Angeles County
149856	Fee-for-Service	1710335278	1710335278	1	1	ESTRADA VIAMONTES, REINER M	12/16/2019	208M00000X	NA	Other	026	PHYSICIANS	161894	41	Internal Medicine	0	In state provider	D	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
149877	Fee-for-Service	1508971169	1508971169	1	1	EDWARDS, STEPHEN B PT	10/30/2018	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
149960	Fee-for-Service	1568671774	1568671774	1	2	EDWARD P. & DIANE M. HERNAND	12/19/2022	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	EZ	6001 PACIFIC BLVD	128	HUNTINGTON PARK	CA	90255	2950	19	06037	33.9871287	-118.2252886	Los Angeles County
149990	Fee-for-Service	1376922328	1376922328	1	2	EPIPHANY COUNSELING, CONSULT	3/4/2024	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ING & TREATMENT SERVIC	302 W 5TH ST STE 308	None	SAN PEDRO	CA	90731	2750	19	06037	33.73971572	-118.284045	Los Angeles County
150019	Fee-for-Service	1053473157	1053473157	1	1	ELIZABETH A HERSCH	8/25/2011	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	5555 LESA ROAD	None	LA MESA	CA	91942	1705	37	06073	32.77848189	-117.0365405	San Diego County
150077	Fee-for-Service	1841685856	1841685856	1	1	ESTRADA, JEREMY J L MD	8/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155327	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 W LAS POSITAS BLVD	None	PLEASANTON	CA	94588	4000	01	06001	37.69212528	-121.8803442	Alameda County
150163	Fee-for-Service	1144357252	1144357252	1	1	EPIPHANY CARE HOMES INC	7/6/2004	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	994 PHOENIX AVE	None	VENTURA	CA	93004	2207	56	06111	34.27196276	-119.1733213	Ventura County
150211	Fee-for-Service	1811032550	1811032550	1	2	EDWARD A. MENA, M.D., INC	6/22/2021	207RI0008X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	301 SOUTH FAIR OAKS AV	305	PASADENA	CA	91105	2562	19	06037	34.140348	-118.1504565	Los Angeles County
150237	Fee-for-Service	1790965341	1790965341	1	1	EAST BAY RETINA CONSULT	11/4/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	3300 TELEGRAPH AVE	None	OAKLAND	CA	94609	3028	01	06001	37.82176506	-122.266417	Alameda County
150261	Fee-for-Service	1023208311	1023208311	1	1	ELLIOTT, MARIA D LMFT	1/17/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	30263 HORSESHOE DRIVE	None	COARSEGOLD	CA	93614	8856	20	06039	37.1891351	-119.7830928	Madera County
150277	Fee-for-Service	1376922328	1376922328	1	2	EPIPHANY COUNSELING, CONSULT	3/4/2024	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ING & TREATMENT SERVIC	302 W 5TH ST STE 308	None	SAN PEDRO	CA	90731	2750	19	06037	33.73971572	-118.284045	Los Angeles County
150307	Fee-for-Service	1578026407	1578026407	1	1	EMILY JAMES OD INC	1/4/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	22247 MULHOLLAND HWY	None	CALABASAS	CA	91302	5156	19	06037	34.14755037	-118.6125002	Los Angeles County
150373	Fee-for-Service	1093989295	1093989295	1	1	EISDORFER, SETH E MD	8/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
150392	Fee-for-Service	1952546053	1952546053	1	1	EVANS, MICHELE A MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	101579	40	Pediatrics	0	In state provider	None	1900 DRESDEN DRIVE	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
150472	Fee-for-Service	1700967098	1700967098	2	1	ELISHA, JOSEPH O MD	6/4/2012	207L00000X	NA	Other	026	PHYSICIANS	79062	05	Anesthesiology	0	In state provider	None	1117 E DEVONSHIRE AVE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
150482	Fee-for-Service	1114075082	1114075082	1	1	EGAN, JOHN ROBERT MD	2/8/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	5214	10	Gastroenterology (M.D. only)	0	In state provider	None	1441 AVOCADO AVE	STE 807	NEWPORT BEACH	CA	92660	7709	30	06059	33.61338536	-117.8693961	Orange County
150496	Fee-for-Service	1104120054	1104120054	1	1	ELLSTROM, COURTNEY L PT	12/8/2017	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3191 B MISSION INN AVE	None	RIVERSIDE	CA	92507	4138	33	06065	33.98015514	-117.3677324	Riverside County
150499	Fee-for-Service	1699339747	1699339747	1	1	ELDORADO HEALTH	10/8/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14553 DELANO ST	SUITE 318	VAN NUYS	CA	91411	2897	19	06037	34.18266949	-118.450629	Los Angeles County
150522	Fee-for-Service	1700926359	1700926359	1	1	EL DORADO COE	9/15/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	6767 GREEN VALLEY RD	None	PLACERVILLE	CA	95667	8984	09	06017	38.72034462	-120.8664954	El Dorado County
150525	Fee-for-Service	1225241219	1225241219	1	2	EILEEN M LINDER OPTOMETRIST	3/9/2022	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4051 LONE TREE WAY STE E	None	ANTIOCH	CA	94531	6204	07	06013	37.97536168	-121.8003374	Contra Costa County
150557	Fee-for-Service	1699323634	1699323634	1	1	EMERGENCY PHYSICIANS URGENT	1/22/2021	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	6789 N BLACKSTONE AVE	None	FRESNO	CA	93710	3530	10	06019	36.83695148	-119.7904013	Fresno County
150591	Fee-for-Service	1215517008	1215517008	1	1	EMERALD ELDER CARE LLC	12/12/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6997 TREASURE WAY	None	SACRAMENTO	CA	95831	2533	34	06067	38.499696	-121.539933	Sacramento County
150597	Fee-for-Service	1023051281	1023051281	1	1	ELLIOTT, CHRISTIE L MD	2/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	1	Border provider	None	475 KIRMAN AVE	None	RENO	NV	89502	1907	00	None	39.52158339	-119.7984943	Washoe County
150716	Fee-for-Service	1629020755	1629020755	1	1	EZRA, JOSEPH MD	11/10/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	31354	-	NOT APPLICABLE	0	In state provider	None	44447 N 10TH ST	BUILDING B	LANCASTER	CA	93534	3324	19	06037	34.69104127	-118.1480655	Los Angeles County
150768	Fee-for-Service	1144315565	1144315565	1	1	ESPINOZA-LOPEZ, ANGELINA	10/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85984	None	None	0	In state provider	None	3144 SANTA ANITA AVE	None	EL MONTE	CA	91733	1366	19	06037	34.06553046	-118.0426244	Los Angeles County
150769	Fee-for-Service	1114075082	1114075082	1	1	EGAN, JOHN ROBERT MD	2/8/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	5214	41	Internal Medicine	0	In state provider	None	1441 AVOCADO AVE	STE 807	NEWPORT BEACH	CA	92660	7709	30	06059	33.61338536	-117.8693961	Orange County
150831	Fee-for-Service	1508058678	1508058678	1	1	EVERSOLE, GALEN M MD	9/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	22	Pathology (M.D. only)	1	Border provider	None	1350 STARDUST STREET	SUITE D	RENO	NV	89503	4264	00	None	39.52858204	-119.8347915	Washoe County
150846	Fee-for-Service	1699323634	1699323634	1	1	EMERGENCY PHYSICIANS URGENT	9/30/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	6789 N BLACKSTONE AVE	None	FRESNO	CA	93710	3530	10	06019	36.83695148	-119.7904013	Fresno County
150855	Fee-for-Service	1588707285	1588707285	1	1	EISENBERG, NINA MD	7/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91509	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
150936	Fee-for-Service	1154730828	1154730828	1	7	EL PROYECTO DEL BARRIO INC	5/1/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	20800 SHERMAN WAY	None	WINNETKA	CA	91306	2707	19	06037	34.20097455	-118.586502	Los Angeles County
151021	Fee-for-Service	1134478852	1134478852	1	1	ESCALON COMMUNITY AMBULANCE	10/26/2012	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1480 ULLREY AVENUE	None	ESCALON	CA	95320	8612	39	06077	37.78771959	-120.995362	San Joaquin County
151040	Fee-for-Service	1861090086	1861090086	1	1	ELDA	11/20/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2334 BUCHANAN RD	2356	ANTIOCH	CA	94509	4411	07	06013	37.99866447	-121.839483	Contra Costa County
151076	Fee-for-Service	1386700664	1386700664	1	1	ELENA'S ICF/DD-H	6/1/1994	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	25611 BELHAVEN ST	None	HAYWARD	CA	94545	2529	01	06001	37.64239552	-122.0999091	Alameda County
151100	Fee-for-Service	1992134696	1992134696	1	1	EMINENT HOSPICE CARE INC	4/10/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10999 RIVERSIDE DR	STE 306	NORTH HOLLYWOOD	CA	91602	2239	19	06037	34.15230395	-118.3693888	Los Angeles County
151156	Fee-for-Service	1922276864	1922276864	1	1	EVRIPIDOU, MARIANNA A LMFT	3/26/2024	106H00000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
151223	Fee-for-Service	1154730828	1154730828	1	7	EL PROYECTO DEL BARRIO INC	7/2/2019	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	20800 SHERMAN WAY	None	WINNETKA	CA	91306	2707	19	06037	34.20097455	-118.586502	Los Angeles County
151244	Fee-for-Service	1912934472	1912934472	1	1	EDWARDS-SILVA, RACINE N	9/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87527	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MD	8700 BEVERLY BLVD	STE 3611	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
151390	Fee-for-Service	1992134696	1992134696	1	1	EMINENT HOSPICE CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10999 RIVERSIDE DR	STE 306	NORTH HOLLYWOOD	CA	91602	2239	19	06037	34.15230395	-118.3693888	Los Angeles County
151425	Fee-for-Service	1528113768	1528113768	1	1	ENLOW, BRENT E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5633 N LIDGERWOOD ST	None	SPOKANE	WA	99208	1224	00	None	47.709423	-117.406944	Spokane County
151453	Fee-for-Service	1134529795	1134529795	1	1	ESTRADA-MELGAR, JENNIFER R	1/23/2018	390200000X	NA	Other	026	PHYSICIANS	153010	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
151477	Fee-for-Service	1770774770	1770774770	1	1	EGHBALIEH, BABAK MD	10/10/2007	208600000X	NA	General Surgery	026	PHYSICIANS	89592	02	General Surgery	0	In state provider	None	445 SOUTH CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
151658	Fee-for-Service	1609879436	1609879436	1	1	EYE CARE MEDICAL GRP INC	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	1665 DOMINICAN WAY	STE 122	SANTA CRUZ	CA	95065	1528	44	06087	36.99032886	-121.9811968	Santa Cruz County
151875	Fee-for-Service	1588734123	1588734123	1	1	EVERGREEN PHARMACEUTICAL OF	8/26/2005	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	OMNICARE OF SAN DIEGO	5825 OBERLIN DR	STE 300	SAN DIEGO	CA	92121	3709	37	06073	32.89402012	-117.1931813	San Diego County
151885	Fee-for-Service	1174802532	1174802532	1	1	ENVISTA MEDICAL NECK AND	3/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	6314	None	None	0	In state provider	BACK CENTER PC	3900 COFFEE RD	STE 3	BAKERSFIELD	CA	93308	5050	15	06029	35.39498227	-119.0921227	Kern County
151893	Fee-for-Service	1285689091	1285689091	1	1	ELLENA HENDERSON	1/27/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1331 UNION AVE	STE 1023	MEMPHIS	TN	38104	7509	00	None	35.13689783	-90.01724681	Shelby County
151913	Fee-for-Service	1174885206	1174885206	1	1	ESPARTO UNIFIED SCHOOL	7/1/2014	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	26675 PLAINFIELD ST	None	ESPARTO	CA	95627	2192	57	06113	38.690883	-122.0156415	Yolo County
151989	Fee-for-Service	1740458900	1740458900	1	1	EFTIMIE, BOGDAN S MD	8/31/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77323	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
152007	Fee-for-Service	1669225355	1669225355	1	1	EPIC ASSISTANCE CARE HME INC	4/30/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1061 E BRADLEY AVE	None	EL CAJON	CA	92021	1232	37	06073	32.81905355	-116.9468685	San Diego County
152055	Fee-for-Service	1417679465	1417679465	1	2	ESHUN, STEPHEN NP	6/21/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95022563	-	NOT APPLICABLE	0	In state provider	None	4200 LATHAM ST STE A	None	RIVERSIDE	CA	92501	1766	33	06065	34.00148305	-117.3721328	Riverside County
152096	Fee-for-Service	1992117592	1992117592	1	2	ENLOE MEDICAL CENTER	1/16/2020	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	SURGERY CLINIC	2 GOVERNORS LN	SUITE A	CHICO	CA	95926	6300	04	06007	39.75567003	-121.8588553	Butte County
152104	Fee-for-Service	1245233485	1245233485	1	1	ERISMAN, ALLEN DO	7/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	4880 S WYNN RD	None	LAS VEGAS	NV	89103	5406	00	None	36.10169134	-115.1953733	Clark County
152202	Fee-for-Service	1174885206	1174885206	1	1	ESPARTO UNIFIED SCHOOL	3/13/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	26675 PLAINFIELD ST	None	ESPARTO	CA	95627	2192	57	06113	38.690883	-122.0156415	Yolo County
152276	Fee-for-Service	1740458900	1740458900	1	1	EFTIMIE, BOGDAN S MD	8/31/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77323	01	General Practice	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
152285	Fee-for-Service	1104673656	1104673656	1	1	EL CAMINO COMMUNITY COLLEGE	5/30/2024	261QS1000X	NA	Other	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	16007 CRENSHAW BLVD	None	TORRANCE	CA	90506	0001	19	06037	33.884577	-118.3300155	Los Angeles County
152290	Fee-for-Service	1720136047	1720136047	1	1	EL MONTE UNION HSD	3/8/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	3537 JOHNSON AVE	None	EL MONTE	CA	91731	3211	19	06037	34.07167541	-118.0307334	Los Angeles County
152314	Fee-for-Service	1609862176	1609862176	1	1	ENGLER, DAVID G MD	10/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54531	40	Pediatrics	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
152347	Fee-for-Service	1881057461	1881057461	1	1	EL CONCILIO CALIFORNIA	8/27/2024	104100000X	NA	Mental Health Outpatient Services	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	445 N SAN JOAQUIN ST	None	STOCKTON	CA	95202	2026	39	06077	37.95801471	-121.2885563	San Joaquin County
152384	Fee-for-Service	1992117592	1992117592	1	2	ENLOE MEDICAL CENTER	1/16/2020	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	28	Proctology (colon and rectal)	0	In state provider	SURGERY CLINIC	2 GOVERNORS LN	SUITE A	CHICO	CA	95926	6300	04	06007	39.75567003	-121.8588553	Butte County
152423	Fee-for-Service	1588163190	1588163190	1	1	EELLS, MACKENZIE E OT	10/6/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
152487	Fee-for-Service	1336835933	1336835933	1	1	ENCINA, LEA CAYANAN	6/7/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	9425 MAINLINE DRIVE	None	ELK GROVE	CA	95624	4402	34	06067	38.402424	-121.346811	Sacramento County
152717	Fee-for-Service	1295049260	1295049260	1	1	EMAMI, AMIR	1/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11833	None	None	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
152730	Fee-for-Service	1265694962	1265694962	1	1	EFTEKHARI, HOSSEIN MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	103425	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11480 BROOKSHIRE AVE	None	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
152755	Fee-for-Service	1427429521	1427429521	1	1	ENENBACH, MICHELLE LCSW	4/22/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
152773	Fee-for-Service	1801224217	1801224217	1	1	ENTEEN, LAUREN CNP	12/1/2021	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2740 GRANT ST	None	CONCORD	CA	94520	2265	07	06013	37.98580944	-122.0385574	Contra Costa County
152775	Fee-for-Service	1336835933	1336835933	1	1	ENCINA, LEA CAYANAN	6/7/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	9425 MAINLINE DRIVE	None	ELK GROVE	CA	95624	4402	34	06067	38.402424	-121.346811	Sacramento County
152837	Fee-for-Service	1962892588	1962892588	1	1	ETERNAL FAITH HOSPICE, INC	5/7/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	315 W VERDUGO AVE	STE 116	BURBANK	CA	91502	2469	19	06037	34.17082135	-118.314366	Los Angeles County
152843	Fee-for-Service	1306204318	1306204318	2	2	EDS-I PRACTICES OF CALIFORNI	1/12/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	36485 INLAND VALLEY DR	None	WILDOMAR	CA	92595	9681	33	06065	33.591699	-117.2368285	Riverside County
152871	Fee-for-Service	1306824503	1306824503	1	1	ELLIS, WILLARD S MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73530	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
152908	Fee-for-Service	1104205129	1104205129	1	1	ENRIQUEZ, MATTHEW R LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
152972	Fee-for-Service	1093783425	1093783425	1	1	ENDICOTT, MARK E MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	46261	20	Orthopedic Surgery	0	In state provider	None	2801 K ST	STE 500	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
152987	Fee-for-Service	1760895510	1760895510	1	1	ELFEKY, SARAH H MD	8/16/2022	207R00000X	NA	Other	026	PHYSICIANS	171410	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
153025	Fee-for-Service	1740632223	1740632223	1	1	ENOCH, ROBERT M PHD	12/8/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
153056	Fee-for-Service	1174671994	1174671994	1	1	ELSWICK, MARIA H MD	1/31/1996	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	83746	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	752 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6658	37	06073	32.61800405	-117.0232585	San Diego County
153098	Fee-for-Service	1205537297	1205537297	1	1	EMERY, LISA RCP	11/3/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
153125	Fee-for-Service	1962892588	1962892588	1	1	ETERNAL FAITH HOSPICE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	315 W VERDUGO AVE	STE 116	BURBANK	CA	91502	2469	19	06037	34.17082135	-118.314366	Los Angeles County
153148	Fee-for-Service	1790746998	1790746998	1	1	ERIC HOOVER	8/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	205 N EAST AVE	None	JACKSON	MI	49201	1753	00	None	42.25035275	-84.39360669	Jackson County
153150	Fee-for-Service	1689200883	1689200883	1	1	EVERY DAY HOSPICE CARE INC	11/17/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3029 N SAN FERNANDO BLVD	SUITE 110	BURBANK	CA	91504	4704	19	06037	34.20199573	-118.3439717	Los Angeles County
153197	Fee-for-Service	1104171289	1104171289	1	1	EMPIRE HOTEL ALCOHOLIC	1/30/2014	261QR0401X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION CENTER	1616 WEST STREET	None	REDDING	CA	96001	1726	45	06089	40.58145964	-122.3966513	Shasta County
153232	Fee-for-Service	1730319070	1730319070	1	1	EXCEPTIONAL CHILDRENS FNDTN	9/8/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	11124 FAIRBANKS WAY	None	CULVER CITY	CA	90230	4945	19	06037	34.00023768	-118.3974394	Los Angeles County
153238	Fee-for-Service	1659340156	1659340156	1	1	ELIHU, NADIA MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67627	41	Internal Medicine	0	In state provider	None	1310 W STEWART DR	None	ORANGE	CA	92868	3854	30	06059	33.78236048	-117.8664975	Orange County
153272	Fee-for-Service	1649725383	1649725383	1	1	ERIAN, MARY	10/27/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3460 E LA PALMA AVE	None	ANAHEIM	CA	92806	2020	30	06059	33.85429451	-117.8446551	Orange County
153304	Fee-for-Service	1336255686	1336255686	1	1	EKUAN, JUSTIN H MD	9/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	34183	22	Pathology (M.D. only)	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
153325	Fee-for-Service	1659304459	1659304459	1	1	ECCLES, RALPH P DO	12/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	2865 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25240042	-121.7859055	Klamath County
153362	Fee-for-Service	1912467978	1912467978	1	1	ELSKEN, SIERRA S MD	5/31/2023	207R00000X	NA	Other	026	PHYSICIANS	182171	None	None	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
153380	Fee-for-Service	1619025541	1619025541	1	1	EVANS, LINDA S CNM	12/2/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	5893 COPLEY DRIVE	None	SAN DIEGO	CA	92111	7906	37	06073	32.84332697	-117.1728709	San Diego County
153439	Fee-for-Service	1689200883	1689200883	1	1	EVERY DAY HOSPICE CARE INC	11/17/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3029 N SAN FERNANDO BLVD	SUITE 110	BURBANK	CA	91504	4704	19	06037	34.20199573	-118.3439717	Los Angeles County
153448	Fee-for-Service	1952161291	1952161291	1	1	EZEIGWE, MAUREEN NP	5/16/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2373 COLORADO BLVD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
153561	Fee-for-Service	1811068737	1811068737	1	1	ESMAIL, ADIL N MD	5/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77324	20	Orthopedic Surgery	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
153624	Fee-for-Service	1144889601	1144889601	1	1	ENGELMANN, ALEXANDER R MD	7/21/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	187936	None	None	0	In state provider	None	625 S FAIR OAKS AVE	227, 240, 280, 285	PASADENA	CA	91105	2613	19	06037	34.134894	-118.1504155	Los Angeles County
153648	Fee-for-Service	1740584325	1740584325	1	1	ELDEREINY, HANAA M LMFT	4/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
153708	Fee-for-Service	1487800223	1487800223	1	1	EDWARDS, JAMES W LCSW	12/5/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	322 HARBOUR WAY	STE 20	RICHMOND	CA	94801	3142	07	06013	37.9362474	-122.3599855	Contra Costa County
153841	Fee-for-Service	1639394919	1639394919	1	1	EHREN, AVIVA LMFT	9/20/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	222 CANON PERDIDO ST	SUITE 207B	SANTA BARBARA	CA	93101	2283	42	06083	34.42318988	-119.6976845	Santa Barbara County
153851	Fee-for-Service	1609841816	1609841816	1	1	ELIA, MANANA B MD	11/2/2022	207RX0202X	NA	Oncology	026	PHYSICIANS	177706	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
153871	Fee-for-Service	1003897117	1003897117	1	1	ENGELHARDT, JONATHAN T	8/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89837	66	Emergency Medicine (Urgent Care)	0	In state provider	MD	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
153917	Fee-for-Service	1073856712	1073856712	1	1	EVANS, TIARE N MD	11/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150721	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON STREET	STE 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
153958	Fee-for-Service	1063411767	1063411767	1	1	ESSENT PRMC, LP	11/28/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	820 CLARKSVILLE ST	None	PARIS	TX	75460	6027	00	None	33.66028621	-95.54711357	Lamar County
153962	Fee-for-Service	1801023825	1801023825	1	1	EASTBAY UPRIGHT MRI LLC	2/1/2012	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	25001 INDUSTRIAL BLVD	SUITE A	HAYWARD	CA	94545	2801	01	06001	37.63841873	-122.1169742	Alameda County
153979	Fee-for-Service	1699845149	1699845149	1	1	EDMONDS, ZACHARY V MD	9/29/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92210	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
154029	Fee-for-Service	1215468434	1215468434	1	1	EDBERG, JORDAN L MD	6/3/2021	207L00000X	NA	Other	026	PHYSICIANS	157133	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
154097	Fee-for-Service	1033184452	1033184452	1	1	EMERSON, STANTON T DO	2/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10280	08	Family Practice	0	In state provider	None	115 W E ST	None	TEHACHAPI	CA	93561	1607	15	06029	35.13009994	-118.4488237	Kern County
154145	Fee-for-Service	1417021361	1417021361	1	1	ELMAN, JOHN W OD	7/27/1968	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1431 7TH ST	STE 101	SANTA MONICA	CA	90401	2638	19	06037	34.01801015	-118.4914623	Los Angeles County
154148	Fee-for-Service	1629653860	1629653860	1	1	EGAN, KAITLYN N PSYD	4/25/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
154173	Fee-for-Service	1477727444	1477727444	1	1	EUBANKS, CHRISTY A MD	11/7/2019	207R00000X	NA	Other	026	PHYSICIANS	159647	41	Internal Medicine	0	In state provider	None	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
154178	Fee-for-Service	1831149574	1831149574	1	1	EDDY, ORIN L MD	2/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55212	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
154241	Fee-for-Service	1609884493	1609884493	1	1	ELSHAFEI, GAMAL E MD INC	5/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	50606	05	Anesthesiology	0	In state provider	None	751 MEDICAL CENTER DR	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
154244	Fee-for-Service	1063411767	1063411767	1	1	ESSENT PRMC, LP	1/11/2004	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	820 CLARKSVILLE ST	None	PARIS	TX	75460	6027	00	None	33.66028621	-95.54711357	Lamar County
154342	Fee-for-Service	1659705689	1659705689	1	1	ELARMO, ALLAN C NP	2/14/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	23180 HEMLOCK AVE	SUITE 201	MORENO VALLEY	CA	92557	8001	33	06065	33.94245952	-117.2585565	Riverside County
154412	Fee-for-Service	1073674040	1073674040	1	2	ENUMCLAW REGIONAL HOSPITAL A	12/27/2019	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1455 BATTERSBY AVE	None	ENUMCLAW	WA	98022	3634	00	None	47.20854954	-121.9883958	King County
154415	Fee-for-Service	1447603162	1447603162	1	1	ESTRADA, OSCAR PT	4/25/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
154436	Fee-for-Service	1083490361	1083490361	1	1	ELITEMED, INC.	9/26/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10515 BALBOA BLVD	125	GRANADA HILLS	CA	91344	6343	19	06037	34.261497	-118.502318	Los Angeles County
154441	Fee-for-Service	1588630081	1588630081	1	2	EXCELL HOME CARE, INC	5/1/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4201 LONG BEACH BLVD	SUITE 101	LONG BEACH	CA	90807	2010	19	06037	33.83493255	-118.1895197	Los Angeles County
154487	Fee-for-Service	1710986435	1710986435	1	2	EAST BAY HOME HEALTH	2/7/2014	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1710 PENNSYLVANIA AVE	SUITE E	FAIRFIELD	CA	94533	3549	48	06095	38.260476	-122.0498715	Solano County
154582	Fee-for-Service	1659430239	1659430239	1	1	EVERSON, JOEL E MD	4/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	52741	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
154617	Fee-for-Service	1063705978	1063705978	1	1	ELROD, KRISTEEN E LMFT	1/9/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
154699	Fee-for-Service	1073674040	1073674040	1	2	ENUMCLAW REGIONAL HOSPITAL A	12/27/2019	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1455 BATTERSBY AVE	None	ENUMCLAW	WA	98022	3634	00	None	47.20854954	-121.9883958	King County
154707	Fee-for-Service	1588734123	1588734123	1	2	EVERGREEN PHARMACEUTICAL OF	10/3/2019	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5601 OBERLIN DR	STE 124	SAN DIEGO	CA	92121	3747	37	06073	32.89166824	-117.1974547	San Diego County
154804	Fee-for-Service	1619351707	1619351707	1	1	EL SEGUNDO DERMATOLOGY	5/3/2019	174400000X	NA	Other	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	713 N DOUGLAS ST.	None	EL SEGUNDO	CA	90245	2830	19	06037	33.92546537	-118.3832318	Los Angeles County
154823	Fee-for-Service	1477868578	1477868578	1	1	ELLISON, TATYANA V MD	8/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129792	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
154870	Fee-for-Service	1659430239	1659430239	1	1	EVERSON, JOEL E MD	4/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	52741	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
154931	Fee-for-Service	1255687919	1255687919	1	1	EMILIA D SANTUCCI FAMILY	2/23/2018	193400000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	THERAPIST A PROFESSIONAL	203 N FIRST AVENUE	None	OAKDALE	CA	95361	3048	50	06099	37.76689815	-120.850492	Stanislaus County
154953	Fee-for-Service	1912909037	1912909037	1	1	EPHRAIM, PAUL D MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	14895	10	Gastroenterology (M.D. only)	0	In state provider	None	2601 W ALAMEDA AVE	STE 100	BURBANK	CA	91505	4808	19	06037	34.15783817	-118.3293969	Los Angeles County
154970	Fee-for-Service	1497016489	1497016489	1	1	ESSIG, MICHELLE T MD	12/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115298	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
155100	Fee-for-Service	1255853651	1255853651	1	1	ENDERS, OLGA N	2/3/2023	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1467 WANDA RD	STE 135	ORANGE	CA	92867	5344	30	06059	33.81173472	-117.8219635	Orange County
155101	Fee-for-Service	1285855619	1285855619	1	1	EASY ACCESS MED SUPPLY	5/15/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	EASY ACCESS MED SUPPLY	12555 LAKEWOOD BLVD	SUITE B	DOWNEY	CA	90242	2771	19	06037	33.91728647	-118.137699	Los Angeles County
155130	Fee-for-Service	1366028789	1366028789	1	1	ESCHER, KIRIN MD	10/10/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186911	08	Family Practice	0	In state provider	None	2110 N BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
155196	Fee-for-Service	1184225054	1184225054	1	1	EKMECIC, VUK PT	5/20/2021	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
155243	Fee-for-Service	1912909037	1912909037	1	1	EPHRAIM, PAUL D MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	14895	41	Internal Medicine	0	In state provider	None	2601 W ALAMEDA AVE	STE 100	BURBANK	CA	91505	4808	19	06037	34.15783817	-118.3293969	Los Angeles County
155304	Fee-for-Service	1811062813	1811062813	1	1	EYAL, ROY MD	9/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	93577	26	Psychiatry (child)	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
155389	Fee-for-Service	1992390884	1992390884	1	1	EBEN HAVEN INC	10/7/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	30792 STONE CREEK CT	None	MENIFEE	CA	92584	2722	33	06065	33.67328976	-117.1905829	Riverside County
155419	Fee-for-Service	1700953379	1700953379	1	1	ERWIN, LISA D LCSW	3/16/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
155606	Fee-for-Service	1346402419	1346402419	1	1	ELKINS, OBADIAH R MD	6/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113204	30	Radiology	0	In state provider	None	3900 GEER ROAD	None	TURLOCK	CA	95382	1147	50	06099	37.52828715	-120.8488829	Stanislaus County
155772	Fee-for-Service	1831307883	1831307883	1	1	ESCOBAR, SHAWNA R MD	9/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105744	01	General Practice	0	In state provider	None	1524 MCHENRY AVE	STE 100	MODESTO	CA	95350	4566	50	06099	37.666233	-120.993933	Stanislaus County
155847	Fee-for-Service	1205872413	1205872413	1	1	ELLER, DAVID J MD	12/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	48187	None	None	0	In state provider	None	2525 STOCKTON BLVD	STE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
155868	Fee-for-Service	1790246189	1790246189	1	1	EDWARDS, MARK S MD	7/16/2023	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	182387	None	None	0	In state provider	None	11370 ANDERSON ST	STE B100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
155881	Fee-for-Service	1265410013	1265410013	1	1	ELIAS, GRACE S MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	45811	24	Plastic Surgery	0	In state provider	None	3660 ARLINGTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94621853	-117.3953655	Riverside County
155989	Fee-for-Service	1972803229	1972803229	1	1	EDALATPARSI, KATAYOUN K DO	12/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11563	41	Internal Medicine	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
156121	Fee-for-Service	1013926435	1013926435	1	1	EWING, SUSANNAH S NP	5/17/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
156159	Fee-for-Service	1003577305	1003577305	1	1	EVELYN J NAKAGAWA MD INC	9/27/2022	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	2800 BENEDICT DR	None	SAN LEANDRO	CA	94577	6840	01	06001	37.71593435	-122.131151	Alameda County
156237	Fee-for-Service	1609892017	1609892017	1	1	EDEN, STEPHANIE M MD	10/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	93354	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
156296	Fee-for-Service	1427459189	1427459189	1	1	ENLIGHT CONSULTING CO	8/17/2015	207R00000X	NA	Other	026	PHYSICIANS	94954	None	None	0	In state provider	None	728 PACIFIC AVENUE	SUITE 501	SAN FRANCISCO	CA	94133	4449	38	06075	37.79687859	-122.4074282	San Francisco County
156299	Fee-for-Service	1760159198	1760159198	1	2	EVERGREEN SPINE AND PAIN CEN	12/6/2022	208VP0014X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	TERS INC.	4000 HARRISON ST	None	RIVERSIDE	CA	92503	3514	33	06065	33.92064	-117.4541365	Riverside County
156313	Fee-for-Service	1902572811	1902572811	1	1	EVANS, MONA MARIE B NP	1/1/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
156417	Fee-for-Service	1871268060	1871268060	1	1	ENRIQUEZ, YVETTE NP	6/13/2023	363LG0600X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
156431	Fee-for-Service	1326334335	1326334335	1	1	EDWARDS, CHRISTINA S DO	2/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13281	41	Internal Medicine	0	In state provider	None	165 ROWLAND WAY	STE 201	NOVATO	CA	94945	5055	21	06041	38.09824386	-122.559872	Marin County
156483	Fee-for-Service	1942532619	1942532619	1	2	ELLISON, SHERRY PHD	11/15/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	36	06071	34.10675048	-117.6646365	San Bernardino County
156570	Fee-for-Service	1427016120	1427016120	1	3	EYECARE MEDICAL CORP	12/26/2018	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	PORATION	5832 BEACH BLVD	STE 109	BUENA PARK	CA	90621	2022	30	06059	33.875469	-117.9981525	Orange County
156713	Fee-for-Service	1649299199	1649299199	1	1	EDWARDS, JOHN B MD	10/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	38967	25	Physical Medicine and Rehabilitation	0	In state provider	None	3837 N CLARK ST	None	FRESNO	CA	93726	4806	10	06019	36.788049	-119.7852065	Fresno County
156786	Fee-for-Service	1518549534	1518549534	1	1	EPIC ORTHOPEDICS	11/5/2021	207XX0801X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2662 EDITH AVE	None	REDDING	CA	96001	3043	45	06089	40.57071892	-122.3974077	Shasta County
156814	Fee-for-Service	1902456213	1902456213	1	1	ELITE SURGERY MEDICAL GROUP	8/18/2023	208600000X	NA	General Surgery	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	38920 TRADE CENTER DR	None	PALMDALE	CA	93551	3715	19	06037	34.58884303	-118.1430688	Los Angeles County
156861	Fee-for-Service	1427016120	1427016120	1	3	EYECARE MEDICAL CORP	7/25/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PORATION	5832 BEACH BLVD	STE 109	BUENA PARK	CA	90621	2022	30	06059	33.875469	-117.9981525	Orange County
156976	Fee-for-Service	1649350174	1649350174	1	1	ENDO, CATHY S MD	3/23/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	-	None	None	1	Border provider	None	880 ALDER AVE	None	INCLINE VILLAGE	NV	89451	8335	00	None	39.25092003	-119.9543846	Washoe County
157012	Fee-for-Service	1538250899	1538250899	1	1	EASTMAN, MARK E DO	9/22/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	7345	09	Gynecology (D.O. only)	0	In state provider	FOOTHILLS WMS MED CTR	235 NEW YORK RANCH RD	STE B	JACKSON	CA	95642	2147	03	06005	38.35435951	-120.7677827	Amador County
157051	Fee-for-Service	1689060030	1689060030	1	1	EMERY, ERIC J LCSW	5/5/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	16194	-	NOT APPLICABLE	0	In state provider	None	270 COUNTY HOSPITAL RD	STE 109	QUINCY	CA	95971	9173	32	06063	39.95246516	-120.9635967	Plumas County
157104	Fee-for-Service	1902456213	1902456213	1	1	ELITE SURGERY MEDICAL GROUP	8/18/2023	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	38920 TRADE CENTER DR	None	PALMDALE	CA	93551	3715	19	06037	34.58884303	-118.1430688	Los Angeles County
157143	Fee-for-Service	1356588826	1356588826	1	1	EMPIRECARE HEALTH ASSOCIATES	6/22/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	3401 LEMON STREET	None	RIVERSIDE	CA	92501	2861	33	06065	33.98441848	-117.369785	Riverside County
157206	Fee-for-Service	1518131283	1518131283	1	1	ETHAN M MCCULLAR MD	3/23/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	None	LITTLE ROCK	AR	72205	6321	00	None	34.744437	-92.3813595	Pulaski County
157299	Fee-for-Service	1659354454	1659354454	1	1	EVANS, WILLIAM N MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	35	Pediatric Cardiology (M.D. only)	1	Border provider	None	3006 S MARYLAND PKWY	STE 690	LAS VEGAS	NV	89109	2297	00	None	36.135288	-115.1368705	Clark County
157302	Fee-for-Service	1538250899	1538250899	1	1	EASTMAN, MARK E DO	9/22/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	7345	01	General Practice	0	In state provider	FOOTHILLS WMS MED CTR	235 NEW YORK RANCH RD	STE B	JACKSON	CA	95642	2147	03	06005	38.35435951	-120.7677827	Amador County
157507	Fee-for-Service	1740467224	1740467224	1	1	ESLAMIAN, SHAW S MD	8/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101252	41	Internal Medicine	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
157510	Fee-for-Service	1760884209	1760884209	1	1	EVANS RENO, TINELLE	2/23/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4012 GALBRATH DRIVE	None	SACRAMENTO	CA	95814	0894	34	06067	38.697498	-121.3706565	Sacramento
157526	Fee-for-Service	1023055928	1023055928	1	1	ELLEDGE, KAY E MD	3/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86986	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4201 TORRANCE BLVD	STE 350	TORRANCE	CA	90503	4573	19	06037	33.8375955	-118.358748	Los Angeles County
157590	Fee-for-Service	1538250899	1538250899	1	1	EASTMAN, MARK E DO	9/22/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	7345	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	FOOTHILLS WMS MED CTR	235 NEW YORK RANCH RD	STE B	JACKSON	CA	95642	2147	03	06005	38.35435951	-120.7677827	Amador County
157702	Fee-for-Service	1598252173	1598252173	1	1	EDWARDS, MELISSA NP	2/18/2020	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
157708	Fee-for-Service	1235316068	1235316068	2	1	EL CAMINO PHARMACY INC	11/4/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10940 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	3725	19	06037	34.18667253	-118.3695885	Los Angeles County
157745	Fee-for-Service	1417905639	1417905639	1	1	EDWARDS, JOHN W MD INC	5/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	21138	34	Urology and Urological Surgery	0	In state provider	None	112 N MADISON AVE	None	PASADENA	CA	91101	1710	19	06037	34.147926	-118.1383915	Los Angeles County
157773	Fee-for-Service	1376241968	1376241968	1	1	ELWOOD HOME CARE LLC	3/16/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	4099 ELWOOD AVENUE	None	PALMDALE	CA	93552	3615	19	06037	34.56608521	-118.0546318	Los Angeles County
157785	Fee-for-Service	1952633448	1952633448	1	1	EVANS, DEREK G CRNA	1/6/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
157967	Fee-for-Service	1639212624	1639212624	1	1	ELSEN, ROBERT J MD	4/29/1999	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	71096	41	Internal Medicine	0	In state provider	None	45 CASTRO ST	STE 415	SAN FRANCISCO	CA	94114	1029	38	06075	37.76829732	-122.4357056	San Francisco County
157970	Fee-for-Service	1962023770	1962023770	1	1	ELBANNA, YASMEEN LMFT	1/14/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17111 BEACH BLVD	STE 205	HUNTINGTON BEACH	CA	92647	5947	30	06059	33.713937	-117.9892085	Orange County
158008	Fee-for-Service	1588630081	1588630081	1	3	EXCELL HOME CARE, INC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14023 PARAMOUNT BLVD	None	PARAMOUNT	CA	90723	2605	19	06037	33.90647903	-118.1602918	Los Angeles County
158011	Fee-for-Service	1164003315	1164003315	1	1	EDDY, WILLIAM MD	7/5/2024	390200000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
158034	Fee-for-Service	1417905639	1417905639	1	1	EDWARDS, JOHN W MD INC	5/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	21138	02	General Surgery	0	In state provider	None	112 N MADISON AVE	None	PASADENA	CA	91101	1710	19	06037	34.147926	-118.1383915	Los Angeles County
158115	Fee-for-Service	1205030830	1205030830	1	1	ESPELETA, VIDAL J MD INC	4/3/2009	193400000X	NA	Other	026	PHYSICIANS	83599	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	24411 HEALTH CENTER DR	STE 620	LAGUNA HILLS	CA	92653	3672	30	06059	33.6087201	-117.7076948	Orange County
158176	Fee-for-Service	1447391693	1447391693	1	1	ENG, DANIEL K OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8227 DAY CREEK BLVD	STE 100	RANCHO CUCAMONGA	CA	91739	8568	36	06071	34.10403102	-117.5371827	San Bernardino County
158177	Fee-for-Service	1184614521	1184614521	1	1	EARLY, DEAN G DC	3/21/1996	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	4260 SISK RD	STE E-1	MODESTO	CA	95356	8732	50	06099	37.70123222	-121.0703185	Stanislaus County
158250	Fee-for-Service	1891349932	1891349932	1	1	EVERSON, BRITTANY DPM	4/19/2022	208600000X	NA	General Surgery	027	PODIATRISTS	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
158254	Fee-for-Service	1639212624	1639212624	1	1	ELSEN, ROBERT J MD	4/29/1999	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	71096	10	Gastroenterology (M.D. only)	0	In state provider	None	45 CASTRO ST	STE 415	SAN FRANCISCO	CA	94114	1029	38	06075	37.76829732	-122.4357056	San Francisco County
158271	Fee-for-Service	1982714887	1982714887	1	1	EL-HARAZI, SHERIF M MD	10/26/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74584	01	General Practice	0	In state provider	None	801 S CHEVY CHASE DR	STE 103	GLENDALE	CA	91205	4437	19	06037	34.136757	-118.2396195	Los Angeles County
158287	Fee-for-Service	1770926875	1770926875	1	1	ELLIOTT, IRMINA A MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136620	02	General Surgery	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
158344	Fee-for-Service	1982661922	1982661922	1	1	EWING, AMANDA T MD	3/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83044	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
158370	Fee-for-Service	1700830296	1700830296	1	1	EAST VALLEY COMMUNITY CLINIC	3/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INC	2470 ALVIN AVE	SUITE 60	SAN JOSE	CA	95121	1664	43	06085	37.31946663	-121.8268813	Santa Clara County
158385	Fee-for-Service	1922156744	1922156744	1	1	ELSNER, CHAD MD	12/1/1997	204D00000X	NA	Other	026	PHYSICIANS	69623	20	Orthopedic Surgery	0	In state provider	None	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
158386	Fee-for-Service	1528169620	1528169620	1	1	ERICKSON, DOUGLAS J MD	6/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88706	22	Pathology (M.D. only)	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
158402	Fee-for-Service	1205030830	1205030830	1	1	ESPELETA, VIDAL J MD INC	4/3/2009	193400000X	NA	Other	026	PHYSICIANS	83599	41	Internal Medicine	0	In state provider	None	24411 HEALTH CENTER DR	STE 620	LAGUNA HILLS	CA	92653	3672	30	06059	33.6087201	-117.7076948	Orange County
158540	Fee-for-Service	1669942462	1669942462	1	1	ESTONILO, PAMELA	8/1/2022	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	AID SERVICE	3517 PLEASANT CREST DR	None	SAN JOSE	CA	95148	1911	43	06085	37.34719239	-121.7907811	Santa Clara County
158601	Fee-for-Service	1104431147	1104431147	1	1	EVOLVE HOME HEALTH	7/28/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	22048 SHERMAN WAY	STE 313	CANOGA PARK	CA	91303	3014	19	06037	34.20099048	-118.60776	Los Angeles County
158644	Fee-for-Service	1194873976	1194873976	1	1	ELIZONDO, LEOBARDO MD	8/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	47567	08	Family Practice	0	In state provider	ATTN MGA OFFICE	5601 DE SOTO AVE	None	WOODLAND HLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
158662	Fee-for-Service	1114998374	1114998374	1	1	EDWARDS, TERESA	4/18/2022	207L00000X	NA	Other	026	PHYSICIANS	55977	None	None	0	In state provider	None	1650 CREEKSIDE DRIVE	None	FOLSOM	CA	95630	3400	34	06067	38.67021	-121.145382	Sacramento County
158870	Fee-for-Service	1710036777	1710036777	1	1	ELLIS, ROBERT J MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	32619	02	General Surgery	0	In state provider	None	1 SHRADER ST	STE 570	SAN FRANCISCO	CA	94117	1044	38	06075	37.77467326	-122.4529451	San Francisco County
158889	Fee-for-Service	1154612596	1154612596	1	1	ERIC LEW	9/2/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2719	00	None	35.08771808	-106.6192188	Bernalillo County
158934	Fee-for-Service	1194285585	1194285585	1	1	EBY, JESSICA E MD	8/15/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	187543	None	None	0	In state provider	None	1245 16TH STREET	SUITE 125, 204, 307	SANTA MONICA	CA	90404	1240	19	06037	34.02726451	-118.4857138	Los Angeles County
158952	Fee-for-Service	1649955964	1649955964	1	1	EJC TRANSPORT LLC	6/21/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2268 W 20TH ST	#2	LOS ANGELES	CA	90018	1412	19	06037	34.03891164	-118.3140348	Los Angeles County
158958	Fee-for-Service	1477787919	1477787919	1	1	EDSON, EMMANUEL MD	7/27/2021	207L00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1093 ROYAL COURT	None	MEDFORD	OR	97504	8383	00	None	42.34017467	-122.8666022	Jackson County
158962	Fee-for-Service	1972646743	1972646743	1	1	EVERGREEN WORLD ADHC	2/11/2009	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	9856 WESTMINSTER AVE	None	GARDEN GROVE	CA	92844	2907	30	06059	33.75945049	-117.956592	Orange County
158966	Fee-for-Service	1013193127	1013193127	1	1	ENCINO OPTOMETRIC CENTER	11/20/2008	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CORP	16255 VENTURA BLVD	STE 705	ENCINO	CA	91436	2311	19	06037	34.15693902	-118.4876816	Los Angeles County
158980	Fee-for-Service	1679092944	1679092944	1	1	ELDABH, AMANDA LCSW	10/10/2023	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
159112	Fee-for-Service	1811901572	1811901572	1	1	ECKLEY, VALERIA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	903 S ADAMS ST	None	RITZVILLE	WA	99169	2227	00	None	47.12103402	-118.3723179	Adams County
159178	Fee-for-Service	1720009855	1720009855	1	1	ELMELIGY, HAZIM M MD	7/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	44235	01	General Practice	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
159212	Fee-for-Service	1043943467	1043943467	1	1	EDWARDS, JAMIE	2/7/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	34	06067	0	0	None
159413	Fee-for-Service	1396947925	1396947925	1	1	EL RANCHO USD	9/30/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	9333 LOCH LOMOND DR	None	PICO RIVERA	CA	90660	2913	19	06037	33.99484196	-118.0815839	Los Angeles County
159465	Fee-for-Service	1720009855	1720009855	1	1	ELMELIGY, HAZIM M MD	7/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	44235	02	General Surgery	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
159504	Fee-for-Service	1518043025	1518043025	1	1	ERNSTING, KEVIN SCOTT MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74128	66	Emergency Medicine (Urgent Care)	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
159535	Fee-for-Service	1487982526	1487982526	1	1	ECK, RACHEL J NP	9/1/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
159692	Fee-for-Service	1659408615	1659408615	1	1	EFIRD, DEBRA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13123 E 16TH AVE	None	AURORA	CO	80045	0000	00	None	39.742164	-104.8350375	Adams County
159705	Fee-for-Service	1063441293	1063441293	1	3	EMANATE HEALTH MEDICAL	3/10/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1135 S SUNSET AVE	SUITE 401	WEST COVINA	CA	91790	3921	19	06037	34.06215064	-117.9453997	Los Angeles County
159714	Fee-for-Service	1053429456	1053429456	1	1	EBERLY, VANCE C MD INC	7/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81586	20	Orthopedic Surgery	0	In state provider	None	11411 BROOKSHIRE AVE	STE 307	DOWNEY	CA	90241	5005	19	06037	33.93667091	-118.1309273	Los Angeles County
159772	Fee-for-Service	1487136412	1487136412	1	1	ENDOSCOPY CENTER OF SOUTH	10/1/2018	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SACRAMENTO LLC	8120 TIMBERLAKE WAY	SUITE 103	SACRAMENTO	CA	95823	5413	34	06067	38.461023	-121.41414	Sacramento County
159785	Fee-for-Service	1972257699	1972257699	1	1	EARLEY, KELLY D NP	6/13/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
159792	Fee-for-Service	1952755738	1952755738	1	1	EL TEJON UNIFIED SCHOOL	7/1/2016	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	4337 LEBEC ROAD	None	LEBEC	CA	93243	9705	15	06029	34.87318296	-118.886747	Kern County
159803	Fee-for-Service	1477811362	1477811362	1	1	ESPARZA, BRIANA N LMFT	9/12/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7177 BROCKTON AVE	SUITE 445	RIVERSIDE	CA	92506	2631	33	06065	33.94289496	-117.3943941	Riverside County
159815	Fee-for-Service	1093250433	1093250433	1	1	EQUANIMITY HOME HEALTH	3/4/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	3169 BARBARA CT	UNIT D	LOS ANGELES	CA	90068	1700	19	06037	34.12773574	-118.3471473	Los Angeles County
159886	Fee-for-Service	1851717706	1851717706	2	1	EDS-I PRACTICES OF CALIFORNI	3/31/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	800 SOUTH MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
159907	Fee-for-Service	1790517035	1790517035	1	1	EDWARDS, KAITLYN	9/12/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2335 VISTA WAY	None	OCEANSIDE	CA	92054	5663	37	06073	33.18316476	-117.3365251	San Diego County
159908	Fee-for-Service	1043725773	1043725773	1	1	ENGEL, CATHY A	12/23/2020	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
159941	Fee-for-Service	1790801025	1790801025	1	1	ELGIN, KRISTINE A LMFT	10/22/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
159992	Fee-for-Service	1134371743	1134371743	1	1	EPSTEIN, AARON J MD	5/25/2010	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	98154	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
160047	Fee-for-Service	1225084700	1225084700	1	1	ESTELA APOLINAR	6/1/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1100 S DOBSON RD	STE 118	CHANDLER	AZ	85286	6158	00	None	33.289956	-111.8769075	Maricopa County
160056	Fee-for-Service	1083786800	1083786800	1	1	ESCAY, MARI MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	39588	20	Orthopedic Surgery	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
160083	Fee-for-Service	1568410173	1568410173	1	1	ECKERT, MARK K MD	2/1/1995	207PE0004X	NA	Other	026	PHYSICIANS	31187	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
160095	Fee-for-Service	1366482960	1366482960	1	2	EDELMAN, DAVID L MD	6/1/1984	207RS0012X	NA	Other	026	PHYSICIANS	51844	13	Neurology (M.D. only)	0	In state provider	None	502 TORRANCE BLVD	None	REDONDO BEACH	CA	90277	3413	19	06037	33.83783749	-118.3832414	Los Angeles County
160135	Fee-for-Service	1720316714	1720316714	1	1	EMILY SPENCER POFF, MD	2/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	48 W 1500 N	None	NEPHI	UT	84648	8900	00	None	39.7306275	-111.83724	Juab County
160166	Fee-for-Service	1164588356	1164588356	1	1	ECHOLS, JOHN C MD	8/31/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84042	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
160171	Fee-for-Service	1730440611	1730440611	1	1	ERICA CARLSSON MD	8/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKRA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
160194	Fee-for-Service	1699184838	1699184838	1	1	ENGLEMAN, MARISSA LCSW	3/15/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
160248	Fee-for-Service	1548729965	1548729965	1	1	ELLIOTT, MARLA R LMFT	1/9/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	136669	-	NOT APPLICABLE	0	In state provider	None	200 E WASHINGTON AVE	SUITE 100	ESCONDIDO	CA	92025	1806	37	06073	33.12748922	-117.0822898	San Diego County
160334	Fee-for-Service	1568620375	1568620375	1	1	ELMORE, DUDLEY G NP	6/9/2009	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
160359	Fee-for-Service	1497443618	1497443618	1	1	ELLIOTT, HANNA CRNA	2/19/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
160465	Fee-for-Service	1396482741	1396482741	1	1	ELSTON, JOANA NP	10/26/2022	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
160567	Fee-for-Service	1235669482	1235669482	1	1	EISENHOWER HEALTHCARE, LLC	6/1/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1470 N FAIR OAKS AVE	None	PASADENA	CA	91103	1801	19	06037	34.171128	-118.1506815	Los Angeles County
160619	Fee-for-Service	1770743403	1770743403	1	1	ENNEN, WILLIAM B MD	5/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104930	05	Anesthesiology	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
160625	Fee-for-Service	1912667171	1912667171	1	1	ELATED HOME HEALTH CARE INC.	5/28/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14401 GILMORE ST	ST 20B	VAN NUYS	CA	91401	6231	19	06037	34.18766945	-118.446723	Los Angeles County
160674	Fee-for-Service	1306287073	1306287073	1	1	EADIE, JENMARIE C LCSW	11/29/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	66634	-	NOT APPLICABLE	0	In state provider	None	845 E ARROW HIGHWAY	None	POMONA	CA	91767	2535	19	06037	34.09032048	-117.734769	Los Angeles County
160715	Fee-for-Service	1619082773	1619082773	1	1	ES MED DISTRIBUTORS INC	3/23/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ES MEDICAL DISTRIBUTOR	8760 S BROADWAY	None	LOS ANGELES	CA	90003	3340	19	06037	33.9576852	-118.2782005	Los Angeles County
160812	Fee-for-Service	1396787289	1396787289	1	1	ERNST, RYAN P MD	5/20/2019	207P00000X	NA	Other	026	PHYSICIANS	160975	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
160821	Fee-for-Service	1801316922	1801316922	1	1	ESPINOZA-SAISI, MARIA A DO	10/22/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17029	08	Family Practice	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
160863	Fee-for-Service	1982905055	1982905055	1	1	EIDE, MICHAEL LMFT	11/30/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	82983	-	NOT APPLICABLE	0	In state provider	None	1735 ENTERPRISE DR	BLDG 1 STE 105A	FAIRFIELD	CA	94533	6822	48	06095	38.24294683	-122.060841	Solano County
160886	Fee-for-Service	1821071507	1821071507	1	1	ELLERBROEK, NANCY A MD	11/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	53683	78	Neoplastic Diseases/Oncology	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
160923	Fee-for-Service	1780220525	1780220525	1	1	ELK GROVE CARDIOLOGY INC	4/22/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	8120 TIMBERLAKE WAY	STE 210B	SACRAMENTO	CA	95823	5414	34	06067	38.461023	-121.41414	Sacramento County
161148	Fee-for-Service	1558674374	1558674374	1	1	ENTEZARI, AMIR E MD	2/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122478	42	Nuclear Medicine	0	In state provider	None	2110 N BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
161277	Fee-for-Service	1518915883	1518915883	1	1	EIRICH, CHRISTIAN A MD	8/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93355	05	Anesthesiology	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
161308	Fee-for-Service	1821258138	1821258138	1	1	ELDRIDGE, ROBERT L MD	12/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126988	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
161340	Fee-for-Service	1326017617	1326017617	1	1	EISLER, JESSE MD	8/24/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	91900	20	Orthopedic Surgery	0	In state provider	None	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	30	06059	33.67110839	-117.8658914	Orange County
161429	Fee-for-Service	1558802843	1558802843	1	1	EVANS, NEIL MD	9/23/2022	390200000X	NA	Other	026	PHYSICIANS	182303	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
161458	Fee-for-Service	1508026550	1508026550	1	1	EGARI, ROY MD MEDICAL	7/27/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	CLINIC	18011 PIONEER BLVD	None	ARTESIA	CA	90701	3904	19	06037	33.867315	-118.082318	Los Angeles County
161518	Fee-for-Service	1780616979	1780616979	1	1	ELLIOTT, EDWARD A MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	46299	36	Psychiatry	0	In state provider	None	3017 SANTA MONICA BLVD	STE 201	SANTA MONICA	CA	90404	2536	19	06037	34.03673939	-118.470075	Los Angeles County
161608	Fee-for-Service	1073680757	1073680757	2	1	EL MONTE FAMILY MEDICAL	3/2/2018	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	GROUP	11227 VALLEY BLVD	None	EL MONTE	CA	91731	3225	19	06037	34.07208303	-118.0320879	Los Angeles County
161621	Fee-for-Service	1619175254	1619175254	1	1	ELIAS, ZOUHEIR H MD APC	6/24/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33856	41	Internal Medicine	0	In state provider	None	18350 ROSCOE BLVD	SUITE 401	NORTHRIDGE	CA	91325	4169	19	06037	34.22071855	-118.5341175	Los Angeles County
161669	Fee-for-Service	1568894988	1568894988	1	1	ESKENAZI, JONATHAN J MD	2/6/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	140464	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1842	19	06037	34.07671715	-118.3799413	Los Angeles County
161701	Fee-for-Service	1174336135	1174336135	1	1	ELIZABETH IAQUINTO LICENSED	1/31/2025	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	RAPY	420 BULLARD AVENUE	STE 104	CLOVIS	CA	93612	1054	10	06019	36.82298124	-119.7038474	Fresno County
161869	Fee-for-Service	1407111826	1407111826	1	1	EWING, JENNA R	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
161886	Fee-for-Service	1215970793	1215970793	1	1	EVANS, STEPHEN S MD	7/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131431	41	Internal Medicine	0	In state provider	None	1600 NORTH ROSE AVE	None	OXNARD	CA	93030	3722	56	06111	34.21700406	-119.1582582	Ventura County
161889	Fee-for-Service	1497136055	1497136055	1	1	ELLIS, AMANDA CHRISTINE PT	7/7/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	815 TUCKER RD	B	TEHACHAPI	CA	93561	2513	15	06029	35.123004	-118.4678255	Kern County
161897	Fee-for-Service	1073680757	1073680757	2	1	EL MONTE FAMILY MEDICAL	1/27/2012	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP	11227 VALLEY BLVD	None	EL MONTE	CA	91731	3225	19	06037	34.07208303	-118.0320879	Los Angeles County
161904	Fee-for-Service	1558821769	1558821769	1	1	ELLISON, JUSTIN T CRNA	3/10/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4700 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6082	19	06037	34.09812055	-118.2921165	Los Angeles County
161945	Fee-for-Service	1083073175	1083073175	1	1	EMERGENCY PHYSICIANS URGENT	9/18/2018	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	4871 WHITE LN	None	BAKERSFIELD	CA	93309	6375	15	06029	35.31793896	-119.0561249	Kern County
161953	Fee-for-Service	1689921363	1689921363	1	1	EMAMI-NAEINI, PARISA MD	7/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142855	18	Ophthalmology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
161976	Fee-for-Service	1720545742	1720545742	1	1	EVEXIA HEALTH SERVICES, LLC.	8/6/2019	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	109 E 11TH ST	SUITE 1	CORONA	CA	92879	2157	33	06065	33.87018535	-117.5668144	Riverside County
162002	Fee-for-Service	1023305331	1023305331	1	1	EGB HOLDINGS	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	151 KALMUS DRIVE	SUITE D-101	COSTA MESA	CA	92626	5988	30	06059	33.67282141	-117.8824994	Orange County
162013	Fee-for-Service	1033174933	1033174933	1	1	EVERGREEN HOSP MED CTR	6/1/1998	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	12040 NE 128TH ST	None	KIRKLAND	WA	98034	3013	00	None	47.71493427	-122.1792761	King County
162022	Fee-for-Service	1225337447	1225337447	1	1	EMRANI, PARASTU S MD	8/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147980	41	Internal Medicine	0	In state provider	None	11370 ANDERSON STREET	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
162049	Fee-for-Service	1790798460	1790798460	1	1	EASTERN SIERRA RADIOLOGY, A	11/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	22120	30	Radiology	0	In state provider	MEDICAL CORPORATION	150 PIONEER LN	None	BISHOP	CA	93514	2556	14	06027	37.36193834	-118.4073304	Inyo County
162163	Fee-for-Service	1851728919	1851728919	1	1	EPPS, MINDY L LMFT	8/27/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
162175	Fee-for-Service	1932318565	1932318565	1	1	EKPENYONG, ATIM MD	4/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134969	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
162232	Fee-for-Service	1083073175	1083073175	1	1	EMERGENCY PHYSICIANS URGENT	9/29/2020	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4871 WHITE LN	None	BAKERSFIELD	CA	93309	6375	15	06029	35.31793896	-119.0561249	Kern County
162255	Fee-for-Service	1013453612	1013453612	1	1	EGUCHI, KELLY J CNP	8/19/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
162263	Fee-for-Service	1720545742	1720545742	1	1	EVEXIA HEALTH SERVICES, LLC.	8/6/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	109 E 11TH ST	SUITE 1	CORONA	CA	92879	2157	33	06065	33.87018535	-117.5668144	Riverside County
162300	Fee-for-Service	1033174933	1033174933	1	1	EVERGREEN HOSP MED CTR	6/1/1998	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	12040 NE 128TH ST	None	KIRKLAND	WA	98034	3013	00	None	47.71493427	-122.1792761	King County
162351	Fee-for-Service	1942753157	1942753157	1	1	ESHANZADA, RIBA	8/28/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
162462	Fee-for-Service	1932318565	1932318565	1	1	EKPENYONG, ATIM MD	4/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134969	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
162838	Fee-for-Service	1164748901	1164748901	1	1	EVENS, ALEXANDER DO INC	12/16/2009	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	9461	41	Internal Medicine	0	In state provider	None	1199 DELBON AVE	STE 5	TURLOCK	CA	95382	2006	50	06099	37.51067196	-120.835684	Stanislaus County
163031	Fee-for-Service	1447703954	1447703954	1	1	ESHBAUGH, ROBERT M MD	7/25/2023	207R00000X	NA	Other	026	PHYSICIANS	166855	None	None	0	In state provider	None	10 CONGRESS ST	STE 208	PASADENA	CA	91105	3027	19	06037	34.13396893	-118.1528162	Los Angeles County
163107	Fee-for-Service	1528394319	1528394319	1	1	ENG, STEVE M DPM INC	11/30/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	18111 BROOKHURST ST	STE 3400	FOUNTAIN VALLEY	CA	92870	6728	30	06059	33.70027259	-117.9544055	Orange County
163120	Fee-for-Service	1063857597	1063857597	1	1	ELLIOTT, PETER A MD	6/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134837	34	Urology and Urological Surgery	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
163121	Fee-for-Service	1871203273	1871203273	1	2	EDWARDS, TARA E LMFT	7/24/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
163161	Fee-for-Service	1760607790	1760607790	1	1	EASTERN SIERRA UROLOGY APC.	6/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	67284	34	Urology and Urological Surgery	0	In state provider	INC	152 PIONEER LN	STE F	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
163241	Fee-for-Service	1679767792	1679767792	1	1	ECKSTEIN, LAUREN A MD	12/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	95107	18	Ophthalmology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
163343	Fee-for-Service	1114364502	1114364502	1	1	EVON, KATHIE R LMFT	3/9/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2667 CAMINO DEL RIO S	STE 301-9	SAN DIEGO	CA	92108	3705	37	06073	32.76977026	-117.135564	San Diego County
163384	Fee-for-Service	1558466607	1558466607	1	1	ERIC SMEDEGAARD M.D.	2/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	98-1079 MOANALUA RD	None	AIEA	HI	96701	4713	00	None	21.38373524	-157.937629	Honolulu County
163443	Fee-for-Service	1033109145	1033109145	1	1	EBBA, HAILU MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69622	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
163451	Fee-for-Service	1760607790	1760607790	1	1	EASTERN SIERRA UROLOGY APC.	6/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	67284	01	General Practice	0	In state provider	INC	152 PIONEER LN	STE F	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
163500	Fee-for-Service	1912004193	1912004193	1	1	ENDOSCOPY SURGERY CENTER	3/2/2001	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	OF SANTA MARIA, LP	116 S PALISADE DR	None	SANTA MARIA	CA	93454	8904	42	06083	34.9523869	-120.4120717	Santa Barbara County
163515	Fee-for-Service	1093905374	1093905374	1	1	EISENSTEIN, DHANYA B LMFT	7/19/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	519 N LA CIENEGA BLVD	STE 16	WEST HOLLYWOOD	CA	90048	2007	19	06037	34.0807556	-118.3766237	Los Angeles County
163549	Fee-for-Service	1720038599	1720038599	1	1	ELLIOTT, GREGORY MD	7/24/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
163657	Fee-for-Service	1639549991	1639549991	1	1	ENRIQUEZ QUEZADA, JOSUE D LC	4/30/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
163715	Fee-for-Service	1508875808	1508875808	1	1	EVANS, HELEN A MD	1/1/1998	207L00000X	NA	Other	026	PHYSICIANS	80287	05	Anesthesiology	0	In state provider	BAY ANESTHESIA MED GROUP	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
163837	Fee-for-Service	1558352559	1558352559	1	1	EIDENBERG, MARSHALL E DO	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	26036	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2700 DOLBEER STREET	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
163876	Fee-for-Service	1962053496	1962053496	1	1	ELITE HOME HEALTH GROUP	3/30/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	232 N LAKE AVE	SUITE 215	PASADENA	CA	91101	1862	19	06037	34.150005	-118.1323505	Los Angeles County
163877	Fee-for-Service	1174151450	1174151450	1	1	EBERHARDT, CARA MD	7/13/2023	390200000X	NA	Other	026	PHYSICIANS	181202	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
163890	Fee-for-Service	1154664910	1154664910	1	1	EDLINGER, JOSHUA P	8/18/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
163901	Fee-for-Service	1861504797	1861504797	3	1	ELEVATE PHARMACY INC	10/26/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12370 HESPERIA RD	SUITE 7	VICTORVILLE	CA	92395	7719	36	06071	34.47625382	-117.2913208	San Bernardino County
163936	Fee-for-Service	1902415086	1902415086	1	1	ELTA HOME HEALTH CARE INC	9/24/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6454 VAN NUYS BLVD	STE 6	VAN NUYS	CA	91401	1445	19	06037	34.187886	-118.448714	Los Angeles County
164019	Fee-for-Service	1083641864	1083641864	1	1	ENGERS, JOHN A III MD	9/26/2007	2084P0800X	NA	Psychiatry	026	PHYSICIANS	42499	36	Psychiatry	0	In state provider	None	1860 MOWRY AVE	STE 200	FREMONT	CA	94538	1730	01	06001	37.55887933	-121.9797796	Alameda County
164036	Fee-for-Service	1184078099	1184078099	1	1	ENWEASOR, CHIOMA MD	9/1/2021	2080P0201X	NA	Neurology	026	PHYSICIANS	151014	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
164062	Fee-for-Service	1578560413	1578560413	1	1	EHRLICH, RICHARD M MD	12/15/1998	208800000X	NA	Other	026	PHYSICIANS	14024	34	Urology and Urological Surgery	0	In state provider	None	100 UCLA MEDICAL PLZ	STE 690	LOS ANGELES	CA	90024	7000	19	06037	34.06544724	-118.4459249	Los Angeles County
164135	Fee-for-Service	1295701621	1295701621	1	1	ERMAN, RUSS D MD	3/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	63323	05	Anesthesiology	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1804	56	06111	34.2064445	-118.8824085	Ventura County
164136	Fee-for-Service	1821232877	1821232877	2	1	EXPRESS MEDI-TRANS INC	9/2/2014	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2553 VICTOR AVE.	B	REDDING	CA	96002	9338	45	06089	40.57002683	-122.3388964	Shasta County
164194	Fee-for-Service	1154352508	1154352508	1	1	ENGEL, MOSHE D MD	1/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88149	08	Family Practice	0	In state provider	None	911 SUNSET DRIVE	None	HOLLISTER	CA	95023	5695	35	06069	36.83504962	-121.3858245	San Benito County
164341	Fee-for-Service	1780627141	1780627141	1	1	ENG, STEVE M DPM	4/1/2002	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	11160 WARNER AVE	STE 405	FOUNTAIN VALLEY	CA	92708	4056	30	06059	33.71630854	-117.934317	Orange County
164350	Fee-for-Service	1578560413	1578560413	1	1	EHRLICH, RICHARD M MD	12/15/1998	208800000X	NA	Other	026	PHYSICIANS	14024	02	General Surgery	0	In state provider	None	100 UCLA MEDICAL PLZ	STE 690	LOS ANGELES	CA	90024	7000	19	06037	34.06544724	-118.4459249	Los Angeles County
164482	Fee-for-Service	1154352508	1154352508	1	1	ENGEL, MOSHE D MD	1/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88149	66	Emergency Medicine (Urgent Care)	0	In state provider	None	911 SUNSET DRIVE	None	HOLLISTER	CA	95023	5695	35	06069	36.83504962	-121.3858245	San Benito County
164516	Fee-for-Service	1336118702	1336118702	1	1	EUGENE ORTIZ, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3811 OHARA ST	None	PITTSBURGH	PA	15213	2593	00	None	40.44350017	-79.95952606	Allegheny County
164586	Fee-for-Service	1295266179	1295266179	1	1	ERNSTBERGER, ZACHARY J MD	7/28/2020	207QA0505X	NA	Adult Primary Care	026	PHYSICIANS	159105	08	Family Practice	0	In state provider	None	12746 W JEFFERSON BLVD	FL 2-4	LOS ANGELES	CA	90094	2885	19	06037	33.97751255	-118.417598	Los Angeles County
164636	Fee-for-Service	1366581456	1366581456	1	1	EVILSIZER, DANIELLE L PSYD	4/8/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	801 TRAEGER AVE	SUITE 209	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
164670	Fee-for-Service	1245668607	1245668607	1	1	ELITE WOMEN HEALTH APMC	6/16/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	99801	None	None	0	In state provider	None	1801 28TH ST	None	BAKERSFIELD	CA	93301	2101	15	06029	35.38478709	-119.0223992	Kern County
164710	Fee-for-Service	1699323709	1699323709	1	1	EZRA HOSPICE INC	3/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	16114 HART ST	None	VAN NUYS	CA	91406	3903	19	06037	34.19749625	-118.4843828	Los Angeles County
164715	Fee-for-Service	1841565504	1841565504	1	1	ESCOBAR, AMBERLY N LMFT	9/6/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9000 MING AVE	STE L-1B	BAKERSFIELD	CA	93311	1318	15	06029	35.33989328	-119.1034715	Kern County
164740	Fee-for-Service	1215477617	1215477617	1	1	ELHAJ, TAMARA	8/18/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
164754	Fee-for-Service	1689236598	1689236598	1	1	ENABLE BIOSCIENCES INC	11/22/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	510 MYRTLE AVE	STE 101	SOUTH SAN FRANCIS	CA	94080	4562	41	06081	37.64784196	-122.4200436	San Mateo County
164999	Fee-for-Service	1699323709	1699323709	1	1	EZRA HOSPICE INC	3/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	16114 HART ST	None	VAN NUYS	CA	91406	3903	19	06037	34.19749625	-118.4843828	Los Angeles County
165049	Fee-for-Service	1841711967	1841711967	1	1	EILKHANI, ELNOUR LMFT	7/8/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
165181	Fee-for-Service	1104096825	1104096825	1	1	ENGELSTAD, CHERYL A MFT	10/24/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	36007	-	NOT APPLICABLE	0	In state provider	None	1885 LUNDY AVENUE	223	SAN JOSE	CA	95131	1888	43	06085	37.39329538	-121.8907367	Santa Clara County
165265	Fee-for-Service	1336634559	1336634559	1	1	EVERLY, DANIELLE LMFT	12/14/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	116445	-	NOT APPLICABLE	0	In state provider	None	1207 EAST FRUIT STREET	BUILDING B	SANTA ANA	CA	92701	4206	30	06059	33.75238847	-117.8539245	Orange County
165274	Fee-for-Service	1518796192	1518796192	1	1	ERIKA OLIVAREZ MARRIAGE AND	8/1/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FAMILY THERAPIST INC	1267 S MAIN ST	None	SALINAS	CA	93901	2293	27	06053	36.65617771	-121.6599411	Monterey County
165302	Fee-for-Service	1225238694	1225238694	1	1	EALEY, SHALBE PSYD	1/23/2019	103TF0200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
165336	Fee-for-Service	1396257382	1396257382	1	1	EZEMONYE, IJEOMA H NP	3/31/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95007825	-	NOT APPLICABLE	0	In state provider	None	4450 W. CENTURY BLVD.	None	INGLEWOOD	CA	90304	1504	19	06037	33.94541353	-118.3540815	Los Angeles County
165370	Fee-for-Service	1295761864	1295761864	1	1	ENRIGHT, STEVE MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30846	08	Family Practice	0	In state provider	None	PO BOX 2576	None	TRUCKEE	CA	96160	2576	29	06057	0	0	None
165396	Fee-for-Service	1063514479	1063514479	1	1	ESFANDIARIFARD, ESFANDIA	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74046	41	Internal Medicine	0	In state provider	MD INC	16661 VENTURA BLVD	STE 515	ENCINO	CA	91436	1972	19	06037	34.15820737	-118.496492	Los Angeles County
165420	Fee-for-Service	1154715514	1154715514	1	1	ELHAWARY, CHADDY MD	7/29/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163010	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
165424	Fee-for-Service	1811529308	1811529308	1	1	EMERY, MEGAN L LMFT	5/2/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1068 E MAIN ST	STE 140C	VENTURA	CA	93001	5045	56	06111	34.28082049	-119.284443	Ventura County
165551	Fee-for-Service	1699177857	1699177857	1	1	EASTONE ACUPUNCTURE, INC	3/2/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	4951 LINCOLN AVE	None	CYPRESS	CA	90630	2655	30	06059	33.8318043	-118.0466562	Orange County
165577	Fee-for-Service	1003202813	1003202813	1	1	ELLINGTON, NATALIE MD	3/4/2021	207ZP0102X	NA	Other	026	PHYSICIANS	128785	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
165591	Fee-for-Service	1356990998	1356990998	1	1	ESPINOZA, VANESSA	6/7/2021	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2908 WESTMINSTER	None	SEAL BEACH	CA	90740	5305	30	06059	33.7594287	-118.0804604	Orange County
165642	Fee-for-Service	1467588350	1467588350	1	1	ESCALANTE DE LEAL, ISABEL C	7/26/2021	174400000X	NA	Other	026	PHYSICIANS	52929	None	None	0	In state provider	MD	2755 HERNDON AVE	None	CLOVIS	CA	93611	6801	10	06019	36.83745149	-119.6604315	Fresno County
165657	Fee-for-Service	1295761864	1295761864	1	1	ENRIGHT, STEVE MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30846	66	Emergency Medicine (Urgent Care)	0	In state provider	None	PO BOX 2576	None	TRUCKEE	CA	96160	2576	29	06057	0	0	None
165795	Fee-for-Service	1720559511	1720559511	1	1	EASY NEMT INC	1/29/2019	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1100 MELODY LN	133	ROSEVILLE	CA	95678	5203	31	06061	38.72518759	-121.2912717	Placer County
165835	Fee-for-Service	1801272398	1801272398	1	1	EYE INSTITUTE OF SOUTHERN	5/9/2016	207W00000X	NA	Ophthalmology	026	PHYSICIANS	120299	18	Ophthalmology	0	In state provider	CALIFORNIA AMC	16311 VENTURA BLVD	SUITE 955	ENCINO	CA	91436	4339	19	06037	34.15706864	-118.4885978	Los Angeles County
165863	Fee-for-Service	1386813103	1386813103	1	1	EL-BERSHAWI MEDICAL CORP	6/29/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3975 JACKSON ST	STE 303	RIVERSIDE	CA	92503	3950	33	06065	33.92729721	-117.4413503	Riverside County
165926	Fee-for-Service	1356887210	1356887210	1	1	EPPS, JASMINE S	12/1/2017	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	8424 HOOPER AVENUE	None	LOS ANGELES	CA	90001	3741	19	06037	33.96221486	-118.2539868	Los Angeles County
166037	Fee-for-Service	1255007175	1255007175	1	1	EVERLAST HOME HEALTH CARE	6/20/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1545 N VERDUGO RD	UNIT 219	GLENDALE	CA	91208	3223	19	06037	34.16921698	-118.2280083	Los Angeles County
166066	Fee-for-Service	1932790391	1932790391	1	1	EAGLE EYE HOSPICE INC	8/5/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	127 S BRAND BLVD	STE 223	GLENDALE	CA	91204	1373	19	06037	34.145289	-118.255096	Los Angeles County
166103	Fee-for-Service	1053456608	1053456608	1	1	ERLICH, MICHAEL A MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	23888	13	Neurology (M.D. only)	0	In state provider	None	3650 SOUTH ST	STE 108	LAKEWOOD	CA	90712	1533	19	06037	33.86019847	-118.149255	Los Angeles County
166190	Fee-for-Service	1376626754	1376626754	1	1	EMONT, ERIC M MD	9/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	41135	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
166214	Fee-for-Service	1780639039	1780639039	1	1	ELLISON, HARRY P MD	7/1/1985	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	50309	None	None	0	In state provider	None	5565 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3020	37	06073	32.77978322	-117.0094766	San Diego County
166215	Fee-for-Service	1356887210	1356887210	1	1	EPPS, JASMINE S	12/1/2017	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	8424 HOOPER AVENUE	None	LOS ANGELES	CA	90001	3741	19	06037	33.96221486	-118.2539868	Los Angeles County
166233	Fee-for-Service	1992996235	1992996235	1	1	EMANUEL PHYSICIAN CENTER	10/4/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2121 COLORADO AVE	None	TURLOCK	CA	95382	2011	50	06099	37.5117454	-120.8353096	Stanislaus County
166352	Fee-for-Service	1750651675	1750651675	1	1	EYO, VERONICA N N LCSW	7/26/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	482 N ROSEMEAD BLVD	STE 103	PASADENA	CA	91107	3000	19	06037	34.15457831	-118.078192	Los Angeles County
166354	Fee-for-Service	1932790391	1932790391	1	1	EAGLE EYE HOSPICE INC	8/5/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	127 S BRAND BLVD	STE 223	GLENDALE	CA	91204	1373	19	06037	34.145289	-118.255096	Los Angeles County
166466	Fee-for-Service	1326070913	1326070913	1	1	EYECARE SPECIALISTS MEDICAL	10/3/2018	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	361 HOSPITAL RD	STE 425	NEWPORT BEACH	CA	92663	3525	30	06059	33.62579141	-117.9299554	Orange County
166471	Fee-for-Service	1952963316	1952963316	1	1	EYO MORALES, JENNIFER LCSW	2/22/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
166634	Fee-for-Service	1720047897	1720047897	1	1	EGAN, JAMES W JR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	39625	41	Internal Medicine	0	In state provider	None	920 SUNNYSLOPE RD	None	HOLLISTER	CA	95023	5784	35	06069	36.83913141	-121.3857821	San Benito County
166653	Fee-for-Service	1215768692	1215768692	1	1	EILEEN WARREN PHD PROFESSION	1/30/2025	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	AL PSYCHOLOGY CORPORATIO	1140 RAILROAD ST	None	PASO ROBLES	CA	93446	2532	40	06079	35.62645486	-120.6881426	San Luis Obispo County
166687	Fee-for-Service	1275549115	1275549115	1	1	ENGEVIK, RUSSELL W MD	11/30/1989	207P00000X	NA	Other	026	PHYSICIANS	56460	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3475 KENYON ST	None	SAN DIEGO	CA	92110	5002	37	06073	32.74962645	-117.2151566	San Diego County
166710	Fee-for-Service	1689287492	1689287492	1	1	EXCLUSIVE HOSPICE CARE INC	4/5/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	30101 AGUORA CT	SUITE 123	AGUORA HILLS	CA	91301	4311	19	06037	34.14595891	-118.7777602	Los Angeles County
166754	Fee-for-Service	1326070913	1326070913	1	1	EYECARE SPECIALISTS MEDICAL	10/3/2018	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	361 HOSPITAL RD	STE 425	NEWPORT BEACH	CA	92663	3525	30	06059	33.62579141	-117.9299554	Orange County
166765	Fee-for-Service	1063403988	1063403988	1	1	EDWARD K CHIU	7/23/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1021 MT DECHANTAL RD	None	WHEELING	WV	26003	0000	00	None	40.06623652	-80.6942475	Ohio County
166775	Fee-for-Service	1396779344	1396779344	1	3	EAST BAY VISION CENTER OPTOM	11/6/2019	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ETRY	388 9TH STREET	SUITE 157	OAKLAND	CA	94607	4290	01	06001	37.80019425	-122.2715222	Alameda County
166807	Fee-for-Service	1811968605	1811968605	1	2	EPSTEIN, BEVERLY A MD	12/31/1987	207N00000X	NA	Dermatology	026	PHYSICIANS	58602	07	Dermatology	0	In state provider	None	450 SUTTER ST	RM 1306	SAN FRANCISCO	CA	94108	4002	38	06075	37.78934929	-122.4077786	San Francisco County
166838	Fee-for-Service	1922022029	1922022029	1	1	ELLISON, DOUGLAS JULES	1/31/1990	207ZP0102X	NA	Other	026	PHYSICIANS	53026	01	General Practice	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
166910	Fee-for-Service	1417164427	1417164427	1	1	EGUCHI, JIM H MD	10/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85667	40	Pediatrics	0	In state provider	None	565 N MOUNT VERNON AVE	None	SAN BERNARDINO	CA	92411	2661	36	06071	34.109406	-117.313813	San Bernardino County
166975	Fee-for-Service	1992232565	1992232565	1	1	EHTESHAMI AFSHAR, SOLMAZ MD	10/12/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	173572	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
166993	Fee-for-Service	1750488656	1750488656	1	1	E.C. MEDICAL EQUIP, INC	4/14/2005	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1501 MARINER DR	None	OXNARD	CA	93033	2469	56	06111	34.18604556	-119.1670414	Ventura County
166998	Fee-for-Service	1689287492	1689287492	1	1	EXCLUSIVE HOSPICE CARE INC	4/5/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	30101 AGUORA CT	SUITE 123	AGUORA HILLS	CA	91301	4311	19	06037	34.14595891	-118.7777602	Los Angeles County
167035	Fee-for-Service	1033241401	1033241401	1	1	ESCUDERO-ANDERSON, MARGOT L	12/3/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CSW	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
167067	Fee-for-Service	1609898659	1609898659	2	1	EBRAHIMIAN, SHAHIN MD	4/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	88201	05	Anesthesiology	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
167075	Fee-for-Service	1043212376	1043212376	1	1	EAR, NOSE AND THROAT	7/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	03	Allergy	0	In state provider	MEDICAL CLINIC, INC	1050 LAS TABLAS RD	None	TEMPLETON	CA	93465	9729	40	06079	35.55442352	-120.7183455	San Luis Obispo County
167078	Fee-for-Service	1538677398	1538677398	1	1	ENCINO MEDICAL PHARMACY INC	11/19/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17479 VENTURA BLVD	None	ENCINO	CA	91316	3828	19	06037	34.16138071	-118.5132766	Los Angeles County
167114	Fee-for-Service	1730585456	1730585456	1	1	ELITEMED LABORATORIES LLC	5/23/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	14468 MIDWAY RD	None	DALLAS	TX	75244	3509	00	None	32.94839739	-96.83876425	Dallas County
167154	Fee-for-Service	1861480717	1861480717	1	1	EL-KHOURY,GEORGES Y MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	0000	00	None	41.659929	-91.548099	Johnson County
167174	Fee-for-Service	1164713517	1164713517	3	1	EUREKA PHARMACY LLC	9/10/2021	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	ACY	525 5TH	STE. B	EUREKA	CA	95501	1032	12	06023	40.8020516	-124.1653625	Humboldt County
167206	Fee-for-Service	1841619160	1841619160	1	1	ESTRADA, DILIANA B LMFT	8/29/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4502 EAST AVE S	None	PALMDALE	CA	93552	4480	19	06037	34.55800153	-118.0488825	Los Angeles County
167263	Fee-for-Service	1992232565	1992232565	1	1	EHTESHAMI AFSHAR, SOLMAZ MD	10/12/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	173572	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
167267	Fee-for-Service	1346350386	1346350386	1	1	ELIZABETH J. COVINGTON, MD,	12/1/1981	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	40179	08	Family Practice	0	In state provider	P	3762 SANTA ROSALIA DR	C30	LOS ANGELES	CA	90008	3612	19	06037	34.0093581	-118.3391847	Los Angeles County
167328	Fee-for-Service	1578677969	1578677969	1	1	ESMAILIAN, FARBOD MD	4/10/2025	208200000X	NA	General Surgery	026	PHYSICIANS	74047	24	Plastic Surgery	0	In state provider	None	2888 LONG BEACH BLVD	165	LONG BEACH	CA	90806	1561	19	06037	33.809706	-118.189343	Los Angeles County
167360	Fee-for-Service	1043212376	1043212376	1	1	EAR, NOSE AND THROAT	7/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	MEDICAL CLINIC, INC	1050 LAS TABLAS RD	None	TEMPLETON	CA	93465	9729	40	06079	35.55442352	-120.7183455	San Luis Obispo County
167538	Fee-for-Service	1164886982	1164886982	1	1	EIDEMILLER, SETH A MD	8/14/2019	207P00000X	NA	Other	026	PHYSICIANS	151960	66	Emergency Medicine (Urgent Care)	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
167618	Fee-for-Service	1508292053	1508292053	1	1	ESTIU SANCHEZ, HERBERT MD	9/21/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	131705	08	Family Practice	0	In state provider	None	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	15	06029	35.3687456	-119.1106561	Kern County
167676	Fee-for-Service	1275909525	1275909525	1	1	EDWARDS, KONEECHIA C CNP	6/29/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
167684	Fee-for-Service	1508824525	1508824525	1	1	EBENEZER, SUDESH MD	9/9/2024	207T00000X	NA	General Surgery	026	PHYSICIANS	100489	14	Neurological Surgery	0	In state provider	None	6555 COYLE	SUITE 220	CARMICHAEL	CA	95608	0303	34	06067	38.66859	-121.3118055	Sacramento County
167767	Fee-for-Service	1346317203	1346317203	1	1	EZROJ, ALBERT MD	7/1/1984	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	37348	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
167793	Fee-for-Service	1295190361	1295190361	1	1	ESSELSTROM, LINNEA M PSYD	2/6/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	6968	19	06037	34.07067	-118.4432445	Los Angeles County
167935	Fee-for-Service	1467195073	1467195073	1	12	EMANATE HEALTH MEDICAL CARE	10/7/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOUNDATION	315 E ROUTE 66	None	GLENDORA	CA	91740	6244	19	06037	34.1288429	-117.8607244	Los Angeles County
167938	Fee-for-Service	1366705329	1366705329	1	1	ENTER, DANIEL H MD	7/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154259	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
168075	Fee-for-Service	1639203672	1639203672	1	1	EAST BAY SURGICAL ASSOC	4/30/1992	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	MEDICAL GROUP	1430 TARA HILLS DR	STE D	PINOLE	CA	94564	2512	07	06013	37.99573181	-122.3044538	Contra Costa County
168123	Fee-for-Service	1750732988	1750732988	1	1	ELITE HEALTH & WELLNESS INC	4/10/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	22949 VENTURA BLVD	SUITE E	WOODLAND HILLS	CA	91364	1273	19	06037	34.16498048	-118.6266959	Los Angeles County
168130	Fee-for-Service	1467584730	1467584730	1	1	ESTRADA, RUBY M LMFT	4/2/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10722 ARROW RTE	314-316	RANCHO CUCAMONGA	CA	91730	4811	36	06071	34.09917725	-117.5708877	San Bernardino County
168150	Fee-for-Service	1336166305	1336166305	1	1	ELDENBURG,CURTIS E MD	1/4/2001	207L00000X	NA	Other	026	PHYSICIANS	85978	05	Anesthesiology	0	In state provider	None	1531 THE ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
168185	Fee-for-Service	1407116973	1407116973	1	1	EDWARDS, APRIL MD	6/10/2021	2080P0203X	NA	Other	026	PHYSICIANS	147425	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
168207	Fee-for-Service	1063544773	1063544773	1	1	EL SONBATY, MICHAEL R MD	8/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94543	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
168226	Fee-for-Service	1467195073	1467195073	1	12	EMANATE HEALTH MEDICAL CARE	10/7/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	315 E ROUTE 66	None	GLENDORA	CA	91740	6244	19	06037	34.1288429	-117.8607244	Los Angeles County
168296	Fee-for-Service	1417052937	1417052937	1	1	EL DORADO DRUG STORE	1/26/1976	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2005 E MARIPOSA RD	None	STOCKTON	CA	95205	7794	39	06077	37.93944578	-121.2453564	San Joaquin County
168304	Fee-for-Service	1396257382	1396257382	1	2	EZEMONYE, IJEOMA H NP	4/11/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
168355	Fee-for-Service	1104504372	1104504372	1	1	ELLIS, APRIL L LCSW	5/14/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1775 WOODSIDE RD	STE 203	REDWOOD CITY	CA	94061	3454	41	06081	37.45382723	-122.2289725	San Mateo County
168428	Fee-for-Service	1407230154	1407230154	1	1	ERORAHA, KESENA PT	2/10/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
168430	Fee-for-Service	1598373409	1598373409	1	1	ENRIQUEZ, CHRISTOPHER LMFT	6/17/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2140 EASTMAN AVE	STE 111	VENTURA	CA	93003	7786	56	06111	34.25340343	-119.2298871	Ventura County
168499	Fee-for-Service	1649314055	1649314055	1	1	ERICSON, RICHARD P MD	7/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111124	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1540 FLORIDA AVE	STE 100	MODESTO	CA	95350	4430	50	06099	37.667115	-120.9962205	Stanislaus County
168514	Fee-for-Service	1467195073	1467195073	1	12	EMANATE HEALTH MEDICAL CARE	10/7/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	FOUNDATION	315 E ROUTE 66	None	GLENDORA	CA	91740	6244	19	06037	34.1288429	-117.8607244	Los Angeles County
168542	Fee-for-Service	1740675784	1740675784	1	1	EWING, CHELSEA L LMFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
168639	Fee-for-Service	1700987922	1700987922	1	2	EXTENDED CARE HOSP OF	5/2/2005	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	OF WESTMINSTER	206 HOSPITAL CIRCLE	None	WESTMINSTER	CA	92683	3910	30	06059	33.76238177	-117.9945779	Orange County
168823	Fee-for-Service	1275794224	1275794224	1	1	EGHBALIEH, SAMMY D MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133688	01	General Practice	0	In state provider	None	5000 VAN NUYS BLVD	SUITE 200	SHERMAN OAKS	CA	91403	8064	19	06037	34.16148087	-118.4486642	Los Angeles County
168889	Fee-for-Service	1174574032	1174574032	1	1	EMPI, INC	11/3/2005	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	599 CARDIGAN RD	None	SAINT PAUL	MN	55126	4099	00	None	45.04861345	-93.12514692	Ramsey County
168893	Fee-for-Service	1871942029	1871942029	1	1	EGB HOLDINGS	12/15/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	151 KALMUS DR	SUITE D-104	COSTA MESA	CA	92626	5988	30	06059	33.67282141	-117.8824994	Orange County
168923	Fee-for-Service	1386022325	1386022325	1	1	EDEN, NEHA J MD	12/31/2019	390200000X	NA	Other	026	PHYSICIANS	154237	08	Family Practice	0	In state provider	None	1038 E BROKAW ROAD	SUITE 30	SAN JOSE	CA	95131	2309	43	06085	37.3827822	-121.8982439	Santa Clara County
168942	Fee-for-Service	1780754168	1780754168	1	1	ELFELT, TIMOTHY J MD	12/30/1991	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	41728	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	#100	36243 INLAND VALLEY DR	None	WILDOMAR	CA	92595	9549	33	06065	33.591528	-117.2393325	Riverside County
168945	Fee-for-Service	1972739605	1972739605	1	1	ESTRADA, JESSICA L	4/1/2014	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3418 LOMA VISTA RD	SUITE 5A	VENTURA	CA	93003	3016	56	06111	34.27643562	-119.2503132	Ventura County
168976	Fee-for-Service	1023435237	1023435237	1	1	ELITE PHYSICAL THERAPY AND F	8/19/2020	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ITNESS INC.	405 CRANE	None	TURLOCK	CA	95380	4525	50	06099	37.49533801	-120.8431733	Stanislaus County
169050	Fee-for-Service	1588901532	1588901532	1	33	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1300 N LA BREA AVE	None	LOS ANGELES	CA	90028	7504	19	06037	34.094502	-118.3440745	Los Angeles County
169083	Fee-for-Service	1750416038	1750416038	1	1	ESPARZA, SAMUEL D MD	6/26/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	82054	None	None	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
169167	Fee-for-Service	1730365446	1730365446	1	1	EAST-WEST EYE INSTITUTE A ME	3/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	1950 SAWTELLE BLVD	STE 240	LOS ANGELES	CA	90025	7073	19	06037	34.04141344	-118.444019	Los Angeles County
169175	Fee-for-Service	1578306759	1578306759	1	1	ESCOTO, ANTHONY M PT	7/30/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
169179	Fee-for-Service	1871942029	1871942029	1	1	EGB HOLDINGS	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	151 KALMUS DR	SUITE D-104	COSTA MESA	CA	92626	5988	30	06059	33.67282141	-117.8824994	Orange County
169277	Fee-for-Service	1275269086	1275269086	1	1	ERIK KEREKES, M.D., INC.	8/23/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	None	None	0	In state provider	None	401 OLD NEWPORT BLVD	STE 101	NEWPORT BEACH	CA	92663	4276	30	06059	33.62569628	-117.927011	Orange County
169343	Fee-for-Service	1588901532	1588901532	1	22	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	5101 LAKEWOOD BLVD	None	LAKEWOOD	CA	90712	2413	19	06037	33.850746	-118.1428485	Los Angeles County
169422	Fee-for-Service	1598224388	1598224388	1	1	EVANS, EMILY M MD	7/1/2022	207P00000X	NA	Other	026	PHYSICIANS	178703	None	None	0	In state provider	None	2825 CAPITOL AVENUE	None	SACRAMENTO	CA	95816	6039	34	06067	38.570805	-121.4696385	Sacramento County
169444	Fee-for-Service	1275977522	1275977522	1	2	ESTRADA, ROSANNE C MD	9/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134528	40	Pediatrics	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
169573	Fee-for-Service	1801892666	1801892666	1	1	EAPEN, MANOJ K MD	12/9/2020	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	169480	None	None	0	In state provider	None	3443 VILLA LANE	SUITE 2	NAPA	CA	94558	6417	28	06055	38.3259594	-122.2945735	Napa County
169617	Fee-for-Service	1013913508	1013913508	1	1	EMSLIE, JOSSALYN T MD	9/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	61668	08	Family Practice	0	In state provider	None	147 W SIERRA MADRE BLVD	None	SIERRA MADRE	CA	91024	2492	19	06037	34.16191714	-118.0557211	Los Angeles County
169626	Fee-for-Service	1447620562	1447620562	1	1	ENG, BARRETT J LMFT	3/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 E SHAW AVE	STE 230	FRESNO	CA	93710	7708	10	06019	36.80886739	-119.7731624	Fresno County
169630	Fee-for-Service	1588901532	1588901532	1	22	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	5101 LAKEWOOD BLVD	None	LAKEWOOD	CA	90712	2413	19	06037	33.850746	-118.1428485	Los Angeles County
169637	Fee-for-Service	1689677023	1689677023	1	1	EZ DIABETIC SUPPLIES INC	1/25/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	EZ DIABETIC SUPPLIES INC	61 STATE ROAD	None	WEST BATH	ME	04530	6301	00	None	43.905348	-69.837912	Sagadahoc County
169654	Fee-for-Service	1871572990	1871572990	1	1	ERVELLI,DOMINICK DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	311 WEST 1ST	None	WALL LAKE	IA	51466	7014	00	None	42.26939329	-95.09414979	Sac County
169726	Fee-for-Service	1215551858	1215551858	1	1	EDWARDS, MATTHEW MD	3/13/2025	207R00000X	NA	Other	026	PHYSICIANS	190940	41	Internal Medicine	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
169830	Fee-for-Service	1164887949	1164887949	1	1	EMERY, KARA A PSYD	1/21/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
169855	Fee-for-Service	1457375040	1457375040	1	1	ELTERMAN, JOSEPH J MD	9/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	88832	41	Internal Medicine	0	In state provider	None	450 E HUNTINGTON DRIVE	None	ARCADIA	CA	91006	3748	19	06037	34.14015053	-118.0208745	Los Angeles County
169915	Fee-for-Service	1588901532	1588901532	1	46	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	395 SILVER SPUR RD	None	ROLLING HILLS EST	CA	91302	2967	19	06037	33.77545411	-118.3751261	Los Angeles County
169916	Fee-for-Service	1588901532	1588901532	1	22	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	5101 LAKEWOOD BLVD	None	LAKEWOOD	CA	90712	2413	19	06037	33.850746	-118.1428485	Los Angeles County
169986	Fee-for-Service	1174149058	1174149058	1	1	EHLY-YU, JESSICA MD	9/3/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	179737	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
169996	Fee-for-Service	1255326039	1255326039	1	1	ENSIGN WHITTIER EAST LLC	8/1/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CARE CENTER	10426 BOGARDUS AVE	None	WHITTIER	CA	90603	2642	19	06037	33.941682	-117.9842205	Los Angeles County
169997	Fee-for-Service	1326417643	1326417643	1	1	EVANS, WILLIAM T LCSW	12/5/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
170018	Fee-for-Service	1700961489	1700961489	1	1	ESTEVA, JUAN C MD	8/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66995	None	None	0	In state provider	None	2450 WASHINGTON AVE	STE 120	SAN LEANDRO	CA	94577	5943	01	06001	37.7139863	-122.1490905	Alameda County
170049	Fee-for-Service	1235287038	1235287038	1	1	EPSTEIN, JOSEPH DAVID MD	5/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	38902	07	Dermatology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
170088	Fee-for-Service	1457791352	1457791352	1	1	ELIZABETH ROEBER M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 BROADWAY N	None	FARGO	ND	58102	3641	00	None	46.885068	-96.7872375	Cass County
170135	Fee-for-Service	1093910283	1093910283	1	2	EMC HOME HEALTH PROVIDERS	5/7/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7851 WALKER ST	SUITE 101	LA PALMA	CA	90623	1734	30	06059	33.848253	-118.037309	Orange County
170183	Fee-for-Service	1821289778	1821289778	1	1	ECKHART, KYLE CPO	7/25/2007	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1525 WEBSTER ST	STE E	FAIRFIELD	CA	94533	4997	48	06095	38.2570563	-122.0475622	Solano County
170199	Fee-for-Service	1588901532	1588901532	1	33	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1300 N LA BREA AVE	None	LOS ANGELES	CA	90028	7504	19	06037	34.094502	-118.3440745	Los Angeles County
170201	Fee-for-Service	1588901532	1588901532	1	46	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	395 SILVER SPUR RD	None	ROLLING HILLS EST	CA	91302	2967	19	06037	33.77545411	-118.3751261	Los Angeles County
170336	Fee-for-Service	1235287038	1235287038	1	1	EPSTEIN, JOSEPH DAVID MD	5/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	38902	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
170371	Fee-for-Service	1376800037	1376800037	1	1	ECKSTEIN, DONNA A MD	6/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153012	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
170384	Fee-for-Service	1174670764	1174670764	1	1	EAST SIDE UNION HIGH SD	3/10/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	830 N CAPITOL AVE	None	SAN JOSE	CA	95133	1316	43	06085	37.38132732	-121.8545737	Santa Clara County
170487	Fee-for-Service	1588901532	1588901532	1	46	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	395 SILVER SPUR RD	None	ROLLING HILLS EST	CA	91302	2967	19	06037	33.77545411	-118.3751261	Los Angeles County
170495	Fee-for-Service	1588901532	1588901532	1	22	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	5101 LAKEWOOD BLVD	None	LAKEWOOD	CA	90712	2413	19	06037	33.850746	-118.1428485	Los Angeles County
170541	Fee-for-Service	1669465258	1669465258	1	1	ENTABI, ANAS MD	6/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89044	41	Internal Medicine	0	In state provider	None	38925 TRADE CENTER DR	STE H	PALMDALE	CA	93551	3655	19	06037	34.59028112	-118.1433053	Los Angeles County
170573	Fee-for-Service	1730533795	1730533795	1	1	EVE GARDEN CONGREGATE LIVING	7/13/2017	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6703 NAGLE AVE	None	VAN NUYS	CA	91401	1212	19	06037	34.19226	-118.4236675	Los Angeles County
170602	Fee-for-Service	1043368905	1043368905	1	1	ELSWICK, BARRY D MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	60066	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
170671	Fee-for-Service	1174670764	1174670764	1	1	EAST SIDE UNION HIGH SD	11/20/1994	251300000X	NA	Other	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	830 N CAPITOL AVE	None	SAN JOSE	CA	95133	1316	43	06085	37.38132732	-121.8545737	Santa Clara County
170774	Fee-for-Service	1588901532	1588901532	1	33	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1300 N LA BREA AVE	None	LOS ANGELES	CA	90028	7504	19	06037	34.094502	-118.3440745	Los Angeles County
170775	Fee-for-Service	1588901532	1588901532	1	32	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2100 S EUCLID ST	102	ANAHEIM	CA	92802	4572	30	06059	33.7955698	-117.9412136	Orange County
170777	Fee-for-Service	1588901532	1588901532	1	46	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	395 SILVER SPUR RD	None	ROLLING HILLS EST	CA	91302	2967	19	06037	33.77545411	-118.3751261	Los Angeles County
170809	Fee-for-Service	1407261217	1407261217	1	1	ESFAHANI, AMIN MD	3/3/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	172964	None	None	0	In state provider	None	1324 NELSON AVE	STE B	MODESTO	CA	95350	5374	50	06099	37.66254751	-120.9881942	Stanislaus County
170838	Fee-for-Service	1558880773	1558880773	1	1	ELLA HOME HEALTH CARE INC	12/16/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	150 E MONTECITO AVE	SUITE A	SIERRA MADRE	CA	91204	2971	19	06037	34.16308921	-118.0495138	Los Angeles County
170890	Fee-for-Service	1891253100	1891253100	1	1	ESPARZA, BEATRIZ S LMFT	1/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
170904	Fee-for-Service	1689443772	1689443772	1	1	EPIDAURUS	10/1/2024	251B00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	3316 S MAIN ST	None	LOS ANGELES	CA	90007	4126	19	06037	34.01895179	-118.2724023	Los Angeles County
170928	Fee-for-Service	1689730236	1689730236	1	1	ELIAS, LETICIA S LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1392	43	06085	37.23418124	-121.7818366	Santa Clara County
171033	Fee-for-Service	1922309376	1922309376	1	1	ESOTERIX GENETIC LAB LLC	12/3/2010	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	655 EAST HUNTINGTON DR	None	MONROVIA	CA	91016	3636	19	06037	34.1406843	-117.9913223	Los Angeles County
171035	Fee-for-Service	1578703161	1578703161	1	1	EVANS, EDWARD H MD	2/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89211	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	MDCC B2-375	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
171063	Fee-for-Service	1588901532	1588901532	1	33	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1300 N LA BREA AVE	None	LOS ANGELES	CA	90028	7504	19	06037	34.094502	-118.3440745	Los Angeles County
171065	Fee-for-Service	1588901532	1588901532	1	32	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2100 S EUCLID ST	102	ANAHEIM	CA	92802	4572	30	06059	33.7955698	-117.9412136	Orange County
171067	Fee-for-Service	1588901532	1588901532	1	46	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	395 SILVER SPUR RD	None	ROLLING HILLS EST	CA	91302	2967	19	06037	33.77545411	-118.3751261	Los Angeles County
171078	Fee-for-Service	1912912486	1912912486	1	1	ELIZABETH A MIKOLA MD	3/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
171185	Fee-for-Service	1255300802	1255300802	1	1	ELLIOTT, JOHN P MD	8/23/2010	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	36299	01	General Practice	0	In state provider	None	24411 HEALTH CENTER DR	STE 300	LAGUNA HILLS	CA	92653	3689	30	06059	33.6087201	-117.7076948	Orange County
171217	Fee-for-Service	1588899512	1588899512	1	1	ERICK H ALAYO MC	6/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107506	10	Gastroenterology (M.D. only)	0	In state provider	None	353 CHURCH AVE	STE A	CHULA VISTA	CA	91910	3906	37	06073	32.63971988	-117.0781089	San Diego County
171238	Fee-for-Service	1568894988	1568894988	1	2	ESKENAZI, JONATHAN J MD	2/6/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	140464	13	Neurology (M.D. only)	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
171253	Fee-for-Service	1740273994	1740273994	1	1	ECTOR CO HOSP DIST	4/23/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	500 W 4TH ST	None	ODESSA	TX	79761	5001	00	None	31.84530365	-102.3731945	Ector County
171265	Fee-for-Service	1053652701	1053652701	1	1	ERICKSON, PENELOPE J	5/15/2014	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4510 VIEWRIDGE AVE	None	SAN DIEGO	CA	92123	1637	37	06073	32.82283469	-117.1248707	San Diego County
171292	Fee-for-Service	1639518004	1639518004	1	1	ESCONDIDO OPERATIONS, LP	1/19/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	500 E VALLEY PARKWAY	None	ESCONDIDO	CA	92025	3054	37	06073	33.12629953	-117.0759525	San Diego County
171301	Fee-for-Service	1962413443	1962413443	1	1	EICHBAUM, ELDAN B MD	2/2/1995	207T00000X	NA	General Surgery	026	PHYSICIANS	75775	14	Neurological Surgery	0	In state provider	None	45 CASTRO ST	STE 423	SAN FRANCISCO	CA	94114	1027	38	06075	37.76829732	-122.4357056	San Francisco County
171302	Fee-for-Service	1922091487	1922091487	1	1	ETNYRE & MIKUNI MEDICAL	7/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	GROUP	301 S MILLER STREET	SUITE 214	SANTA MARIA	CA	93454	5244	42	06083	34.950501	-120.431509	Santa Barbara County
171305	Fee-for-Service	1689664724	1689664724	1	1	ERICH W GARLAND, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3200 CHANNING WAY	None	IDAHO FALLS	ID	83404	7546	00	None	43.469028	-111.9901975	Bonneville County
171319	Fee-for-Service	1336181965	1336181965	1	1	EILBER, KARYN S MD	11/12/2010	208800000X	NA	Other	026	PHYSICIANS	62451	34	Urology and Urological Surgery	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
171322	Fee-for-Service	1578703161	1578703161	1	1	EVANS, EDWARD H MD	2/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89211	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10833 LE CONTE AVE	MDCC B2-375	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
171351	Fee-for-Service	1043463581	1043463581	1	1	EYMANN, CRAIG E DC	10/1/2020	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	131 FRONT ST	STE C4	SANTA CRUZ	CA	95060	4401	44	06087	36.96783621	-122.0235184	Santa Cruz County
171352	Fee-for-Service	1588901532	1588901532	1	32	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2100 S EUCLID ST	102	ANAHEIM	CA	92802	4572	30	06059	33.7955698	-117.9412136	Orange County
171358	Fee-for-Service	1588901532	1588901532	1	22	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5101 LAKEWOOD BLVD	None	LAKEWOOD	CA	90712	2413	19	06037	33.850746	-118.1428485	Los Angeles County
171431	Fee-for-Service	1992588313	1992588313	1	1	EUGENE ROSENMAN MD PROFESSIO	3/4/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	NAL CORPORATION	2401 E KATELLA AVE	625	ANAHEIM	CA	92806	5995	30	06059	33.80588529	-117.8828675	Orange County
171535	Fee-for-Service	1740273994	1740273994	1	1	ECTOR CO HOSP DIST	4/23/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	500 W 4TH ST	None	ODESSA	TX	79761	5001	00	None	31.84530365	-102.3731945	Ector County
171589	Fee-for-Service	1962413443	1962413443	1	1	EICHBAUM, ELDAN B MD	2/2/1995	207T00000X	NA	General Surgery	026	PHYSICIANS	75775	41	Internal Medicine	0	In state provider	None	45 CASTRO ST	STE 423	SAN FRANCISCO	CA	94114	1027	38	06075	37.76829732	-122.4357056	San Francisco County
171640	Fee-for-Service	1588901532	1588901532	1	33	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1300 N LA BREA AVE	None	LOS ANGELES	CA	90028	7504	19	06037	34.094502	-118.3440745	Los Angeles County
171642	Fee-for-Service	1588901532	1588901532	1	32	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2100 S EUCLID ST	102	ANAHEIM	CA	92802	4572	30	06059	33.7955698	-117.9412136	Orange County
171656	Fee-for-Service	1114905155	1114905155	1	1	EDWARDS, DANA C MD	8/31/1994	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	51908	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 OLD RIVER RD	STE 200	BAKERSFIELD	CA	93311	9506	15	06029	35.352648	-119.1122505	Kern County
171695	Fee-for-Service	1740347640	1740347640	1	1	ENG, STEPHEN K DO	4/1/1991	207LP2900X	NA	Other	026	PHYSICIANS	5336	05	Anesthesiology	0	In state provider	None	2275 HUNTINGTON DR	STE 337	SAN MARINO	CA	91108	2640	19	06037	34.12241876	-118.105206	Los Angeles County
171720	Fee-for-Service	1992588313	1992588313	1	1	EUGENE ROSENMAN MD PROFESSIO	3/4/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	NAL CORPORATION	2401 E KATELLA AVE	625	ANAHEIM	CA	92806	5995	30	06059	33.80588529	-117.8828675	Orange County
171801	Fee-for-Service	1528146370	1528146370	1	1	ESPINAS, PAUL A MD	11/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79542	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
171866	Fee-for-Service	1972934719	1972934719	1	1	ENTWISLE, JONATHAN M CRNA	9/16/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
171867	Fee-for-Service	1356536023	1356536023	1	1	EPLER, CHERYL L LCSW	5/26/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
171929	Fee-for-Service	1588901532	1588901532	1	32	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2100 S EUCLID ST	102	ANAHEIM	CA	92802	4572	30	06059	33.7955698	-117.9412136	Orange County
171938	Fee-for-Service	1164993408	1164993408	1	1	EMA HEALTHCARE INC	3/1/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1049 W GARDENA BLVD	SUITE A	GARDENA	CA	90247	4957	19	06037	33.88157045	-118.2931561	Los Angeles County
171958	Fee-for-Service	1366861825	1366861825	1	1	EDWARDS, ASHLEY R DO	8/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
171982	Fee-for-Service	1265863179	1265863179	1	3	ENLOE MEDICAL CENTER	9/29/2020	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ECIALISTS	135 MISSION RANCH BLVD	SUITE 100	CHICO	CA	95926	2175	04	06007	39.75330715	-121.8611016	Butte County
172022	Fee-for-Service	1457714982	1457714982	1	1	ESTEPANIAN, DERENIK MD	11/1/2020	207R00000X	NA	Other	026	PHYSICIANS	151787	41	Internal Medicine	0	In state provider	None	1509 WILSON TER	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
172056	Fee-for-Service	1548365554	1548365554	1	1	ELENA ADRIANA DESILLIER MD	1/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 WASHINGTON ST	None	BOSTON	MA	02111	1552	00	None	42.349662	-71.063514	Suffolk County
172082	Fee-for-Service	1699040063	1699040063	1	1	EINSTEIN MORROW, GABRIELLE F	1/31/2022	207P00000X	NA	Other	026	PHYSICIANS	152837	None	None	0	In state provider	MD	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
172186	Fee-for-Service	1609452192	1609452192	1	1	ENDOW, CHARISSA OT	4/19/2021	225XP0019X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 EAST MAIN ST.	STE 104	EL CAJON	CA	92021	5223	37	06073	32.80969963	-116.9203429	San Diego County
172188	Fee-for-Service	1598143638	1598143638	1	1	ESCOBAR, DIANA P MD	10/7/2019	207L00000X	NA	Other	026	PHYSICIANS	162580	05	Anesthesiology	0	In state provider	None	1328 22ND ST	None	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
172219	Fee-for-Service	1588901532	1588901532	1	24	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	111 S WESTLAKE BLVD	110	WESTLAKE VILLAGE	CA	91362	3807	56	06111	34.15995563	-118.8235677	Ventura County
172271	Fee-for-Service	1265863179	1265863179	1	3	ENLOE MEDICAL CENTER	12/22/2020	207Y00000X	NA	ENT/Otolaryngology	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	ECIALISTS	135 MISSION RANCH BLVD	SUITE 100	CHICO	CA	95926	2175	04	06007	39.75330715	-121.8611016	Butte County
172362	Fee-for-Service	1619502481	1619502481	1	1	ENCINO VALLEY HOSPICE INC	3/12/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	18075 VENTURA BLVD	STE 227	ENCINO	CA	91316	3597	19	06037	34.16527698	-118.5267	Los Angeles County
172466	Fee-for-Service	1366454225	1366454225	1	1	ELDER, JOHN G MD	2/8/2015	207RN0300X	NA	Nephrology	026	PHYSICIANS	42663	41	Internal Medicine	0	In state provider	None	222 PESETAS LN	None	SANTA BARBARA	CA	93110	1417	42	06083	34.443558	-119.758393	Santa Barbara County
172489	Fee-for-Service	1588901532	1588901532	1	45	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	725 S PACIFIC COAST HWY	None	REDONDO BEACH	CA	90277	4226	19	06037	33.8290737	-118.385509	Los Angeles County
172505	Fee-for-Service	1588901532	1588901532	1	19	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	359 CARMEN DR	None	CAMARILLO	CA	93010	6033	56	06111	34.219728	-119.053215	Ventura County
172507	Fee-for-Service	1588901532	1588901532	1	24	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	111 S WESTLAKE BLVD	110	WESTLAKE VILLAGE	CA	91362	3807	56	06111	34.15995563	-118.8235677	Ventura County
172521	Fee-for-Service	1366568511	1366568511	1	1	ERIKSSON ZUKERMAN, PIA C	9/1/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	CRNA	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
172546	Fee-for-Service	1851511281	1851511281	1	1	EDELSTEIN, MARC A MD INC	8/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	61509	10	Gastroenterology (M.D. only)	0	In state provider	None	150 N ROBERTSON BLVD	STE 205	BEVERLY HILLS	CA	90211	2144	19	06037	34.06812722	-118.3837146	Los Angeles County
172650	Fee-for-Service	1619502481	1619502481	1	1	ENCINO VALLEY HOSPICE INC	3/12/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	18075 VENTURA BLVD	STE 227	ENCINO	CA	91316	3597	19	06037	34.16527698	-118.5267	Los Angeles County
172701	Fee-for-Service	1619267838	1619267838	1	1	EGHTESAD, MANSOOREH MD	4/26/2020	207ZP0102X	NA	Other	026	PHYSICIANS	163716	22	Pathology (M.D. only)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
172731	Fee-for-Service	1467195073	1467195073	1	4	EMANATE HEALTH MEDICAL CARE	2/20/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CINE	315 N 3RD AVE	STE 207	COVINA	CA	91723	1917	19	06037	34.08873786	-117.8923869	Los Angeles County
172755	Fee-for-Service	1366454225	1366454225	1	1	ELDER, JOHN G MD	2/8/2015	207RN0300X	NA	Nephrology	026	PHYSICIANS	42663	45	Nephrology (Renal-Kidney)	0	In state provider	None	222 PESETAS LN	None	SANTA BARBARA	CA	93110	1417	42	06083	34.443558	-119.758393	Santa Barbara County
172761	Fee-for-Service	1043242290	1043242290	1	1	ERIC THOMPSON	5/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 N 7TH ST	None	BISMARCK	ND	58501	4439	00	None	46.808109	-100.782261	Burleigh County
172778	Fee-for-Service	1588901532	1588901532	1	45	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	725 S PACIFIC COAST HWY	None	REDONDO BEACH	CA	90277	4226	19	06037	33.8290737	-118.385509	Los Angeles County
172793	Fee-for-Service	1306913710	1306913710	1	1	EBY, JOSEPH B MD	5/7/2008	208200000X	NA	General Surgery	026	PHYSICIANS	68283	24	Plastic Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
172794	Fee-for-Service	1588901532	1588901532	1	19	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	359 CARMEN DR	None	CAMARILLO	CA	93010	6033	56	06111	34.219728	-119.053215	Ventura County
172795	Fee-for-Service	1326366733	1326366733	1	1	EHSANI GHASSEMIEH, MAHVASH	4/8/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
172798	Fee-for-Service	1588901532	1588901532	1	24	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	111 S WESTLAKE BLVD	110	WESTLAKE VILLAGE	CA	91362	3807	56	06111	34.15995563	-118.8235677	Ventura County
172802	Fee-for-Service	1629354808	1629354808	1	1	EXECUTIVE HOME HEALTH INC	6/4/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	777 S ARROYO PKWY	SUITE 103	PASADENA	CA	91105	3907	19	06037	34.13229163	-118.1474118	Los Angeles County
172813	Fee-for-Service	1427016120	1427016120	1	1	EYECARE MEDICAL CORP	4/1/2000	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	505 VIRGIL AVE	300	LOS ANGELES	CA	90020	1406	19	06037	34.064883	-118.287086	Los Angeles County
172825	Fee-for-Service	1760099501	1760099501	1	1	EVOLVE HOSPICE INC	11/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	18305 SHERMAN WAY	UNIT 23	RESEDA	CA	91335	4425	19	06037	34.20121152	-118.5319665	Los Angeles County
172833	Fee-for-Service	1851511281	1851511281	1	1	EDELSTEIN, MARC A MD INC	8/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	61509	41	Internal Medicine	0	In state provider	None	150 N ROBERTSON BLVD	STE 205	BEVERLY HILLS	CA	90211	2144	19	06037	34.06812722	-118.3837146	Los Angeles County
172864	Fee-for-Service	1093762593	1093762593	1	2	EL MONTE CLINICA MEDICA GENE	3/30/2023	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	RAL MEDICAL CENTER INC	11001 MAIN ST	301E	EL MONTE	CA	91731	2620	19	06037	34.07388835	-118.0353001	Los Angeles County
172988	Fee-for-Service	1750634952	1750634952	1	1	ESQUIVEL BRAVO, SINTHIA LCS	2/2/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
173060	Fee-for-Service	1588901532	1588901532	1	45	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	725 S PACIFIC COAST HWY	None	REDONDO BEACH	CA	90277	4226	19	06037	33.8290737	-118.385509	Los Angeles County
173083	Fee-for-Service	1588901532	1588901532	1	19	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	359 CARMEN DR	None	CAMARILLO	CA	93010	6033	56	06111	34.219728	-119.053215	Ventura County
173088	Fee-for-Service	1588901532	1588901532	1	24	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	111 S WESTLAKE BLVD	110	WESTLAKE VILLAGE	CA	91362	3807	56	06111	34.15995563	-118.8235677	Ventura County
173104	Fee-for-Service	1427016120	1427016120	1	1	EYECARE MEDICAL CORP	7/25/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	505 VIRGIL AVE	300	LOS ANGELES	CA	90020	1406	19	06037	34.064883	-118.287086	Los Angeles County
173113	Fee-for-Service	1760099501	1760099501	1	1	EVOLVE HOSPICE INC	11/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	18305 SHERMAN WAY	UNIT 23	RESEDA	CA	91335	4425	19	06037	34.20121152	-118.5319665	Los Angeles County
173129	Fee-for-Service	1205360765	1205360765	1	1	ESPINOZA, ERIC MD	10/5/2020	207R00000X	NA	Other	026	PHYSICIANS	169742	41	Internal Medicine	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
173151	Fee-for-Service	1093762593	1093762593	1	2	EL MONTE CLINICA MEDICA GENE	3/30/2023	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	RAL MEDICAL CENTER INC	11001 MAIN ST	301E	EL MONTE	CA	91731	2620	19	06037	34.07388835	-118.0353001	Los Angeles County
173243	Fee-for-Service	1619017613	1619017613	1	1	EHRENHAFT, ELLEN E LCSW	4/15/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
173244	Fee-for-Service	1477705028	1477705028	1	1	EDISON, BIANCA R MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111538	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
173267	Fee-for-Service	1023329638	1023329638	1	1	ESIOBU, PRINCE C MD	9/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156386	None	None	0	In state provider	None	400 NORTH PEPPER AVENUE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
173273	Fee-for-Service	1518494145	1518494145	1	1	ENGELHARDT, ANNE M	6/27/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
173353	Fee-for-Service	1588901532	1588901532	1	45	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	725 S PACIFIC COAST HWY	None	REDONDO BEACH	CA	90277	4226	19	06037	33.8290737	-118.385509	Los Angeles County
173365	Fee-for-Service	1588901532	1588901532	1	17	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	7077 W WILLOUGHBY AVE	3	LOS ANGELES	CA	90038	2377	19	06037	34.0871613	-118.3436187	Los Angeles County
173369	Fee-for-Service	1588901532	1588901532	1	19	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	359 CARMEN DR	None	CAMARILLO	CA	93010	6033	56	06111	34.219728	-119.053215	Ventura County
173373	Fee-for-Service	1588901532	1588901532	1	24	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	111 S WESTLAKE BLVD	110	WESTLAKE VILLAGE	CA	91362	3807	56	06111	34.15995563	-118.8235677	Ventura County
173376	Fee-for-Service	1285905232	1285905232	1	1	EVENDEN, CARRIE K PHD	11/5/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2489 WASHINGTON ST	None	SAN FRANCISCO	CA	94115	1816	38	06075	37.79159604	-122.4341541	San Francisco County
173420	Fee-for-Service	1265134639	1265134639	1	1	ELITE TRANSIT TRANSPORTATION	3/20/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	10110 GRIZZLY ST	None	BAKERSFIELD	CA	93311	9529	15	06029	35.30650069	-119.1147498	Kern County
173440	Fee-for-Service	1093762593	1093762593	1	2	EL MONTE CLINICA MEDICA GENE	3/30/2023	261QP2300X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	RAL MEDICAL CENTER INC	11001 MAIN ST	301E	EL MONTE	CA	91731	2620	19	06037	34.07388835	-118.0353001	Los Angeles County
173478	Fee-for-Service	1093795544	1093795544	1	2	EAP OPTOMETRY	9/18/2018	193400000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6541 E SPRING ST	None	LONG BEACH	CA	90808	4023	19	06037	33.81057952	-118.106379	Los Angeles County
173640	Fee-for-Service	1588901532	1588901532	1	45	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	725 S PACIFIC COAST HWY	None	REDONDO BEACH	CA	90277	4226	19	06037	33.8290737	-118.385509	Los Angeles County
173646	Fee-for-Service	1245627421	1245627421	1	1	EMERUWA, UKACHI N	9/23/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	182152	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
173657	Fee-for-Service	1588901532	1588901532	1	17	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	7077 W WILLOUGHBY AVE	3	LOS ANGELES	CA	90038	2377	19	06037	34.0871613	-118.3436187	Los Angeles County
173660	Fee-for-Service	1588901532	1588901532	1	19	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	359 CARMEN DR	None	CAMARILLO	CA	93010	6033	56	06111	34.219728	-119.053215	Ventura County
173719	Fee-for-Service	1972965622	1972965622	1	1	EELLS, MADELINE E MD	11/29/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166581	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
173728	Fee-for-Service	1093762593	1093762593	1	2	EL MONTE CLINICA MEDICA GENE	3/30/2023	261QP2300X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	RAL MEDICAL CENTER INC	11001 MAIN ST	301E	EL MONTE	CA	91731	2620	19	06037	34.07388835	-118.0353001	Los Angeles County
173730	Fee-for-Service	1790232783	1790232783	1	1	EL-NIMRI, NEVIN W OD	3/4/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
173810	Fee-for-Service	1437354677	1437354677	1	1	ELK GROVE PEDIATRICS INC	1/1/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	A MEDICAL GROUP	9727 ELK GROVE FLORIN RD	SUITE 250	ELK GROVE	CA	95624	2266	34	06067	38.404503	-121.370994	Sacramento County
173915	Fee-for-Service	1306311576	1306311576	1	2	EMERGENCY PHYSICIANS ASSOCIA	6/29/2023	207P00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	TES SAN JOSE PC	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
173923	Fee-for-Service	1588901532	1588901532	1	62	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	797 S FAIR OAKS AVENUE	SUITE 100	PASADENA	CA	91105	2617	19	06037	34.131942	-118.1503885	Los Angeles County
173957	Fee-for-Service	1588901532	1588901532	1	17	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7077 W WILLOUGHBY AVE	3	LOS ANGELES	CA	90038	2377	19	06037	34.0871613	-118.3436187	Los Angeles County
174071	Fee-for-Service	1194230086	1194230086	1	1	EVOLVE FAMILY THERAPY	12/12/2018	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	359 W 11TH ST	STE A1	TRACY	CA	95376	3869	39	06077	37.7397196	-121.431262	San Joaquin County
174128	Fee-for-Service	1578131280	1578131280	1	1	EMHOSPICE LLC	9/14/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	629 S HILL STREET	SUITE 704	LOS ANGELES	CA	90014	1735	19	06037	34.04678754	-118.2536719	Los Angeles County
174137	Fee-for-Service	1306917661	1306917661	1	1	ESTRADA, JAIME E MD	5/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	67747	08	Family Practice	0	In state provider	None	251 W COLE BLVD	None	CALEXICO	CA	92231	9722	13	06025	32.6940145	-115.503705	Imperial County
174206	Fee-for-Service	1306311576	1306311576	1	2	EMERGENCY PHYSICIANS ASSOCIA	8/24/2023	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	TES SAN JOSE PC	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
174212	Fee-for-Service	1588901532	1588901532	1	62	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	797 S FAIR OAKS AVENUE	SUITE 100	PASADENA	CA	91105	2617	19	06037	34.131942	-118.1503885	Los Angeles County
174234	Fee-for-Service	1588901532	1588901532	1	17	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	7077 W WILLOUGHBY AVE	3	LOS ANGELES	CA	90038	2377	19	06037	34.0871613	-118.3436187	Los Angeles County
174293	Fee-for-Service	1811223175	1811223175	1	1	ENGLE, SARAH A MD	7/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119842	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	12-311 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
174295	Fee-for-Service	1912332297	1912332297	1	1	EOS HOSPICE AND PALLIATIVE	5/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	646 SOUTH BARRANCA AVE	None	COVINA	CA	91723	3601	19	06037	34.07797235	-117.8812379	Los Angeles County
174322	Fee-for-Service	1639140015	1639140015	1	1	EVANSTON HOSPITAL	9/21/2018	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORPORATION	190 ARROWHEAD DRIVE	None	EVANSTON	WY	82930	9266	00	None	41.24228479	-110.9907847	Uinta County
174360	Fee-for-Service	1669520326	1669520326	1	1	EVERGREEN ELEMENTARY SD	10/30/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	3188 QUIMBY RD	None	SAN JOSE	CA	95148	3022	43	06085	37.32483503	-121.7858392	Santa Clara County
174400	Fee-for-Service	1780448027	1780448027	1	1	EDELSTEIN, SHERRI LYNN	4/24/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	56187 PERRIS AVE	None	YUCCA VALLEY	CA	92284	1687	36	06071	34.23857551	-116.437626	San Bernardino County
174417	Fee-for-Service	1578131280	1578131280	1	1	EMHOSPICE LLC	9/14/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	629 S HILL STREET	SUITE 704	LOS ANGELES	CA	90014	1735	19	06037	34.04678754	-118.2536719	Los Angeles County
174501	Fee-for-Service	1588901532	1588901532	1	62	EXER MEDICAL CORPORATION	4/2/2025	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	797 S FAIR OAKS AVENUE	SUITE 100	PASADENA	CA	91105	2617	19	06037	34.131942	-118.1503885	Los Angeles County
174518	Fee-for-Service	1588901532	1588901532	1	17	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7077 W WILLOUGHBY AVE	3	LOS ANGELES	CA	90038	2377	19	06037	34.0871613	-118.3436187	Los Angeles County
174582	Fee-for-Service	1912332297	1912332297	1	1	EOS HOSPICE AND PALLIATIVE	5/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE INC	646 SOUTH BARRANCA AVE	None	COVINA	CA	91723	3601	19	06037	34.07797235	-117.8812379	Los Angeles County
174588	Fee-for-Service	1396277208	1396277208	1	1	ELITE SURGERY CENTER LLC	8/21/2020	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	38920 TRADE CENTER DRIVE	None	PALMDALE	CA	93551	3715	19	06037	34.58884303	-118.1430688	Los Angeles County
174606	Fee-for-Service	1467195073	1467195073	1	8	EMANATE HEALTH MEDICAL CARE	4/30/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	FOUNDATION	412 W CARROLL AVE	SUITE 108	GLENDORA	CA	91741	4707	19	06037	34.13415622	-117.8702547	Los Angeles County
174611	Fee-for-Service	1639140015	1639140015	1	1	EVANSTON HOSPITAL	9/21/2018	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORPORATION	190 ARROWHEAD DRIVE	None	EVANSTON	WY	82930	9266	00	None	41.24228479	-110.9907847	Uinta County
174648	Fee-for-Service	1780910166	1780910166	1	1	EVANGELISTA, LISA M	6/2/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
174688	Fee-for-Service	1780448027	1780448027	1	1	EDELSTEIN, SHERRI LYNN	4/24/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	56187 PERRIS AVE	None	YUCCA VALLEY	CA	92284	1687	36	06071	34.23857551	-116.437626	San Bernardino County
174774	Fee-for-Service	1750481768	1750481768	1	1	EMMAD, NABIL A MD	10/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63370	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
174789	Fee-for-Service	1588901532	1588901532	1	62	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	797 S FAIR OAKS AVENUE	SUITE 100	PASADENA	CA	91105	2617	19	06037	34.131942	-118.1503885	Los Angeles County
174793	Fee-for-Service	1073600961	1073600961	1	1	ENDAYA, JOSELITO L MD	4/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55626	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
174823	Fee-for-Service	1164723615	1164723615	1	1	ECHEVESTRE, LACRISTA J CRNA	2/11/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 THE CITY DR SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
174837	Fee-for-Service	1134391964	1134391964	1	1	ENRIQUEZ, JORGE A MD INC	12/1/1999	193400000X	NA	Other	026	PHYSICIANS	49936	02	General Surgery	0	In state provider	None	2521 G ST	None	BAKERSFIELD	CA	93301	2811	15	06029	35.382393	-119.0223575	Kern County
174895	Fee-for-Service	1467195073	1467195073	1	8	EMANATE HEALTH MEDICAL CARE	4/30/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOUNDATION	412 W CARROLL AVE	SUITE 108	GLENDORA	CA	91741	4707	19	06037	34.13415622	-117.8702547	Los Angeles County
174965	Fee-for-Service	1316004559	1316004559	1	1	EILERMAN, KEITH A MD	4/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	43738	78	Neoplastic Diseases/Oncology	0	In state provider	None	64 E DAILY DR	None	CAMARILLO	CA	93010	5803	56	06111	34.22174543	-119.0683503	Ventura County
174987	Fee-for-Service	1528279387	1528279387	1	1	EDMOND, REGINA LOUISE MD	3/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	91799	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	617 W MANCHESTER AVE	None	LOS ANGELES	CA	90044	5718	19	06037	33.96008547	-118.2846105	Los Angeles County
175061	Fee-for-Service	1750481768	1750481768	1	1	EMMAD, NABIL A MD	10/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63370	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
175092	Fee-for-Service	1184294001	1184294001	1	1	ELWISHAHI, SUZANE OD	6/28/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
175120	Fee-for-Service	1033642335	1033642335	1	1	ELLER, LAUREN DPM	4/5/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1580 CREEKSIDE DR	STE 100	FOLSOM	CA	95630	3886	34	06067	38.668914	-121.148028	Sacramento County
175182	Fee-for-Service	1467195073	1467195073	1	8	EMANATE HEALTH MEDICAL CARE	4/30/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	412 W CARROLL AVE	SUITE 108	GLENDORA	CA	91741	4707	19	06037	34.13415622	-117.8702547	Los Angeles County
175453	Fee-for-Service	1053437509	1053437509	1	1	EAST VALLEY COMMUNITY	5/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	19	06037	34.06750236	-117.925203	Los Angeles County
175468	Fee-for-Service	1700322013	1700322013	1	1	ENKELI PHARMACY GROUP INC	2/14/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2392 UNIVERSITY AVE	None	RIVERSIDE	CA	92507	4266	33	06065	33.97552264	-117.360763	Riverside County
175483	Fee-for-Service	1598381212	1598381212	1	1	EDEN MEDICAL SUPPLY, LLC	10/7/2022	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	2840 NW 2ND AVE	SUITE 106	BOCA RATON	FL	33431	6692	00	None	26.37741034	-80.08553508	Palm Beach County
175579	Fee-for-Service	1821021130	1821021130	1	1	ESRAILIAN, ERIC MD	2/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77669	41	Internal Medicine	0	In state provider	None	100 MEDICAL PLAZA STE 45	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
175591	Fee-for-Service	1083741151	1083741151	1	1	EPIPHANY CARE HOMES, INC	12/16/2005	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MOONSTONE HOME ICF/DD-N	2331 KNOLLHAVEN ST	None	SIMI VALLEY	CA	93065	2528	56	06111	34.27400449	-118.75176	Ventura County
175606	Fee-for-Service	1417950304	1417950304	1	1	EZQUERRO, RUBEN A DPM	3/24/1997	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2621 S BRISTOL ST	STE 209	SANTA ANA	CA	92704	5719	30	06059	33.711876	-117.885371	Orange County
175693	Fee-for-Service	1285948968	1285948968	1	1	ESWARAN, PRABHU CCC-SLP	7/7/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	740 S PLACENTIA AVE	STE 100	PLACENTIA	CA	92870	6832	30	06059	33.86285731	-117.8822066	Orange County
175740	Fee-for-Service	1851904585	1851904585	1	1	ESMEIRAT, DEENA LMFT	11/2/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23822 VALENCIA BLVD	207	VALENCIA	CA	91355	5302	19	06037	34.41372708	-118.5513626	Los Angeles County
175775	Fee-for-Service	1467094219	1467094219	1	1	EVANS, SARAJEAN NP	12/9/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4500 BROCKTON AVE.	SUITE 305	RIVERSIDE	CA	92501	4027	33	06065	33.97785263	-117.3836152	Riverside County
175895	Fee-for-Service	1114005717	1114005717	1	1	EIBAND, JASON D	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	71538	66	Emergency Medicine (Urgent Care)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
175963	Fee-for-Service	1205857315	1205857315	1	1	ECP HOMES, INC	10/18/2000	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	8341 SAN PABLO DR	None	BUENA PARK	CA	90620	2919	30	06059	33.84176546	-118.0146517	Orange County
175976	Fee-for-Service	1407142201	1407142201	1	1	ELSHARIF, MOHAMED S MD	10/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138404	13	Neurology (M.D. only)	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
176076	Fee-for-Service	1407821887	1407821887	1	1	ENAYAT, NIGAR MD	10/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150700	41	Internal Medicine	0	In state provider	None	17095 MAIN ST	None	HESPERIA	CA	92345	6004	36	06071	34.41984761	-117.2904344	San Bernardino County
176087	Fee-for-Service	1427144666	1427144666	1	1	ELLINI, AHMAD R MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122753	None	None	0	In state provider	None	1010 W LA VETA AVE	SUITE 575	ORANGE	CA	92868	4305	30	06059	33.78028244	-117.8635552	Orange County
176128	Fee-for-Service	1023127644	1023127644	1	1	ELLIOTT, STEPHEN J	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	50190	40	Pediatrics	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
176153	Fee-for-Service	1861043366	1861043366	1	1	EICHEN, DAWN M PHD	10/24/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
176194	Fee-for-Service	1407199912	1407199912	1	1	EKSTROM, ANNA V DO	7/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14076	None	None	0	In state provider	None	9300 VALLEY CHILDRENS PL	GE21	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
176246	Fee-for-Service	1336733203	1336733203	1	1	EMERITUS MEDICAL TECHNOLOGY	6/17/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	12 SPECTRUM POINTE DRIVE	None	LAKE FOREST	CA	92630	2242	30	06059	33.66071369	-117.6943714	Orange County
176282	Fee-for-Service	1427489483	1427489483	1	1	ELEVAZO, ROY ALLAN O CNP	8/4/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5220 CLARK AVE	400	LAKEWOOD	CA	90712	2618	19	06037	33.8527092	-118.1337623	Los Angeles County
176298	Fee-for-Service	1982760500	1982760500	1	1	ERL MEDICAL CORPORATION	10/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	6200 WILSHIRE BLVD	STE 1510	LOS ANGELES	CA	90048	5816	19	06037	34.06319291	-118.3636025	Los Angeles County
176356	Fee-for-Service	1518124056	1518124056	1	1	EMMA P ARALAR	2/10/1996	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	11937 STRATHERN ST	None	NORTH HOLLYWOOD	CA	91605	1413	19	06037	34.21574998	-118.3934206	Los Angeles County
176415	Fee-for-Service	1023127644	1023127644	1	1	ELLIOTT, STEPHEN J	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	50190	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
176468	Fee-for-Service	1134137508	1134137508	1	1	ESCOBAR, CATALINA G MD	7/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82610	None	None	0	In state provider	None	292 EUCLID AVE	STE 210	SAN DIEGO	CA	92114	3613	37	06073	32.70706919	-117.0850896	San Diego County
176513	Fee-for-Service	1285093567	1285093567	1	1	ERICKSON, DAVIS L MD	10/9/2020	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
176540	Fee-for-Service	1235586603	1235586603	1	1	EDWARDS, STEPHEN	10/12/2024	207L00000X	NA	Other	026	PHYSICIANS	21098	05	Anesthesiology	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
176567	Fee-for-Service	1669487450	1669487450	1	1	EREMITA, MONA S MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80718	None	None	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
176570	Fee-for-Service	1811588387	1811588387	1	1	EARLY BIRD HOME HEALTH	7/8/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	125 S LOUISE ST	STE 20	GLENDALE	CA	91205	1024	19	06037	34.14566113	-118.252704	Los Angeles County
176624	Fee-for-Service	1013218551	1013218551	1	1	ENRIQUEZ, KAYLA T MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119843	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 HOSPITAL DRIVE	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
176647	Fee-for-Service	1477915213	1477915213	1	1	ELSENHEIMER, KAITLIN N MD	10/19/2021	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	174038	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
176723	Fee-for-Service	1881682458	1881682458	1	1	ETEMAD, ELIZABETH L DO	1/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	6888	08	Family Practice	0	In state provider	None	5 BON AIR RD	STE 101	LARKSPUR	CA	94939	1134	21	06041	37.9438204	-122.5395357	Marin County
176818	Fee-for-Service	1295368322	1295368322	1	1	EAST BAY MEDICAL PROFESSIONA	5/12/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	None	None	None	0	In state provider	SPREET KAUR MD	1320 EL CAPITAN DR STE 2	None	DANVILLE	CA	94526	6260	07	06013	37.78476866	-121.9658691	Contra Costa County
176848	Fee-for-Service	1245225176	1245225176	1	1	ENSIGN CLOVERDALE, LLC	11/16/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CLOVERDALE HEALTHCARE CT	300 CHERRY CREEK RD	None	CLOVERDALE	CA	95425	3811	49	06097	38.79480942	-123.0245421	Sonoma County
176900	Fee-for-Service	1306311576	1306311576	1	5	EMERGENCY PHYSICIANS ASSOCIA	5/13/2025	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	TES SAN JOSE PC	225 JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.35500597	-121.8401901	Santa Clara County
176936	Fee-for-Service	1255961793	1255961793	1	1	EAST BAY PODIATRY, PC	5/25/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2485 HIGH SCHOOL AVE.	STE. 222	CONCORD	CA	94520	1813	07	06013	37.98507961	-122.034189	Contra Costa County
176997	Fee-for-Service	1770299182	1770299182	1	1	EASON MARCHI, MIKKI M LAC	9/12/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
177049	Fee-for-Service	1588901532	1588901532	1	50	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	242 S ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	2811	19	06037	34.06370697	-118.3835693	Los Angeles County
177133	Fee-for-Service	1285152629	1285152629	1	1	EASTERN STAR HOMES OF CA,	2/22/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	INC	16850 BASTANCHURY ROAD	None	YORBA LINDA	CA	92886	1608	30	06059	33.89923589	-117.8392921	Orange County
177188	Fee-for-Service	1306311576	1306311576	1	5	EMERGENCY PHYSICIANS ASSOCIA	3/19/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	TES SAN JOSE PC	225 JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.35500597	-121.8401901	Santa Clara County
177298	Fee-for-Service	1174301022	1174301022	1	1	EMANATE HEALTH MEDICAL CENTE	9/13/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	R PHARMACY	1135 S SUNSET AVE	104	WEST COVINA	CA	91790	3965	19	06037	34.06215064	-117.9453997	Los Angeles County
177337	Fee-for-Service	1588901532	1588901532	1	50	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	242 S ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	2811	19	06037	34.06370697	-118.3835693	Los Angeles County
177348	Fee-for-Service	1790851624	1790851624	1	1	EIGNER, ADAM H PHD	3/1/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
177361	Fee-for-Service	1396772273	1396772273	1	1	EASTMAN III MD, JOSEPHR	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1717 ARLINGTON AVE	None	CALDWELL	ID	83605	0000	00	None	43.654374	-116.694738	Canyon County
177363	Fee-for-Service	1548024920	1548024920	1	1	ELITE WOUND CARE PRO	12/30/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11428 ARTESIA BLVD	STE 5	ARTESIA	CA	90701	3883	19	06037	33.87289466	-118.0900458	Los Angeles County
177463	Fee-for-Service	1699156943	1699156943	1	1	ETHERIDGE, AMANDA L MD	6/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145435	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
177502	Fee-for-Service	1346287430	1346287430	1	1	EAST VALLEY EMERGENCY	4/1/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MED ASSOC, INC	9080 COLIMA RD	None	WHITTIER	CA	90605	1600	19	06037	33.95062799	-118.0051627	Los Angeles County
177520	Fee-for-Service	1295844256	1295844256	1	1	EDEN HOME HEALTH	2/9/2015	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE, INC	159 E LIVE OAK AVE	STE 205	ARCADIA	CA	91006	5252	19	06037	34.1082455	-118.0251857	Los Angeles County
177626	Fee-for-Service	1588901532	1588901532	1	50	EXER MEDICAL CORPORATION	2/15/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	242 S ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	2811	19	06037	34.06370697	-118.3835693	Los Angeles County
177655	Fee-for-Service	1376853655	1376853655	1	1	ESSILFIE, WILLIAM MD INC	4/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	46137	None	None	0	In state provider	None	1141 W REDONDO BEACH BLV	SUITE 307	GARDENA	CA	90247	3583	19	06037	33.89247036	-118.2941482	Los Angeles County
177695	Fee-for-Service	1194815696	1194815696	1	1	ELIZABETH A FRAZIER, M.D.	5/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 CHILDRENS WAY	# 653	LITTLE ROCK	AR	72202	3500	00	None	34.742745	-92.2927905	Pulaski County
177709	Fee-for-Service	1588866115	1588866115	1	1	ELSTER, JENNIFER D L MD	9/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144876	68	Hematology	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
177800	Fee-for-Service	1386731347	1386731347	1	1	EVELYN, KARL L MD	11/30/1998	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	33860	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4094 4TH AVE	STE 200	SAN DIEGO	CA	92103	2143	37	06073	32.75153771	-117.161688	San Diego County
177870	Fee-for-Service	1023035631	1023035631	1	1	ECK, VERA C LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
177890	Fee-for-Service	1972957850	1972957850	1	1	EVERETT, JAMIE N MD	10/2/2020	207P00000X	NA	Other	026	PHYSICIANS	150826	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 N JACKSON AVE	EMERGENCY DEPARTMENT	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
177917	Fee-for-Service	1588901532	1588901532	1	50	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	242 S ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	2811	19	06037	34.06370697	-118.3835693	Los Angeles County
177918	Fee-for-Service	1831183383	1831183383	1	1	EDELEN, JOHN S MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	26272	None	None	0	In state provider	None	2510 WEBER ST	# 200	BERKELEY	CA	94705	0000	01	06001	0	0	None
177989	Fee-for-Service	1316036387	1316036387	1	1	EIGELBERGER, MONICA S MD	4/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68921	02	General Surgery	0	In state provider	None	3100 SAN PABLO AVE	STE 420	BERKELEY	CA	94702	2498	01	06001	37.85066636	-122.286288	Alameda County
177997	Fee-for-Service	1588866115	1588866115	1	1	ELSTER, JENNIFER D L MD	9/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144876	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
178002	Fee-for-Service	1386007011	1386007011	1	1	EISENLOHR, JOHN L MD	5/20/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	171441	None	None	0	In state provider	None	4300 ROSE DR	None	YORBA LINDA	CA	92886	2026	30	06059	33.89815111	-117.8419708	Orange County
178177	Fee-for-Service	1972957850	1972957850	1	1	EVERETT, JAMIE N MD	10/2/2020	207P00000X	NA	Other	026	PHYSICIANS	150826	70	Clinic (mixed specialty)	0	In state provider	None	225 N JACKSON AVE	EMERGENCY DEPARTMENT	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
178206	Fee-for-Service	1588901532	1588901532	1	50	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	242 S ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	2811	19	06037	34.06370697	-118.3835693	Los Angeles County
178222	Fee-for-Service	1376860395	1376860395	1	1	ELIAS, EMANUEL A MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120139	08	Family Practice	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
178286	Fee-for-Service	1588866115	1588866115	1	1	ELSTER, JENNIFER D L MD	9/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144876	78	Neoplastic Diseases/Oncology	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
178335	Fee-for-Service	1275698896	1275698896	1	1	ENRIQUEZ, ROMUALDO D	2/8/2015	No Taxonomy Provided	NA	None	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	5805 MISSION ST	None	SAN FRANCISCO	CA	94112	4017	38	06075	37.70942628	-122.4507794	San Francisco County
178350	Fee-for-Service	1124676549	1124676549	1	1	EMES MANAGEMENT INC	2/14/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	824 W CAMERON AVE	None	WEST COVINA	CA	91790	4136	19	06037	34.06220906	-117.9326787	Los Angeles County
178599	Fee-for-Service	1992229819	1992229819	1	1	ELSON, JENNIFER LCSW	7/31/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
178663	Fee-for-Service	1134195670	1134195670	1	1	EZZET, KACE A MD	11/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	52718	20	Orthopedic Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
178792	Fee-for-Service	1104445915	1104445915	1	1	ERICKSON, STEFAN MD	12/10/2024	390200000X	NA	Other	026	PHYSICIANS	188524	30	Radiology	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
178926	Fee-for-Service	1619955648	1619955648	1	1	ESCOBEDO, EVA MARIE MD	9/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	57588	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
178935	Fee-for-Service	1487664199	1487664199	1	1	ELLEN KROON DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1305 W 18TH ST	None	SIOUX FALLS	SD	57105	0401	00	None	43.535484	-96.7428585	Minnehaha County
179018	Fee-for-Service	1285929935	1285929935	1	1	ERAKAT, AHMED S MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13939	40	Pediatrics	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
179223	Fee-for-Service	1255358750	1255358750	1	1	EISENBERG, EUGENE MD	2/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	13927	41	Internal Medicine	0	In state provider	None	3434 VILLA LN	STE 280	NAPA	CA	94558	6415	28	06055	38.32515937	-122.2938358	Napa County
179304	Fee-for-Service	1972982775	1972982775	1	1	EDWALL, HEATHER LCSW	2/25/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	152 PIONEER LANE	A-H	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
179412	Fee-for-Service	1346230315	1346230315	2	1	EAGLE MEDICAL EQUIPMENT INC	7/6/2015	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	613 S VICTORY BLVD	None	BURBANK	CA	91502	2424	19	06037	34.16932422	-118.311493	Los Angeles County
179445	Fee-for-Service	1295734622	1295734622	1	1	EMLER, KATRIN E MD	6/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94251	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
179498	Fee-for-Service	1962052365	1962052365	1	1	ENTERPRISE OPTOMETRY GROUP I	6/9/2020	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	NC	3080 VICTOR AVE	None	REDDING	CA	96002	1449	45	06089	40.562622	-122.3395155	Shasta County
179510	Fee-for-Service	1255358750	1255358750	1	1	EISENBERG, EUGENE MD	2/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	13927	67	Endocrinology	0	In state provider	None	3434 VILLA LN	STE 280	NAPA	CA	94558	6415	28	06055	38.32515937	-122.2938358	Napa County
179530	Fee-for-Service	1831313287	1831313287	1	1	ESKIE, BONNIE L LMFT	6/4/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10 WILLIAMSBURG LN	STE C	CHICO	CA	95926	2297	04	06007	39.75250949	-121.8553643	Butte County
179640	Fee-for-Service	1467195073	1467195073	1	7	EMANATE HEALTH MEDICAL CARE	3/4/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	FOUNDATION	1125 VIA VERDE	None	SAN DIMAS	CA	91773	4400	19	06037	34.07402699	-117.829182	Los Angeles County
179675	Fee-for-Service	1588901532	1588901532	1	20	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	2090 WESTWOOD BLVD	None	LOS ANGELES	CA	90025	6329	19	06037	34.04552207	-118.4330933	Los Angeles County
179697	Fee-for-Service	1588901532	1588901532	1	6	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4143 CAMPUS DR	C200	IRVINE	CA	92612	2623	30	06059	33.64951114	-117.8400555	Orange County
179786	Fee-for-Service	1245348465	1245348465	1	1	ETCHELLS, PHILIP T OD	5/13/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	13692 APPLE VALLEY RD	STE 170	APPLE VALLEY	CA	92308	4564	36	06071	34.49982245	-117.2425689	San Bernardino County
179963	Fee-for-Service	1588901532	1588901532	1	20	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2090 WESTWOOD BLVD	None	LOS ANGELES	CA	90025	6329	19	06037	34.04552207	-118.4330933	Los Angeles County
179985	Fee-for-Service	1588901532	1588901532	1	6	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4143 CAMPUS DR	C200	IRVINE	CA	92612	2623	30	06059	33.64951114	-117.8400555	Orange County
180003	Fee-for-Service	1841301405	1841301405	1	1	ELIZABETH LAGOMARSINO,MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
180013	Fee-for-Service	1952689796	1952689796	1	1	ESFAHANE, ALIREZA B MD	8/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136722	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
180027	Fee-for-Service	1285720326	1285720326	1	1	ENCINA, ALBERTO Y MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	33026	01	General Practice	0	In state provider	None	22110 NORWALK BLVD	None	HAWAIIAN GARDENS	CA	90716	1540	19	06037	33.82730003	-118.0718437	Los Angeles County
180054	Fee-for-Service	1750431508	1750431508	1	1	ELANGO, KALAIVANI MD	9/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	95476	41	Internal Medicine	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
180085	Fee-for-Service	1275042459	1275042459	1	1	ELONG PHARMACY LLC	4/9/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15415 JEFFREY ROAD	SUITE 108	IRVINE	CA	92618	4103	30	06059	33.68079737	-117.7776602	Orange County
180148	Fee-for-Service	1407239163	1407239163	1	1	EMPRESS HOSPICE INC	1/18/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7301 TOPANGA CANYON BLVD	SUITE 370	CANOGA PARK	CA	91303	3395	19	06037	34.203222	-118.605988	Los Angeles County
180248	Fee-for-Service	1588901532	1588901532	1	20	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2090 WESTWOOD BLVD	None	LOS ANGELES	CA	90025	6329	19	06037	34.04552207	-118.4330933	Los Angeles County
180263	Fee-for-Service	1699932707	1699932707	1	1	EBONG, IMO A MD	7/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119607	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO ST	STE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
180273	Fee-for-Service	1588901532	1588901532	1	6	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	4143 CAMPUS DR	C200	IRVINE	CA	92612	2623	30	06059	33.64951114	-117.8400555	Orange County
180340	Fee-for-Service	1174283774	1174283774	1	1	EVERY DAY HOME HEALTH CARE	2/19/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14531 HAMLIN ST	SUITE 215	VAN NUYS	CA	91411	1627	19	06037	34.18870941	-118.449902	Los Angeles County
180341	Fee-for-Service	1982891743	1982891743	1	1	ENTERAL PRODUCTS LLC	3/15/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	11333 GREENSTONE AVE	None	SANTA FE SPRINGS	CA	90670	4618	19	06037	33.92883	-118.058137	Los Angeles County
180360	Fee-for-Service	1669002465	1669002465	1	2	ENRICHING LIVES INC	8/31/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2501 CHRISTOPHER LANE	None	COSTA MESA	CA	92626	6793	30	06059	33.66456629	-117.9207591	Orange County
180368	Fee-for-Service	1972595221	1972595221	1	1	EARLY, SEAN D MD INC	4/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	60507	20	Orthopedic Surgery	0	In state provider	None	1919 STATE ST	STE 301	SANTA BARBARA	CA	93101	8443	42	06083	34.4306401	-119.7144766	Santa Barbara County
180432	Fee-for-Service	1407239163	1407239163	1	1	EMPRESS HOSPICE INC	1/18/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7301 TOPANGA CANYON BLVD	SUITE 370	CANOGA PARK	CA	91303	3395	19	06037	34.203222	-118.605988	Los Angeles County
180477	Fee-for-Service	1144293416	1144293416	1	1	ELSON, ROBERT K MD	10/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
180539	Fee-for-Service	1588901532	1588901532	1	20	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2090 WESTWOOD BLVD	None	LOS ANGELES	CA	90025	6329	19	06037	34.04552207	-118.4330933	Los Angeles County
180562	Fee-for-Service	1588901532	1588901532	1	6	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	4143 CAMPUS DR	C200	IRVINE	CA	92612	2623	30	06059	33.64951114	-117.8400555	Orange County
180583	Fee-for-Service	1336489814	1336489814	1	1	ESPOSO, WILFRENGERARD P NP	9/25/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
180655	Fee-for-Service	1972595221	1972595221	1	1	EARLY, SEAN D MD INC	4/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	60507	40	Pediatrics	0	In state provider	None	1919 STATE ST	STE 301	SANTA BARBARA	CA	93101	8443	42	06083	34.4306401	-119.7144766	Santa Barbara County
180672	Fee-for-Service	1700844537	1700844537	1	1	EHLERS,DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2314 NW KINGS BLVD	STE A	CORVALLIS	OR	97339	0000	00	None	44.59018248	-123.2774548	Benton County
180673	Fee-for-Service	1023050655	1023050655	1	1	EBROON, DANIEL A MD	7/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	85742	18	Ophthalmology	0	In state provider	None	3085 LOMA VISTA RD	None	VENTURA	CA	93003	2916	56	06111	34.2757721	-119.2550726	Ventura County
180805	Fee-for-Service	1063817823	1063817823	1	1	ENARA HEALTH GROUP PC	2/2/2015	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1650 S AMPHLETT BLVD	SUITE 216	SAN MATEO	CA	94402	2517	41	06081	37.55960048	-122.3025678	San Mateo County
180819	Fee-for-Service	1952901969	1952901969	1	1	EGEONUIGWE, ELECHI M	9/8/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3801 KATELLA AVE	STE 330	LOS ALAMITOS	CA	90720	6900	30	06059	33.80318951	-118.066068	Orange County
180824	Fee-for-Service	1588901532	1588901532	1	20	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2090 WESTWOOD BLVD	None	LOS ANGELES	CA	90025	6329	19	06037	34.04552207	-118.4330933	Los Angeles County
180849	Fee-for-Service	1588901532	1588901532	1	6	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4143 CAMPUS DR	C200	IRVINE	CA	92612	2623	30	06059	33.64951114	-117.8400555	Orange County
180881	Fee-for-Service	1003161522	1003161522	1	1	ESTAKHRI, HADI MD	6/26/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	147068	36	Psychiatry	0	In state provider	None	3991 MACARTHUR BLVD	SUITE 200	NEWPORT BEACH	CA	92660	3009	30	06059	33.65957329	-117.8631723	Orange County
180896	Fee-for-Service	1861149254	1861149254	1	1	EARLEY, SIERRA PT	1/1/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	733 CEDAR STREET	None	GARBERVILLE	CA	95542	3201	12	06023	40.10148699	-123.7927018	Humboldt County
180910	Fee-for-Service	1790173508	1790173508	1	1	EYECARE SPECIALISTS MEDICAL	10/3/2018	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	22525 MAPLE AVE	STE 100	TORRANCE	CA	90505	2700	19	06037	33.82264238	-118.3401719	Los Angeles County
181082	Fee-for-Service	1184115628	1184115628	1	1	EDER, CORWIN E MD	2/25/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157853	None	None	0	In state provider	None	2122 W KETTLEMAN LANE	None	LODI	CA	95242	4321	39	06077	38.11537452	-121.299291	San Joaquin County
181170	Fee-for-Service	1003161522	1003161522	1	1	ESTAKHRI, HADI MD	6/26/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	147068	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	3991 MACARTHUR BLVD	SUITE 200	NEWPORT BEACH	CA	92660	3009	30	06059	33.65957329	-117.8631723	Orange County
181198	Fee-for-Service	1790173508	1790173508	1	1	EYECARE SPECIALISTS MEDICAL	10/3/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	22525 MAPLE AVE	STE 100	TORRANCE	CA	90505	2700	19	06037	33.82264238	-118.3401719	Los Angeles County
181199	Fee-for-Service	1487159703	1487159703	1	1	ESPINOZA, LESLIE R CNM	6/21/2020	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
181525	Fee-for-Service	1528162690	1528162690	1	2	EYECARE SPECIALISTS MEDICAL	10/3/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	5991 E SPRING ST	None	LONG BEACH	CA	90808	3752	19	06037	33.81062147	-118.1154555	Los Angeles County
181612	Fee-for-Service	1063697563	1063697563	1	1	EGGLESTON YOUTH CENTERS, INC	9/10/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	13001 RAMONA BLVD	SUITE E & J	IRWINDALE	CA	91706	3752	19	06037	34.07969659	-117.9895641	Los Angeles County
181626	Fee-for-Service	1306311576	1306311576	1	3	EMERGENCY PHYSICIANS ASSOCIA	6/29/2023	207P00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	TES SAN JOSE PC	751 BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
181675	Fee-for-Service	1386160810	1386160810	1	2	EASYACCESS MEDICAL GROUP, IN	4/14/2022	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	C	81812 DOCTOR CARREON BLV	E	INDIO	CA	92201	0607	33	06065	33.70742848	-116.236728	Riverside County
181717	Fee-for-Service	1144218306	1144218306	1	1	ECKHOFF, NISHA L CRNA	7/28/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	2	Out of state provider	None	6410 FANNIN STREET	SUITE 1500	HOUSTON	TX	77030	5306	00	None	29.71419639	-95.39755562	Harris County
181767	Fee-for-Service	1952514051	1952514051	1	1	ENRILE, KATRINE J MD	9/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	108230	36	Psychiatry	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
181815	Fee-for-Service	1528162690	1528162690	1	2	EYECARE SPECIALISTS MEDICAL	10/3/2018	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	5991 E SPRING ST	None	LONG BEACH	CA	90808	3752	19	06037	33.81062147	-118.1154555	Los Angeles County
181831	Fee-for-Service	1730667049	1730667049	1	1	ELLINGWOOD, JOYCE ELAINE A C	12/17/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	NP	8260 MIRA MESA BLVD	None	SAN DIEGO	CA	92126	2662	37	06073	32.91277002	-117.1459433	San Diego County
181914	Fee-for-Service	1306311576	1306311576	1	3	EMERGENCY PHYSICIANS ASSOCIA	6/29/2023	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	TES SAN JOSE PC	751 BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
181939	Fee-for-Service	1114320124	1114320124	1	1	EZIRIM-SALAMIALOFOJE, JOVITA	11/19/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	NP	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
181950	Fee-for-Service	1215242490	1215242490	1	1	ESCOBEDO, EDUARDO	10/26/2010	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	101 S 1ST ST	STE 1800	BURBANK	CA	91502	1959	19	06037	34.17942444	-118.3096895	Los Angeles County
181955	Fee-for-Service	1699008011	1699008011	1	1	ELLIS, STEVEN L OD	12/24/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7035 CONVOY CT	None	SAN DIEGO	CA	92111	0044	37	06073	32.8346295	-117.165015	San Diego County
181968	Fee-for-Service	1124370846	1124370846	1	2	ELIAS, ANAS MD	1/13/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	144754	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	811 E 11TH ST	SUITE 104	UPLAND	CA	91786	4872	36	06071	34.1034335	-117.6398415	San Bernardino County
181978	Fee-for-Service	1306387659	1306387659	1	1	ELZAHABY, CHRISTINA MD	3/17/2023	207R00000X	NA	Other	026	PHYSICIANS	167314	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
181995	Fee-for-Service	1467598508	1467598508	1	1	EMRICK, LISA T MD	8/1/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
182015	Fee-for-Service	1639233943	1639233943	1	1	ENGHARDT, MICHAELE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	0000	00	None	32.812245	-96.841584	Dallas County
182056	Fee-for-Service	1629586409	1629586409	1	1	EXCEL FAMILY EYE CARE INC	8/5/2020	152WC0802X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15855 SOQUEL CANYON PKWY	120	CHINO HILLS	CA	91709	7866	36	06071	33.9641021	-117.6923301	San Bernardino County
182059	Fee-for-Service	1952514051	1952514051	1	1	ENRILE, KATRINE J MD	9/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	108230	26	Psychiatry (child)	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
182067	Fee-for-Service	1558328203	1558328203	2	1	ELHAJJAR, ANTOINE J MD	5/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	53481	13	Neurology (M.D. only)	0	In state provider	None	41990 COOK STREET	STE A-102	PALM DESERT	CA	92211	6100	33	06065	33.748371	-116.356173	Riverside County
182245	Fee-for-Service	1740368471	1740368471	1	1	EATHERTON, JANET K	6/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72155	01	General Practice	0	In state provider	None	6815 FIVE STAR BLVD	STE 100	ROCKLIN	CA	95677	2691	31	06061	38.77941119	-121.2639565	Placer County
182279	Fee-for-Service	1912025297	1912025297	1	1	ETIAKA, TABARA LMFT	3/22/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3939 ATLANTIC AVENUE	SUITE 108	LONG BEACH	CA	90807	1797	19	06037	33.830073	-118.1851065	Los Angeles County
182292	Fee-for-Service	1811968605	1811968605	1	1	EPSTEIN, BEVERLY A MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	58602	07	Dermatology	0	In state provider	None	302 SILVER AVE	None	SAN FRANCISCO	CA	94112	1510	38	06075	37.72851602	-122.4296638	San Francisco County
182394	Fee-for-Service	1407570393	1407570393	1	1	EDELWEISS INDIVIDUAL AND FAM	6/20/2023	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ILY THERAPY CORP	1100 QUAIL ST	STE 206	NEWPORT BEACH	CA	92660	2782	30	06059	33.65958081	-117.8666188	Orange County
182454	Fee-for-Service	1417449919	1417449919	1	1	ELAYAPERUMAL, PRAMMA MD	11/7/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
182530	Fee-for-Service	1891241634	1891241634	1	1	ENVIRONMENTAL ALTERNATIVES	9/30/2024	253J00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	350 MAIN ST	None	QUINCY	CA	95971	9375	32	06063	39.9367	-120.9457587	Plumas County
182545	Fee-for-Service	1417068818	1417068818	1	1	ERWAY, RANDALL G. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	555 S 70TH ST	None	LINCOLN	NE	68510	2462	00	None	40.808151	-96.62516802	Lancaster County
182623	Fee-for-Service	1942067723	1942067723	1	1	EVERGREEN RETINA INC A PROFE	7/18/2024	193400000X	NA	Other	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	SSIONAL MEDICAL CORPOR	27335 TOURNEY RD	UNIT J-2	VALENCIA	CA	91355	2205	19	06037	34.41919917	-118.5789065	Los Angeles County
182784	Fee-for-Service	1689699183	1689699183	1	1	ESTRADA, JUAN P MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73210	40	Pediatrics	0	In state provider	None	2701 S BRISTOL ST	None	SANTA ANA	CA	92704	6201	30	06059	33.71114199	-117.8853958	Orange County
182917	Fee-for-Service	1306285317	1306285317	1	1	EPSTEIN, JASON P MD	12/9/2019	207P00000X	NA	Other	026	PHYSICIANS	145041	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
182936	Fee-for-Service	1235373549	1235373549	1	1	ESCUDERO, MARK R MD	8/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129633	30	Radiology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
182959	Fee-for-Service	1588901532	1588901532	1	43	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	475 FOOTHILL BLVD	K	LA CANADA FLINTRI	CA	91011	3555	19	06037	34.20020709	-118.1880617	Los Angeles County
182969	Fee-for-Service	1588901532	1588901532	1	10	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	19346 NORDHOFF ST	None	NORTHRIDGE	CA	91324	2415	19	06037	34.233309	-118.554714	Los Angeles County
183071	Fee-for-Service	1689699183	1689699183	1	1	ESTRADA, JUAN P MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73210	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2701 S BRISTOL ST	None	SANTA ANA	CA	92704	6201	30	06059	33.71114199	-117.8853958	Orange County
183140	Fee-for-Service	1033614706	1033614706	1	2	ELLISON MEDICAL GROUP VEIN T	8/20/2021	207LP2900X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	1270 S WINCHESTER BLVD	102	SAN JOSE	CA	95128	3911	43	06085	37.30214899	-121.9498588	Santa Clara County
183173	Fee-for-Service	1912342007	1912342007	1	1	ELDEMERDASH, ALAA-ELDIN A MD	10/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	MD	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2386	00	None	36.1590063	-115.1674415	Clark County
183257	Fee-for-Service	1588901532	1588901532	1	10	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	19346 NORDHOFF ST	None	NORTHRIDGE	CA	91324	2415	19	06037	34.233309	-118.554714	Los Angeles County
183412	Fee-for-Service	1790725281	1790725281	1	1	EMERGENCY PHYSICIANS	10/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL GROUP	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
183481	Fee-for-Service	1447322847	1447322847	1	1	ENAYATI, LILY N MD	6/30/1993	207R00000X	NA	Other	026	PHYSICIANS	78301	41	Internal Medicine	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
183516	Fee-for-Service	1477044519	1477044519	1	1	ESTRADA, LETICIA	11/7/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	UNSELING	15913 LARAMIE WAY	None	VICTORVILLE	CA	92394	6401	36	06071	34.53788499	-117.3472942	San Bernardino County
183529	Fee-for-Service	1730625294	1730625294	1	1	ELLIS, STEPHANIE A LCSW	1/16/2019	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 MAGNOLIA AVE	STE 1F	CORONA	CA	92879	3121	33	06065	33.85936872	-117.5534605	Riverside County
183543	Fee-for-Service	1912565581	1912565581	1	1	EMERGENCY PHYSICIANS URGENT	1/22/2021	261Q00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	41540 WINCHESTER	None	TEMECULA	CA	92590	4877	33	06065	33.52069117	-117.1653103	Riverside County
183546	Fee-for-Service	1588901532	1588901532	1	10	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	19346 NORDHOFF ST	None	NORTHRIDGE	CA	91324	2415	19	06037	34.233309	-118.554714	Los Angeles County
183550	Fee-for-Service	1447023163	1447023163	1	1	EGBUJIONUMA, MICHAEL CRNA	7/18/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
183598	Fee-for-Service	1487335709	1487335709	1	2	EVERGREEN LIFE CRE HMES, INC	10/24/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	542 W BROWNING AVE	None	FRESNO	CA	93704	1802	10	06019	36.8192755	-119.8025595	Fresno County
183642	Fee-for-Service	1194983932	1194983932	1	1	EISENSTEIN, SAMUEL G MD	9/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132251	02	General Surgery	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
183650	Fee-for-Service	1972650513	1972650513	1	1	EUBANKS, HAYWARD L MD	10/31/1986	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	54388	04	Otology, Laryngology, Rhinology	0	In state provider	A MEDICAL CORPORATION	4477 W 118TH ST	STE 205	HAWTHORNE	CA	90250	2257	19	06037	33.92734752	-118.354221	Los Angeles County
183688	Fee-for-Service	1144705369	1144705369	1	2	ELLIS-BLIED, MONICA U PHD	2/26/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	105 S. SPRING STREET	None	CLAREMONT	CA	91711	4930	19	06037	34.0928799	-117.7167321	Los Angeles County
183771	Fee-for-Service	1902816820	1902816820	1	1	EAMES, WENDELL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1034 N 500 W	None	PROVO	UT	84605	0000	00	None	40.248072	-111.6673905	Utah County
183829	Fee-for-Service	1912565581	1912565581	1	1	EMERGENCY PHYSICIANS URGENT	9/30/2020	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	41540 WINCHESTER	None	TEMECULA	CA	92590	4877	33	06065	33.52069117	-117.1653103	Riverside County
183834	Fee-for-Service	1588901532	1588901532	1	10	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	19346 NORDHOFF ST	None	NORTHRIDGE	CA	91324	2415	19	06037	34.233309	-118.554714	Los Angeles County
183894	Fee-for-Service	1134566235	1134566235	1	1	EL-AKKAD, SAMIH MD	10/4/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	132899	30	Radiology	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
184178	Fee-for-Service	1932159977	1932159977	1	1	EVANS, BRIAN N MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70983	24	Plastic Surgery	0	In state provider	None	7325 MEDICAL CENTER DR	STE 200	WEST HILLS	CA	91307	1938	19	06037	34.20369349	-118.629837	Los Angeles County
184224	Fee-for-Service	1275638876	1275638876	1	1	ELLIS, VIVIAN E DO	12/31/1985	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	4479	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	641 E PENNSYLVANIA AVE	None	ESCONDIDO	CA	92025	3047	37	06073	33.12660916	-117.0744425	San Diego County
184250	Fee-for-Service	1164494811	1164494811	1	1	EDELMAN, KALMAN J MD	3/31/1982	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	41705	10	Gastroenterology (M.D. only)	0	In state provider	None	50 BELLEFONTAINE ST	STE 202	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
184414	Fee-for-Service	1699152595	1699152595	1	1	ELLIS, JONATHAN MD	6/1/2023	207L00000X	NA	Other	026	PHYSICIANS	161127	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
184418	Fee-for-Service	1003150210	1003150210	1	1	ELITE BIOMECHANICAL DESIGN	6/13/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1100 GARDEN HWY	#900	YUBA CITY	CA	95991	7598	51	06101	39.11115001	-121.6171113	Sutter County
184516	Fee-for-Service	1588901532	1588901532	1	41	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	8135 PAINTER AVE	104	WHITTIER	CA	90602	3102	19	06037	33.965829	-118.032738	Los Angeles County
184528	Fee-for-Service	1467195073	1467195073	1	9	EMANATE HEALTH MEDICAL CARE	3/12/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	1135 S SUNSET AVE	STE 206	WEST COVINA	CA	91790	3964	19	06037	34.06215064	-117.9453997	Los Angeles County
184663	Fee-for-Service	1851321632	1851321632	1	1	ERICKSON,KATRINA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	315 MARTIN LUTHER KING	WAY	TACOMA	WA	98405	0000	00	None	47.25960844	-122.4534238	Pierce County
184672	Fee-for-Service	1831277482	1831277482	1	1	EFRON, ALLEN D MD	6/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	66809	14	Neurological Surgery	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
184715	Fee-for-Service	1588901532	1588901532	1	42	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4121 SANTA MONICA BLVD	103	LOS ANGELES	CA	90029	3883	19	06037	34.09195911	-118.282318	Los Angeles County
184803	Fee-for-Service	1588901532	1588901532	1	41	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	8135 PAINTER AVE	104	WHITTIER	CA	90602	3102	19	06037	33.965829	-118.032738	Los Angeles County
184816	Fee-for-Service	1467195073	1467195073	1	9	EMANATE HEALTH MEDICAL CARE	3/12/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOUNDATION	1135 S SUNSET AVE	STE 206	WEST COVINA	CA	91790	3964	19	06037	34.06215064	-117.9453997	Los Angeles County
184835	Fee-for-Service	1902931157	1902931157	1	1	EISENMAN, DANA G MD	2/13/2019	207R00000X	NA	Other	026	PHYSICIANS	63578	41	Internal Medicine	0	In state provider	None	1125 S BEVERLY DR STE 42	None	LOS ANGELES	CA	90035	1192	19	06037	34.05696658	-118.3966613	Los Angeles County
184852	Fee-for-Service	1477797306	1477797306	1	1	ECLAT MEDICAL INC	3/25/2010	207R00000X	NA	Other	026	PHYSICIANS	95845	41	Internal Medicine	0	In state provider	None	525 EAST COLORADO BLVD	SUITE PH	PASADENA	CA	91101	5226	19	06037	34.1458745	-118.139481	Los Angeles County
184853	Fee-for-Service	1417679465	1417679465	1	1	ESHUN, STEPHEN NP	3/22/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
184883	Fee-for-Service	1487773693	1487773693	1	1	ENG HUAN AND TIN HLA	10/29/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	MEDICAL CORP	200 JOSE FIGUERES AVE	STE 430	SAN JOSE	CA	95116	1593	43	06085	37.36122014	-121.8505998	Santa Clara County
185003	Fee-for-Service	1588901532	1588901532	1	42	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4121 SANTA MONICA BLVD	103	LOS ANGELES	CA	90029	3883	19	06037	34.09195911	-118.282318	Los Angeles County
185011	Fee-for-Service	1952379174	1952379174	1	1	EGHBALI, KOUROSH MD	9/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78218	18	Ophthalmology	0	In state provider	None	2601 W ALAMEDA AVE	STE 204	BURBANK	CA	91505	4810	19	06037	34.15783817	-118.3293969	Los Angeles County
185023	Fee-for-Service	1376943290	1376943290	1	1	EDGAR, DANA J V	3/6/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
185093	Fee-for-Service	1588901532	1588901532	1	41	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	8135 PAINTER AVE	104	WHITTIER	CA	90602	3102	19	06037	33.965829	-118.032738	Los Angeles County
185103	Fee-for-Service	1467195073	1467195073	1	9	EMANATE HEALTH MEDICAL CARE	3/12/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	FOUNDATION	1135 S SUNSET AVE	STE 206	WEST COVINA	CA	91790	3964	19	06037	34.06215064	-117.9453997	Los Angeles County
185133	Fee-for-Service	1457744583	1457744583	1	1	ENGELAUF-GONZALEZ, GRISELDA	10/11/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	1255 W COLTON AVE STE 58	None	REDLANDS	CA	92374	2861	36	06071	34.06285254	-117.20178	San Bernardino County
185136	Fee-for-Service	1306101860	1306101860	1	1	ERKLAUER, JENNIFER C MD	7/28/2021	2084N0402X	NA	Neurology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
185173	Fee-for-Service	1487773693	1487773693	1	1	ENG HUAN AND TIN HLA	10/29/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL CORP	200 JOSE FIGUERES AVE	STE 430	SAN JOSE	CA	95116	1593	43	06085	37.36122014	-121.8505998	Santa Clara County
185180	Fee-for-Service	1629281845	1629281845	1	1	ELSISSY, PETER G MD	10/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	100039	20	Orthopedic Surgery	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
185282	Fee-for-Service	1962859041	1962859041	1	1	EDWARD, PRIYA MD	10/10/2022	390200000X	NA	Other	026	PHYSICIANS	182359	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
185289	Fee-for-Service	1588901532	1588901532	1	42	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4121 SANTA MONICA BLVD	103	LOS ANGELES	CA	90029	3883	19	06037	34.09195911	-118.282318	Los Angeles County
185336	Fee-for-Service	1578060760	1578060760	1	1	ELEGANT HOME HEALTH CARE INC	7/21/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1259 S GLENDLE AVE	SUITE H	GLENDALE	CA	91205	3298	19	06037	34.13003451	-118.2525595	Los Angeles County
185380	Fee-for-Service	1588901532	1588901532	1	41	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8135 PAINTER AVE	104	WHITTIER	CA	90602	3102	19	06037	33.965829	-118.032738	Los Angeles County
185459	Fee-for-Service	1487773693	1487773693	1	1	ENG HUAN AND TIN HLA	10/29/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	MEDICAL CORP	200 JOSE FIGUERES AVE	STE 430	SAN JOSE	CA	95116	1593	43	06085	37.36122014	-121.8505998	Santa Clara County
185508	Fee-for-Service	1992054647	1992054647	1	1	ETEMOVIC, JASMINA OT	4/13/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
185622	Fee-for-Service	1699855734	1699855734	1	1	EMERSON, JANE F MD	5/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	78986	22	Pathology (M.D. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
185638	Fee-for-Service	1568737088	1568737088	1	1	EVANS, JEREMY D DPM	7/14/2014	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
185667	Fee-for-Service	1588901532	1588901532	1	41	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8135 PAINTER AVE	104	WHITTIER	CA	90602	3102	19	06037	33.965829	-118.032738	Los Angeles County
185744	Fee-for-Service	1174151450	1174151450	1	2	EBERHARDT, CARA S MD	4/23/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	181202	-	NOT APPLICABLE	0	In state provider	None	280 E STANDLEY ST	None	UKIAH	CA	95482	4414	23	06045	39.15101964	-123.205602	Mendocino County
185746	Fee-for-Service	1841305638	1841305638	1	1	ELINA QUIROGA	9/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11714 N CREEK PKWY N	STE 100	BOTHELL	WA	98011	8250	00	None	47.77467892	-122.1838257	King County
185783	Fee-for-Service	1629476114	1629476114	1	1	ERICKSON, ROBERT A CRNA	2/19/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
185835	Fee-for-Service	1871552679	1871552679	1	1	ENG, GRACE S MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	86467	67	Endocrinology	0	In state provider	None	350 30TH STREET	SUITE 320	OAKLAND	CA	94609	3424	01	06001	37.81892183	-122.2640154	Alameda County
185877	Fee-for-Service	1336309178	1336309178	1	1	EMANUEL, ASHER MD	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119197	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
185898	Fee-for-Service	1386974376	1386974376	2	1	ELITE CARE PHARMACY INC	10/19/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5101 SANTA MONICA BLVD	STE 6	LOS ANGELES	CA	90029	2480	19	06037	34.09086147	-118.3008915	Los Angeles County
185941	Fee-for-Service	1467195073	1467195073	1	6	EMANATE HEALTH MEDICAL CARE	4/1/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOUNDATION	412 W CARROLL AVE	STE 107	GLENDORA	CA	91741	4708	19	06037	34.13415622	-117.8702547	Los Angeles County
186024	Fee-for-Service	1861651614	1861651614	1	1	EDWARDS, STEPHEN J MD	12/1/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
186032	Fee-for-Service	1548678220	1548678220	1	1	EWING, ELIZABETH C NP	4/7/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3779 PIEDMONT	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
186084	Fee-for-Service	1467195073	1467195073	1	2	EMANATE HEALTH MEDICAL CARE	2/12/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOUNDATION	1135 S SUNSET AVE	SUITE 401	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
186153	Fee-for-Service	1720098148	1720098148	1	1	ENT ASSOCIATES MEDICAL	8/29/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	GROUP	3907 WARING RD	STE 1A	OCEANSIDE	CA	92056	4454	37	06073	33.18780783	-117.2918439	San Diego County
186231	Fee-for-Service	1467195073	1467195073	1	6	EMANATE HEALTH MEDICAL CARE	4/1/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	412 W CARROLL AVE	STE 107	GLENDORA	CA	91741	4708	19	06037	34.13415622	-117.8702547	Los Angeles County
186295	Fee-for-Service	1265691646	1265691646	1	1	EUGENE, STEPHANIE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1500 S CALIFORNIA AVE	None	CHICAGO	IL	60608	1729	00	None	41.86116361	-87.69582202	Cook County
186365	Fee-for-Service	1861783789	1861783789	1	1	ESCOBEDO, LIZA V S MD	2/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153059	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4929 VAN NUYS BLVD	None	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
186372	Fee-for-Service	1467195073	1467195073	1	2	EMANATE HEALTH MEDICAL CARE	2/12/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	FOUNDATION	1135 S SUNSET AVE	SUITE 401	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
186375	Fee-for-Service	1932636685	1932636685	1	1	ERIC D VALDER	7/13/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2600 65TH AVENUE	None	OSCEOLA	WI	54020	4370	00	None	45.30352849	-92.7007245	Polk County
186408	Fee-for-Service	1164832861	1164832861	1	1	EMENIKE, IFEOMA LMFT	1/6/2025	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
186428	Fee-for-Service	1003172016	1003172016	1	1	ESPINOSA, YAMINAH DO	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12958	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
186436	Fee-for-Service	1164770780	1164770780	1	1	ESCOBAR, CINDY R LCSW	5/12/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	87182	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVE	SUITE 150	SAN JOSE	CA	95119	1371	43	06085	37.23598537	-121.7783065	Santa Clara County
186459	Fee-for-Service	1639215767	1639215767	1	1	EL DORADO CO HEALTH DEPT	1/27/1992	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	LABORATORY	931 SPRING ST	None	PLACERVILLE	CA	95667	4543	09	06017	38.73225478	-120.802205	El Dorado County
186518	Fee-for-Service	1467195073	1467195073	1	6	EMANATE HEALTH MEDICAL CARE	4/1/2024	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	FOUNDATION	412 W CARROLL AVE	STE 107	GLENDORA	CA	91741	4708	19	06037	34.13415622	-117.8702547	Los Angeles County
186546	Fee-for-Service	1154563476	1154563476	1	1	EISSING, KIMBERLY	4/17/2009	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18350 MOUNT LANGLEY	#105	FOUNTAIN VALLEY	CA	92708	6912	30	06059	33.69633523	-117.9420534	Orange County
186551	Fee-for-Service	1174996136	1174996136	1	1	ELLIS, KRISTEN LMFT	9/7/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	104462	-	NOT APPLICABLE	0	In state provider	None	82380 MILES AVE	None	INDIO	CA	92201	2608	33	06065	33.72120813	-116.2273994	Riverside County
186569	Fee-for-Service	1104852532	1104852532	1	1	ERLICH, KIMBERLY J NP	8/30/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
186575	Fee-for-Service	1831243625	1831243625	1	1	EAST VALLEY COMM HLTH	5/1/1997	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	19	06037	34.06750236	-117.925203	Los Angeles County
186586	Fee-for-Service	1700925724	1700925724	1	1	EDIE, CARLA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
186595	Fee-for-Service	1447251640	1447251640	1	1	EHRET, SUSANNAH M MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68091	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
186619	Fee-for-Service	1063701712	1063701712	1	1	ELFENBEIN, ARYE MD	7/26/2020	207RC0200X	NA	Other	026	PHYSICIANS	139463	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
186623	Fee-for-Service	1730297870	1730297870	1	1	EWING, NADIA MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	23225	40	Pediatrics	0	In state provider	None	2400 S FLOWER ST	None	LOS ANGELES	CA	90007	2629	19	06037	34.02861627	-118.273964	Los Angeles County
186658	Fee-for-Service	1467195073	1467195073	1	2	EMANATE HEALTH MEDICAL CARE	2/12/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	1135 S SUNSET AVE	SUITE 401	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
186675	Fee-for-Service	1275580698	1275580698	1	1	EL-NEWIHI, HUSSEIN M MD	6/1/1999	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	43712	41	Internal Medicine	0	In state provider	None	1600 S IMPERIAL AVE	STE 8	EL CENTRO	CA	92243	4242	13	06025	32.77882919	-115.5697116	Imperial County
186722	Fee-for-Service	1184763005	1184763005	1	1	ESPERANZA, MELIZZA R LCSW	7/10/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
186765	Fee-for-Service	1225781073	1225781073	1	1	EAST BAY HEARING SERVICES	11/22/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1260 A ST	SUITE 100	HAYWARD	CA	94541	2961	01	06001	37.67705643	-122.0794392	Alameda County
186805	Fee-for-Service	1467195073	1467195073	1	6	EMANATE HEALTH MEDICAL CARE	4/1/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	FOUNDATION	412 W CARROLL AVE	STE 107	GLENDORA	CA	91741	4708	19	06037	34.13415622	-117.8702547	Los Angeles County
186814	Fee-for-Service	1891099909	1891099909	1	1	EQUILS, JUANITA R LMFT	1/14/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5250 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91601	3186	19	06037	34.1665161	-118.3755868	Los Angeles County
186860	Fee-for-Service	1831243625	1831243625	1	1	EAST VALLEY COMM HLTH	5/1/1997	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	19	06037	34.06750236	-117.925203	Los Angeles County
186874	Fee-for-Service	1043235203	1043235203	1	1	EBER, LESLIE M MD	1/31/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	15502	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	#365, 420, 120	LOS ANGELES	CA	90024	7002	19	06037	34.06527974	-118.4462792	Los Angeles County
186883	Fee-for-Service	1447251640	1447251640	1	1	EHRET, SUSANNAH M MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68091	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
186907	Fee-for-Service	1801871934	1801871934	1	1	EMERGENCY PHYSICIANS, P.A.	4/27/2023	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	4300 MARKETPOINTE DRIVE	SUITE 100	MINNEAPOLIS	MN	55435	5435	00	None	44.8612569	-93.33472789	Hennepin County
186944	Fee-for-Service	1598724015	1598724015	1	1	EICHINGER, DANIEL J	3/31/1995	207R00000X	NA	Other	026	PHYSICIANS	6413	None	None	0	In state provider	None	420 W ROWLAND ST	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
186960	Fee-for-Service	1619987666	1619987666	1	1	EYE PHYSICIANS MED GRP I	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	225 W MADISON AVE	STE 1	EL CAJON	CA	92020	3454	37	06073	32.80066448	-116.9642655	San Diego County
186962	Fee-for-Service	1275580698	1275580698	1	1	EL-NEWIHI, HUSSEIN M MD	6/1/1999	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	43712	10	Gastroenterology (M.D. only)	0	In state provider	None	1600 S IMPERIAL AVE	STE 8	EL CENTRO	CA	92243	4242	13	06025	32.77882919	-115.5697116	Imperial County
186966	Fee-for-Service	1285720326	1285720326	1	2	ENCINA, ALBERTO Y MD	11/10/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	33026	-	NOT APPLICABLE	0	In state provider	None	44447 N 10TH ST	BUILDING B	LANCASTER	CA	93534	3324	19	06037	34.69104127	-118.1480655	Los Angeles County
187006	Fee-for-Service	1003436551	1003436551	1	1	ELROD, BRYAN G CRNA	6/1/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
187030	Fee-for-Service	1235206889	1235206889	1	1	EDWARD WEINBERGER, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4500 SAND POINT WAY	NE STE 100	SEATTLE	WA	98105	3900	00	None	47.66165594	-122.2864502	King County
187048	Fee-for-Service	1760558498	1760558498	1	1	ELLIOTT AND ELLIOTT, ODS	1/31/1985	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3601 COFFEE RD	None	MODESTO	CA	95355	1161	50	06099	37.69158077	-120.9761536	Stanislaus County
187080	Fee-for-Service	1639594260	1639594260	1	1	EPTING, MARK R LCSW	12/29/2018	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	RAPY & COUNSELING, INC.	12401 WILSHIRE BLVD.	303	LOS ANGELES	CA	90025	5363	19	06037	34.04165884	-118.4705065	Los Angeles County
187103	Fee-for-Service	1932781259	1932781259	1	1	EZZAT, ALI R MD	10/28/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
187162	Fee-for-Service	1043235203	1043235203	1	1	EBER, LESLIE M MD	1/31/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	15502	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365, 420, 120	LOS ANGELES	CA	90024	7002	19	06037	34.06527974	-118.4462792	Los Angeles County
187163	Fee-for-Service	1861465932	1861465932	1	1	ELLISON, MICHAEL J MD	8/31/1988	207RP1001X	NA	Pulmonology	026	PHYSICIANS	64790	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
187182	Fee-for-Service	1861887119	1861887119	1	1	ESTRIN, SARA MD	5/8/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	8767 WILSHIRE BLVD	2ND AND 3RD FLOOR	BEVERLY HILLS	CA	90211	2714	19	06037	34.06704253	-118.3835029	Los Angeles County
187247	Fee-for-Service	1942729207	1942729207	1	1	E3HEALTH SOLUTIONS, LLC	5/10/2021	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	602 STRADA CIR	STE 116	MANSFIELD	TX	76063	3201	00	None	32.571966	-97.13240553	Tarrant County
187277	Fee-for-Service	1518963982	1518963982	1	1	ENGELMAN, JAMES M MD	2/22/2018	207R00000X	NA	Other	026	PHYSICIANS	50384	41	Internal Medicine	0	In state provider	None	1595 SOQUEL DR	STE 400	SANTA CRUZ	CA	95065	1724	44	06087	36.98879599	-121.9826354	Santa Cruz County
187279	Fee-for-Service	1174607881	1174607881	1	1	ENDELMAN, JANET R PHD	12/4/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	525 IRVING ST	None	SAN FRANCISCO	CA	94122	2599	38	06075	37.7641455	-122.4635927	San Francisco County
187349	Fee-for-Service	1992116610	1992116610	1	2	EGLITIS, AUTUMN MD	8/30/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	150389	None	None	0	In state provider	None	517 3RD STREET	22	EUREKA	CA	95501	3203	12	06023	40.80367671	-124.166036	Humboldt County
187407	Fee-for-Service	1922456029	1922456029	1	1	ESPIRITU, JULIUS T LMFT	9/21/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
187504	Fee-for-Service	1013943026	1013943026	1	1	EISENBERG, RONALD L MD	10/17/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	24216	30	Radiology	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
187537	Fee-for-Service	1144294232	1144294232	1	1	EDWARD F GIBBONS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	328 9TH AVE	MS 359110 C/0 UWP	SEATTLE	WA	98104	2420	00	None	47.60426649	-122.3234873	King County
187600	Fee-for-Service	1780823328	1780823328	1	1	ENDERTON, ELIZABETH L DO	2/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12367	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	501 N BRIDGE ST	None	VISALIA	CA	93291	5014	54	06107	36.334107	-119.289186	Tulare County
187633	Fee-for-Service	1215070008	1215070008	1	1	ECHEVERRIA, JANIE R LCSW	6/29/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
187713	Fee-for-Service	1104386325	1104386325	1	1	ESWARAPPA, MEGHANA S MD	6/24/2024	207RN0300X	NA	Nephrology	026	PHYSICIANS	177252	45	Nephrology (Renal-Kidney)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
187925	Fee-for-Service	1699394114	1699394114	1	1	EAGLE, SONJA MD	6/10/2024	207P00000X	NA	Other	026	PHYSICIANS	188644	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
188013	Fee-for-Service	1649332404	1649332404	1	1	EHNOW, COLETTE K MD	3/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97794	18	Ophthalmology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
188025	Fee-for-Service	1588901532	1588901532	1	11	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	13303 RIVERSIDE DR.	None	SHERMAN OAKS	CA	91423	2508	19	06037	34.15763649	-118.423683	Los Angeles County
188149	Fee-for-Service	1588901532	1588901532	1	58	EXER MEDICAL CORPORATION	8/27/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	600 S LAKE AVE	105	PASADENA	CA	91106	3955	19	06037	34.135569	-118.1322515	Los Angeles County
188220	Fee-for-Service	1467195073	1467195073	1	13	EMANATE HEALTH MEDICAL CARE	1/31/2025	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	& GYNECOLOGY	210 S GRAND AVE,	SUITE 400	GLENDORA	CA	91741	4279	19	06037	34.133859	-117.872523	Los Angeles County
188293	Fee-for-Service	1588901532	1588901532	1	52	EXER MEDICAL CORPORATION	3/25/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	16818 HAWTHORNE BLVD	None	LAWNDALE	CA	90260	3218	19	06037	33.877899	-118.3523705	Los Angeles County
188311	Fee-for-Service	1588901532	1588901532	1	11	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	13303 RIVERSIDE DR.	None	SHERMAN OAKS	CA	91423	2508	19	06037	34.15763649	-118.423683	Los Angeles County
188476	Fee-for-Service	1568406114	1568406114	1	1	ENRIQUEZ, RONALD P MD	2/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87219	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
188508	Fee-for-Service	1467195073	1467195073	1	13	EMANATE HEALTH MEDICAL CARE	1/31/2025	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	& GYNECOLOGY	210 S GRAND AVE,	SUITE 400	GLENDORA	CA	91741	4279	19	06037	34.133859	-117.872523	Los Angeles County
188566	Fee-for-Service	1881681526	1881681526	1	1	ELDRIDGE, JOAN E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9395 CROWN CREST BLVD	None	PARKER	CO	80138	8573	00	None	39.5497445	-104.7700003	Douglas County
188579	Fee-for-Service	1588901532	1588901532	1	52	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16818 HAWTHORNE BLVD	None	LAWNDALE	CA	90260	3218	19	06037	33.877899	-118.3523705	Los Angeles County
188582	Fee-for-Service	1891974507	1891974507	1	1	EDUARD FUZAYLOV	4/3/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	225 TAYLORS MILLS RD	None	MANALAPAN	NJ	07726	3229	00	None	40.30220249	-74.30512251	Monmouth County
188584	Fee-for-Service	1285798033	1285798033	1	1	EVES, WILLIAM C MD INC	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	65653	20	Orthopedic Surgery	0	In state provider	None	480 4TH AVE	STE 307	CHULA VISTA	CA	91910	4403	37	06073	32.63411298	-117.0816772	San Diego County
188601	Fee-for-Service	1588901532	1588901532	1	11	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	13303 RIVERSIDE DR.	None	SHERMAN OAKS	CA	91423	2508	19	06037	34.15763649	-118.423683	Los Angeles County
188636	Fee-for-Service	1891046181	1891046181	1	1	ENRIQUEZ, LAUREN A LMFT	3/5/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	308 W STATE ST	UNIT 3D	REDLANDS	CA	92373	4653	36	06071	34.05649746	-117.18603	San Bernardino County
188748	Fee-for-Service	1104640572	1104640572	1	1	EVERLY, KATIE CCC-SLP	1/22/2025	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
188794	Fee-for-Service	1467195073	1467195073	1	13	EMANATE HEALTH MEDICAL CARE	1/31/2025	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	& GYNECOLOGY	210 S GRAND AVE,	SUITE 400	GLENDORA	CA	91741	4279	19	06037	34.133859	-117.872523	Los Angeles County
188827	Fee-for-Service	1568423564	1568423564	1	1	EARL, BRETT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3580 WEST 9000 SOUTH	None	WEST JORDAN	UT	84088	8812	00	None	40.590153	-111.974634	Salt Lake County
188857	Fee-for-Service	1740338664	1740338664	1	1	ELIAN, HALIMEH B NP	9/2/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10605 BALBOA BLVD	None	GRANADA HILLS	CA	91344	6432	19	06037	34.263378	-118.5022965	Los Angeles County
188869	Fee-for-Service	1588901532	1588901532	1	52	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	16818 HAWTHORNE BLVD	None	LAWNDALE	CA	90260	3218	19	06037	33.877899	-118.3523705	Los Angeles County
188886	Fee-for-Service	1588901532	1588901532	1	11	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	13303 RIVERSIDE DR.	None	SHERMAN OAKS	CA	91423	2508	19	06037	34.15763649	-118.423683	Los Angeles County
188994	Fee-for-Service	1851754246	1851754246	1	1	ELLINWOOD, ELIZABETH E DO	8/17/2023	207L00000X	NA	Other	026	PHYSICIANS	20754	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
189002	Fee-for-Service	1265889588	1265889588	1	1	ELDRIDGE, CARIN MD FAAP	8/1/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
189056	Fee-for-Service	1588901532	1588901532	1	26	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	5717 MELROSE AVE	None	LOS ANGELES	CA	90038	3807	19	06037	34.08352353	-118.3251015	Los Angeles County
189095	Fee-for-Service	1053499384	1053499384	1	1	EPSTEIN, ROGER	1/1/1992	2084P0800X	NA	Psychiatry	026	PHYSICIANS	75262	01	General Practice	0	In state provider	None	928 W TOWN AND COUNTRY R	None	ORANGE	CA	92868	4714	30	06059	33.77650848	-117.861867	Orange County
189141	Fee-for-Service	1629530779	1629530779	1	1	ESLAMI-AMIRABADI, MANIZHE M	7/4/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	185642	None	None	0	In state provider	D	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
189157	Fee-for-Service	1588901532	1588901532	1	52	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	16818 HAWTHORNE BLVD	None	LAWNDALE	CA	90260	3218	19	06037	33.877899	-118.3523705	Los Angeles County
189178	Fee-for-Service	1013459817	1013459817	1	1	ESCAMILLA, LUIS PT	12/28/2018	208100000X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4234 RIVERWALK PKWY	SUITE 200	RIVERSIDE	CA	92505	8510	33	06065	33.90290859	-117.4941562	Riverside County
189180	Fee-for-Service	1588901532	1588901532	1	11	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	13303 RIVERSIDE DR.	None	SHERMAN OAKS	CA	91423	2508	19	06037	34.15763649	-118.423683	Los Angeles County
189197	Fee-for-Service	1922261957	1922261957	1	1	EGGE, MELISSA K MD	6/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	92826	None	None	0	In state provider	None	25845 BARTON RD	SUITE F	LOMA LINDA	CA	92354	3899	36	06071	34.04824949	-117.2401425	San Bernardino County
189251	Fee-for-Service	1861482564	1861482564	1	1	EISENBERG, LARA B MD	7/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	88067	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
189294	Fee-for-Service	1295083939	1295083939	1	1	ELHAM TAEED MD A MEDICAL COR	11/5/2022	261QM2500X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	P	4950 BARRANCA PKWY	STE 308	IRVINE	CA	92604	4631	30	06059	33.67620851	-117.7948348	Orange County
189342	Fee-for-Service	1588901532	1588901532	1	26	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	5717 MELROSE AVE	None	LOS ANGELES	CA	90038	3807	19	06037	34.08352353	-118.3251015	Los Angeles County
189368	Fee-for-Service	1053499384	1053499384	1	1	EPSTEIN, ROGER	1/1/1992	2084P0800X	NA	Psychiatry	026	PHYSICIANS	75262	36	Psychiatry	0	In state provider	None	928 W TOWN AND COUNTRY R	None	ORANGE	CA	92868	4714	30	06059	33.77650848	-117.861867	Orange County
189460	Fee-for-Service	1588901532	1588901532	1	25	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	20201 W RINALDI ST	110	NORTHRIDGE	CA	91326	4937	19	06037	34.27520299	-118.5724533	Los Angeles County
189464	Fee-for-Service	1164679940	1164679940	1	1	EMERALD BAY CENTER FOR	12/13/2010	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	WOMENS HEALTH INC	1154 EMERALD BAY RD	STE A	SOUTH LAKE TAHOE	CA	96150	6290	09	06017	38.90859803	-120.0018502	El Dorado County
189545	Fee-for-Service	1922044205	1922044205	1	1	EVANS, GREGORY E OD	5/25/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	71956 MAGNESIA FALLS DR	None	RANCHO MIRAGE	CA	92270	4901	33	06065	33.73550164	-116.4089224	Riverside County
189572	Fee-for-Service	1912524356	1912524356	1	1	ELITE HOSPICE AND PALLIATIVE	10/28/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE LLC	106 S GRAPE ST	STE 2	ESCONDIDO	CA	92025	4407	37	06073	33.12418065	-117.0741642	San Diego County
189630	Fee-for-Service	1588901532	1588901532	1	26	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5717 MELROSE AVE	None	LOS ANGELES	CA	90038	3807	19	06037	34.08352353	-118.3251015	Los Angeles County
189701	Fee-for-Service	1346635430	1346635430	1	1	EDWARDS, KENIA I MD	8/30/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	161805	08	Family Practice	0	In state provider	None	315 MERCY AVE	STE 400	MERCED	CA	95340	8363	24	06047	37.33874349	-120.467493	Merced County
189711	Fee-for-Service	1427003615	1427003615	1	1	EARNEST, KAREN D PHD	6/21/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4700 SUNSET BLVD	None	LOS ANGELES	CA	90027	6082	19	06037	34.09812055	-118.2921165	Los Angeles County
189751	Fee-for-Service	1588901532	1588901532	1	25	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	20201 W RINALDI ST	110	NORTHRIDGE	CA	91326	4937	19	06037	34.27520299	-118.5724533	Los Angeles County
189836	Fee-for-Service	1659740272	1659740272	1	1	ESTRADA, SAMIA PSYD	4/26/2020	101Y00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
189863	Fee-for-Service	1912524356	1912524356	1	1	ELITE HOSPICE AND PALLIATIVE	10/28/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE LLC	106 S GRAPE ST	STE 2	ESCONDIDO	CA	92025	4407	37	06073	33.12418065	-117.0741642	San Diego County
189884	Fee-for-Service	1073981783	1073981783	1	1	EL DORADO COUNTY COMMUNITY	1/14/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	3100 PONTE MORINO DR	STE 120	CAMERON PARK	CA	95682	7450	09	06017	38.66252014	-120.9672091	El Dorado County
189902	Fee-for-Service	1588901532	1588901532	1	60	EXER MEDICAL CORPORATION	10/24/2024	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1365 S GRAND AVE	None	GLENDORA	CA	91740	5047	19	06037	34.11425413	-117.8727587	Los Angeles County
189918	Fee-for-Service	1588901532	1588901532	1	26	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	5717 MELROSE AVE	None	LOS ANGELES	CA	90038	3807	19	06037	34.08352353	-118.3251015	Los Angeles County
190016	Fee-for-Service	1043952492	1043952492	1	1	EUREKA RADIATION ONCOLOGY CO	10/16/2023	2471R0002X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NSULTANTS	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
190022	Fee-for-Service	1588901532	1588901532	1	36	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	11126 CHANDLER BLVD	None	NORTH HOLLYWOOD	CA	91601	3228	19	06037	34.16806853	-118.373289	Los Angeles County
190036	Fee-for-Service	1588901532	1588901532	1	25	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	20201 W RINALDI ST	110	NORTHRIDGE	CA	91326	4937	19	06037	34.27520299	-118.5724533	Los Angeles County
190071	Fee-for-Service	1013307479	1013307479	1	1	EISERT, CHRISTIAN M	1/26/2018	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	134065	04	Otology, Laryngology, Rhinology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
190079	Fee-for-Service	1669655601	1669655601	1	1	EAST EL PASO PHYS MED CTR	3/4/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1416 GEORGE DIETER DR	None	EL PASO	TX	79936	7601	00	None	31.734984	-106.3015711	El Paso County
190128	Fee-for-Service	1548403322	1548403322	1	1	ESCOTO, VIRGINIA D LMFT	8/4/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
190170	Fee-for-Service	1073981783	1073981783	1	1	EL DORADO COUNTY COMMUNITY	7/16/2018	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	3100 PONTE MORINO DR	STE 120	CAMERON PARK	CA	95682	7450	09	06017	38.66252014	-120.9672091	El Dorado County
190191	Fee-for-Service	1013032713	1013032713	1	1	ESTRADA, DEXTER T MD	1/8/2009	207RH0003X	NA	Oncology	026	PHYSICIANS	106094	78	Neoplastic Diseases/Oncology	0	In state provider	None	445 SOUTH CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
190199	Fee-for-Service	1588901532	1588901532	1	51	EXER MEDICAL CORPORATION	3/25/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	166 N MOORPARK RD,	SUITE 102-104	THOUSAND OAKS	CA	91360	4405	56	06111	34.18064394	-118.8759861	Ventura County
190208	Fee-for-Service	1588901532	1588901532	1	26	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	5717 MELROSE AVE	None	LOS ANGELES	CA	90038	3807	19	06037	34.08352353	-118.3251015	Los Angeles County
190245	Fee-for-Service	1447280813	1447280813	1	1	ERLICH, KIM S MD	7/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	52407	77	Infectious Disease	0	In state provider	None	1500 SOUTHGATE AVE	STE 206	DALY CITY	CA	94015	2231	41	06081	37.67558248	-122.4750825	San Mateo County
190286	Fee-for-Service	1043224280	1043224280	1	1	ELLIOTT, JOHN W MD	7/31/1992	207P00000X	NA	Other	026	PHYSICIANS	40989	None	None	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
190299	Fee-for-Service	1669002465	1669002465	1	1	ENRICHING LIVES INC	7/13/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2507 CHRISTOPHER LANE	None	COSTA MESA	CA	92626	6793	30	06059	33.66451305	-117.9208766	Orange County
190313	Fee-for-Service	1588901532	1588901532	1	36	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	11126 CHANDLER BLVD	None	NORTH HOLLYWOOD	CA	91601	3228	19	06037	34.16806853	-118.373289	Los Angeles County
190325	Fee-for-Service	1588901532	1588901532	1	25	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	20201 W RINALDI ST	110	NORTHRIDGE	CA	91326	4937	19	06037	34.27520299	-118.5724533	Los Angeles County
190332	Fee-for-Service	1790782902	1790782902	1	1	ELLINWOOD, JEANINE M MD	12/1/1995	207R00000X	NA	Other	026	PHYSICIANS	80715	41	Internal Medicine	0	In state provider	None	1033 LOS PALOS DR	None	SALINAS	CA	93901	3916	27	06053	36.65911769	-121.6448024	Monterey County
190357	Fee-for-Service	1619953056	1619953056	1	1	EGAN, KENDALL M MD	8/10/2021	207N00000X	NA	Dermatology	026	PHYSICIANS	124554	None	None	0	In state provider	None	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	30	06059	33.67110839	-117.8658914	Orange County
190401	Fee-for-Service	1073783486	1073783486	1	1	ELIZABETH HAINES	5/17/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	426 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10010	4069	00	None	40.73804102	-73.97761354	New York County
190417	Fee-for-Service	1083664262	1083664262	1	1	EVANGELISTA, BAYANI MD	8/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85985	30	Radiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
190419	Fee-for-Service	1144564436	1144564436	1	1	ENRIQUEZ, CHRISTOPHER G DPM	6/12/2014	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2059 CLINTON AVE	None	ALAMEDA	CA	94501	4379	01	06001	37.76321262	-122.2534547	Alameda County
190437	Fee-for-Service	1740372374	1740372374	1	1	EAR NOSE & THROAT	9/17/1996	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	SPECIALISTS INC	895 AEROVISTA PL	STE 103	SAN LUIS OBISPO	CA	93401	8724	40	06079	35.24285786	-120.6403241	San Luis Obispo County
190456	Fee-for-Service	1073981783	1073981783	1	1	EL DORADO COUNTY COMMUNITY	1/14/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	3100 PONTE MORINO DR	STE 120	CAMERON PARK	CA	95682	7450	09	06017	38.66252014	-120.9672091	El Dorado County
190469	Fee-for-Service	1497056105	1497056105	1	1	EGHBALIEH, NAVID MD	6/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136155	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
190479	Fee-for-Service	1013032713	1013032713	1	1	ESTRADA, DEXTER T MD	1/8/2009	207RH0003X	NA	Oncology	026	PHYSICIANS	106094	68	Hematology	0	In state provider	None	445 SOUTH CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
190489	Fee-for-Service	1588901532	1588901532	1	51	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	166 N MOORPARK RD,	SUITE 102-104	THOUSAND OAKS	CA	91360	4405	56	06111	34.18064394	-118.8759861	Ventura County
190502	Fee-for-Service	1659702389	1659702389	1	1	EVERGREEN HOME CARE &	9/13/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	HOSPICE INC	3756 SANTA ROSALIA DRIVE	STE 520B	LOS ANGELES	CA	90008	3606	19	06037	34.00888336	-118.3389334	Los Angeles County
190510	Fee-for-Service	1861576860	1861576860	1	1	EWING, AMY J MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75595	41	Internal Medicine	0	In state provider	None	5900 STATE FARM DR	None	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
190525	Fee-for-Service	1528570074	1528570074	1	1	EAST & WEST ACUPUNCTURE CLIN	3/7/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	IC INC.	30313 CANWOOD ST	STE 23	AGOURA HILLS	CA	91301	2034	19	06037	34.14784973	-118.7817678	Los Angeles County
190545	Fee-for-Service	1558508002	1558508002	1	1	ELLER, ETHAN CRNA	11/5/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
190578	Fee-for-Service	1275983991	1275983991	1	1	ESPANO, JOSHUA LCSW	6/22/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2221 LINCOLN PARK	None	LOS ANGELES	CA	90031	2920	19	06037	34.07105982	-118.202527	Los Angeles County
190592	Fee-for-Service	1063605772	1063605772	1	1	ELHASSAN, AMIR O MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	120538	05	Anesthesiology	0	In state provider	None	1303 E HERNDON AVENUE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
190601	Fee-for-Service	1588901532	1588901532	1	36	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	11126 CHANDLER BLVD	None	NORTH HOLLYWOOD	CA	91601	3228	19	06037	34.16806853	-118.373289	Los Angeles County
190613	Fee-for-Service	1588901532	1588901532	1	25	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	20201 W RINALDI ST	110	NORTHRIDGE	CA	91326	4937	19	06037	34.27520299	-118.5724533	Los Angeles County
190639	Fee-for-Service	1265513527	1265513527	1	1	EILEEN J KLEIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4500 SAND POINT WAY NE	STE 100	SEATTLE	WA	98105	3954	00	None	47.66165594	-122.2864502	King County
190641	Fee-for-Service	1427263482	1427263482	1	1	ELLIOTT, JENNIFER L DO	10/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
190675	Fee-for-Service	1497200745	1497200745	1	1	EDEN HOME HEALTH OF ELK	9/16/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	GROVE LLC	9299 EAST STOCKTON BLVD	SUITE 10	ELK GROVE	CA	95624	4097	34	06067	38.419506	-121.3906455	Sacramento County
190694	Fee-for-Service	1467195073	1467195073	1	5	EMANATE HEALTH MEDICAL CARE	2/21/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	415 W CARROLL AVE	STE 202	GLENDORA	CA	91741	4208	19	06037	34.13420945	-117.870876	Los Angeles County
190738	Fee-for-Service	1902826340	1902826340	1	1	EDWARD FOGARTY, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	222 N 7TH ST	None	BISMARCK	ND	58501	4436	00	None	46.807308	-100.782459	Burleigh County
190774	Fee-for-Service	1588901532	1588901532	1	51	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	166 N MOORPARK RD,	SUITE 102-104	THOUSAND OAKS	CA	91360	4405	56	06111	34.18064394	-118.8759861	Ventura County
190789	Fee-for-Service	1659702389	1659702389	1	1	EVERGREEN HOME CARE &	9/13/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	HOSPICE INC	3756 SANTA ROSALIA DRIVE	STE 520B	LOS ANGELES	CA	90008	3606	19	06037	34.00888336	-118.3389334	Los Angeles County
190890	Fee-for-Service	1588901532	1588901532	1	36	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11126 CHANDLER BLVD	None	NORTH HOLLYWOOD	CA	91601	3228	19	06037	34.16806853	-118.373289	Los Angeles County
190971	Fee-for-Service	1023519006	1023519006	1	1	ESCOBAR-RODAS, FLOR A LMFT	4/19/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
191066	Fee-for-Service	1588901532	1588901532	1	51	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	166 N MOORPARK RD,	SUITE 102-104	THOUSAND OAKS	CA	91360	4405	56	06111	34.18064394	-118.8759861	Ventura County
191107	Fee-for-Service	1427443621	1427443621	1	1	EOM, ELIZABETH MD	7/14/2022	2080P0207X	NA	Hematology	026	PHYSICIANS	162165	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
191158	Fee-for-Service	1467195073	1467195073	1	11	EMANATE HEALTH MEDICAL CARE	5/1/2024	261QH0100X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	NE & REHABILITATION	1135 S SUNSET AVE	SUITE 101	WEST COVINA	CA	91790	3938	19	06037	34.06215064	-117.9453997	Los Angeles County
191175	Fee-for-Service	1588901532	1588901532	1	36	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	11126 CHANDLER BLVD	None	NORTH HOLLYWOOD	CA	91601	3228	19	06037	34.16806853	-118.373289	Los Angeles County
191207	Fee-for-Service	1700316403	1700316403	1	1	ELLISON, BRIAN MD	8/31/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183776	None	None	0	In state provider	None	2428 SANTA MONICA BLVD	102-103	SANTA MONICA	CA	90404	2045	19	06037	34.0317559	-118.4762013	Los Angeles County
191286	Fee-for-Service	1457357220	1457357220	1	1	ESPINOSA, DAVID P OD	1/17/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	828 N IMPERIAL AVE	None	EL CENTRO	CA	92243	1916	13	06025	32.799681	-115.570058	Imperial County
191294	Fee-for-Service	1285720326	1285720326	1	3	ENCINA, ALBERTO Y MD	5/26/2021	207Q00000X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	33026	-	NOT APPLICABLE	0	In state provider	None	44421 10TH ST W	None	LANCASTER	CA	93534	3335	19	06037	34.690095	-118.148058	Los Angeles County
191347	Fee-for-Service	1942529144	1942529144	1	1	ERICKSON, BENJAMIN P MD	5/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141640	18	Ophthalmology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
191357	Fee-for-Service	1427081710	1427081710	1	1	ELLENT, DAVID P. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	920 MEDICAL PLAZA DR	STE 140	SHENANDOAH	TX	77380	3256	00	None	30.17283687	-95.45254904	Montgomery County
191439	Fee-for-Service	1609832625	1609832625	1	1	EIGLER, NEAL MD	10/25/1991	174400000X	NA	Other	026	PHYSICIANS	40863	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
191576	Fee-for-Service	1164628590	1164628590	1	1	EICHENSEHER, JOSEPH I MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	105703	None	None	0	In state provider	None	1179 N MCDOWELL BLVD	None	PETALUMA	CA	94952	6559	49	06097	38.26876442	-122.6598332	Sonoma County
191603	Fee-for-Service	1386961803	1386961803	1	1	EKANAYAKE, RUWAN B MD	5/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119658	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
191626	Fee-for-Service	1407218407	1407218407	1	1	ELDER, WILLIAM J MD	10/3/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	150827	08	Family Practice	0	In state provider	None	717 CENTER ST	None	HEALDSBURG	CA	95448	3604	49	06097	38.61783	-122.8707965	Sonoma County
191639	Fee-for-Service	1073981783	1073981783	1	3	EL DORADO COUNTY COMMUNITY	7/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3104 PONTE MORINO DR	STE 110	CAMERON PARK	CA	95682	8282	09	06017	38.66304719	-120.9667044	El Dorado County
191690	Fee-for-Service	1104904820	1104904820	1	1	ENGLISH, DAVID K MD	9/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	62673	20	Orthopedic Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
191721	Fee-for-Service	1669907275	1669907275	1	1	ESKANDER, ANDREW DPM	11/5/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	18035 BROOKHURST ST	1100	FOUNTAIN VALLEY	CA	92708	6738	30	06059	33.701184	-117.9544385	Orange County
191926	Fee-for-Service	1073981783	1073981783	1	3	EL DORADO COUNTY COMMUNITY	7/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3104 PONTE MORINO DR	STE 110	CAMERON PARK	CA	95682	8282	09	06017	38.66304719	-120.9667044	El Dorado County
191975	Fee-for-Service	1710984075	1710984075	1	1	EHMANN, JENNIFER A MD	6/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	1107 HIGHWAY 395	None	GARDNERVILLE	NV	89410	0000	00	None	38.76078609	-119.576046	Douglas County
191982	Fee-for-Service	1922245125	1922245125	1	1	ECHEVERRIA, PABLO M MD	2/4/2021	207RC0200X	NA	Other	026	PHYSICIANS	168709	None	None	0	In state provider	None	2185 CITRACADO PARKWAY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
192088	Fee-for-Service	1194792515	1194792515	1	1	ELENA SAVILO	3/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1111 E MCDOWELL RD	None	PHOENIX	AZ	85006	2612	00	None	33.463935	-112.0596975	Maricopa County
192096	Fee-for-Service	1699758599	1699758599	1	2	EHTESHAMI, SHAHRAM MD	9/24/2007	174400000X	NA	Other	026	PHYSICIANS	46324	14	Neurological Surgery	0	In state provider	None	432 LEXINGTON ST	STE C	DELANO	CA	93215	3697	15	06029	35.762706	-119.2407725	Kern County
192106	Fee-for-Service	1386752913	1386752913	1	1	EDWARD KIM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12333 NE 130TH LN	STE 320	KIRKLAND	WA	98034	7467	00	None	47.71664854	-122.1792615	King County
192224	Fee-for-Service	1669500302	1669500302	1	1	EGAN, KRISTIN K MD	12/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90465	04	Otology, Laryngology, Rhinology	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
192405	Fee-for-Service	1174849194	1174849194	1	1	EICHSTADT, SHAUNDRA L MD	8/8/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	117884	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
192442	Fee-for-Service	1346788718	1346788718	1	1	EMPATHY TRANSPORT SERVICE	12/20/2017	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	INC	5501 66TH AVE	STE 100	SACRAMENTO	CA	95823	2657	34	06067	38.492775	-121.4408385	Sacramento County
192466	Fee-for-Service	1306183983	1306183983	1	1	ENGELBERT, VANESSA LCSW	1/22/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
192468	Fee-for-Service	1093200222	1093200222	1	1	EMPOWER PHYSICAL THERAPY & A	10/25/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	QUATICS INSTITUTE	777 CORPORATE DR	STE 160	LADERA RANCH	CA	92694	2136	30	06059	33.557436	-117.6293075	Orange County
192548	Fee-for-Service	1851814073	1851814073	1	1	ESPINOZA, GINA M LMFT	8/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 E GARVEY AVE N	B2	WEST COVINA	CA	91791	1544	19	06037	34.07280989	-117.8995249	Los Angeles County
192562	Fee-for-Service	1760159198	1760159198	1	1	EVERGREEN SPINE AND PAIN CEN	12/6/2022	208VP0014X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	TERS INC.	17040 ARNOLD DR	None	RIVERSIDE	CA	92518	2813	33	06065	33.8730097	-117.2923955	Riverside County
192580	Fee-for-Service	1790756070	1790756070	1	1	ESKANDER, ASHRAF I MD	1/23/2009	208M00000X	NA	Other	026	PHYSICIANS	48837	41	Internal Medicine	0	In state provider	None	700 E REDLANDS BLVD	# U345	REDLANDS	CA	92373	6143	36	06071	34.04750423	-117.1691726	San Bernardino County
192723	Fee-for-Service	1558035071	1558035071	1	1	ELLEDGE, DANIEL K PHD	10/2/2024	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7910 FROST ST	None	SAN DIEGO	CA	92123	2771	37	06073	32.80027449	-117.153846	San Diego County
192724	Fee-for-Service	1821556622	1821556622	1	1	EMPATHY HOME HEALTH	8/20/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 202N	VAN NUYS	CA	91411	2398	19	06037	34.18570347	-118.450386	Los Angeles County
192726	Fee-for-Service	1467195073	1467195073	1	1	EMANATE HEALTH MEDICAL CARE	6/7/2023	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	FOUNDATION	440 W FOOTHILL BLVD	None	GLENDORA	CA	91741	3361	19	06037	34.13599629	-117.8714999	Los Angeles County
192761	Fee-for-Service	1306564224	1306564224	1	1	ECO SAFE TRANSPORT INC	12/6/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	19844 TURTLE SPRINGS WAY	None	NORTHRIDGE	CA	91326	3880	19	06037	34.29358323	-118.5662958	Los Angeles County
192929	Fee-for-Service	1083631501	1083631501	1	1	ENCINO CARE PHARMACY INC	4/24/2007	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	ENCINO CARE PHARMACY	16025 VENTURA BLVD	STE 100	ENCINO	CA	91436	4466	19	06037	34.15616242	-118.482059	Los Angeles County
192989	Fee-for-Service	1730267584	1730267584	1	1	ELLENBOGEN, BENJAMIN MD	1/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	46961	04	Otology, Laryngology, Rhinology	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
193013	Fee-for-Service	1467195073	1467195073	1	1	EMANATE HEALTH MEDICAL CARE	6/7/2023	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOUNDATION	440 W FOOTHILL BLVD	None	GLENDORA	CA	91741	3361	19	06037	34.13599629	-117.8714999	Los Angeles County
193104	Fee-for-Service	1952337461	1952337461	1	1	EMON, NORA Z MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70729	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
193298	Fee-for-Service	1467195073	1467195073	1	1	EMANATE HEALTH MEDICAL CARE	6/7/2023	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOUNDATION	440 W FOOTHILL BLVD	None	GLENDORA	CA	91741	3361	19	06037	34.13599629	-117.8714999	Los Angeles County
193316	Fee-for-Service	1588046510	1588046510	1	1	EMPSON, SUSANNAH F MD	12/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145532	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13100 STUDEBAKER RD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
193377	Fee-for-Service	1346728656	1346728656	1	1	EDIGIN, EHIZOGIE MD	7/26/2022	207R00000X	NA	Other	026	PHYSICIANS	174544	None	None	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
193425	Fee-for-Service	1346241700	1346241700	2	1	EVERGREEN RX INC	6/1/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11779 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	2843	19	06037	34.04293769	-118.4579552	Los Angeles County
193525	Fee-for-Service	1508100389	1508100389	1	1	EYE SMART OPTOMETRY, INC	2/14/2013	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9200 BOLSA AVE	#119A	WESTMINSTER	CA	92683	5577	30	06059	33.74474049	-117.9686809	Orange County
193546	Fee-for-Service	1306311576	1306311576	1	4	EMERGENCY PHYSICIANS ASSOCIA	6/29/2023	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	TES SAN JOSE PC	9400 NO NAME UNO	None	GILROY	CA	95020	3528	43	06085	37.03498475	-121.5729235	Santa Clara County
193595	Fee-for-Service	1073981783	1073981783	1	2	EL DORADO COUNTY COMMUNITY	1/14/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3104 PONTE MORINO DR	SUITE 100	CAMERON PARK	CA	95682	8282	09	06017	38.66304719	-120.9667044	El Dorado County
193611	Fee-for-Service	1215974654	1215974654	1	1	EFFENDI, ALI R MD	5/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130612	01	General Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
193654	Fee-for-Service	1497118921	1497118921	1	1	ESHEL, NEIR MD	1/15/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	151211	36	Psychiatry	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
193655	Fee-for-Service	1821431784	1821431784	1	1	ETEMADI, JINOUS MD	11/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141126	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
193725	Fee-for-Service	1265471676	1265471676	1	1	EDMOND-DAVIS, VICTORIA MD	6/17/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	191673	30	Radiology	0	In state provider	None	301 W. HUNTINGTON DR.	SUITE 617	ARCADIA	CA	91007	1519	19	06037	34.13481053	-118.0425638	Los Angeles County
193733	Fee-for-Service	1588901532	1588901532	1	55	EXER MEDICAL CORPORATION	2/6/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	28900 S WESTERN AVE	None	RANCHO PALOS VERD	CA	90275	0805	19	06037	33.75668351	-118.3103535	Los Angeles County
193810	Fee-for-Service	1699758599	1699758599	1	1	EHTESHAMI, SHAHRAM MD	9/30/1992	174400000X	NA	Other	026	PHYSICIANS	46324	14	Neurological Surgery	0	In state provider	None	2020 TRUXTON WAY	None	BAKERSFIELD	CA	93301	5013	15	06029	35.37345149	-119.0254185	Kern County
193835	Fee-for-Service	1306311576	1306311576	1	4	EMERGENCY PHYSICIANS ASSOCIA	6/29/2023	207P00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	TES SAN JOSE PC	9400 NO NAME UNO	None	GILROY	CA	95020	3528	43	06085	37.03498475	-121.5729235	Santa Clara County
193871	Fee-for-Service	1578732541	1578732541	1	1	EGUCHI, AYA MD	8/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105789	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
193882	Fee-for-Service	1073981783	1073981783	1	2	EL DORADO COUNTY COMMUNITY	1/14/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3104 PONTE MORINO DR	SUITE 100	CAMERON PARK	CA	95682	8282	09	06017	38.66304719	-120.9667044	El Dorado County
193926	Fee-for-Service	1205930930	1205930930	1	1	EVERGREEN PHARMACEUTICAL OF	12/13/2005	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	OF CALIFORNIA, INC	3630 BUSINESS DR	STE D	SACRAMENTO	CA	95820	2179	34	06067	38.541852	-121.419702	Sacramento County
193969	Fee-for-Service	1568656791	1568656791	1	1	EASTSIDE FAMILY MEDICAL ASSO	9/9/2020	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	OCIATES	321 S MEDNIK AVE	None	LOS ANGELES	CA	90022	1839	19	06037	34.03278551	-118.162624	Los Angeles County
193973	Fee-for-Service	1912164872	1912164872	1	1	EMER, JASON J MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123791	07	Dermatology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
194009	Fee-for-Service	1588901532	1588901532	1	37	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	11600 VENICE BLVD	None	LOS ANGELES	CA	90066	4014	19	06037	34.00891257	-118.423964	Los Angeles County
194027	Fee-for-Service	1588901532	1588901532	1	55	EXER MEDICAL CORPORATION	2/6/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	28900 S WESTERN AVE	None	RANCHO PALOS VERD	CA	90275	0805	19	06037	33.75668351	-118.3103535	Los Angeles County
194066	Fee-for-Service	1891101762	1891101762	1	1	ESCOBAR, CINDY C LMFT	1/9/2020	1041C0700X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2141	19	06037	33.90413858	-118.1346616	Los Angeles County
194071	Fee-for-Service	1699063941	1699063941	1	1	ERDISSIAN, MOHAMMADOMID MD	11/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	116803	83	Rheumatology	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
194089	Fee-for-Service	1407930480	1407930480	1	1	EKELUND, CAROL A MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	58474	40	Pediatrics	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
194114	Fee-for-Service	1467670265	1467670265	1	1	EVANS, ROBERT F LMFT	3/21/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	970 CAMERADO DRIVE	SUITE #200	CAMERON PARK	CA	95682	7769	09	06017	38.68796248	-120.9882223	El Dorado County
194158	Fee-for-Service	1225241219	1225241219	1	1	EILEEN M LINDER OPTOMETRIST	11/16/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INC	4051 LONE TREE WAY	SUITE E	ANTIOCH	CA	94531	6204	07	06013	37.97536168	-121.8003374	Contra Costa County
194216	Fee-for-Service	1164889036	1164889036	1	1	ENTABI MD INC	2/12/2016	193400000X	NA	Other	026	PHYSICIANS	124555	02	General Surgery	0	In state provider	None	1070 N CHERRY STREET	None	TULARE	CA	93274	2251	54	06107	36.22361913	-119.3373351	Tulare County
194267	Fee-for-Service	1023551264	1023551264	1	1	EDEN CARE CENTER INC	10/13/2016	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4943 SLAUSON AVE	None	MAYWOOD	CA	90270	3020	19	06037	33.98616183	-118.1749602	Los Angeles County
194295	Fee-for-Service	1588901532	1588901532	1	37	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11600 VENICE BLVD	None	LOS ANGELES	CA	90066	4014	19	06037	34.00891257	-118.423964	Los Angeles County
194308	Fee-for-Service	1588901532	1588901532	1	55	EXER MEDICAL CORPORATION	2/6/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	28900 S WESTERN AVE	None	RANCHO PALOS VERD	CA	90275	0805	19	06037	33.75668351	-118.3103535	Los Angeles County
194338	Fee-for-Service	1649682030	1649682030	1	1	EVANGELHO, RACHAEL	2/9/2015	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4859 AVENIDA DE LOS ARBO	None	SANTA CLARA	CA	95054	1424	43	06085	37.403995	-121.9593666	Santa Clara County
194360	Fee-for-Service	1699063941	1699063941	1	1	ERDISSIAN, MOHAMMADOMID MD	11/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	116803	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
194374	Fee-for-Service	1942528674	1942528674	1	1	ENRIQUEZ-CONTRERAS, ALMA L	4/30/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYD	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
194480	Fee-for-Service	1588901532	1588901532	1	18	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	4730 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6902	19	06037	33.98008975	-118.4384514	Los Angeles County
194584	Fee-for-Service	1588901532	1588901532	1	37	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	11600 VENICE BLVD	None	LOS ANGELES	CA	90066	4014	19	06037	34.00891257	-118.423964	Los Angeles County
194602	Fee-for-Service	1588901532	1588901532	1	55	EXER MEDICAL CORPORATION	2/6/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	28900 S WESTERN AVE	None	RANCHO PALOS VERD	CA	90275	0805	19	06037	33.75668351	-118.3103535	Los Angeles County
194624	Fee-for-Service	1649682030	1649682030	1	1	EVANGELHO, RACHAEL	2/9/2015	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4859 AVENIDA DE LOS ARBO	None	SANTA CLARA	CA	95054	1424	43	06085	37.403995	-121.9593666	Santa Clara County
194655	Fee-for-Service	1154683787	1154683787	1	1	EINSTEIN, ERIC R MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134524	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
194768	Fee-for-Service	1588901532	1588901532	1	18	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	4730 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6902	19	06037	33.98008975	-118.4384514	Los Angeles County
194816	Fee-for-Service	1346267093	1346267093	1	2	ELDIKA, SAMER S MD	12/15/2017	207R00000X	NA	Other	026	PHYSICIANS	150038	10	Gastroenterology (M.D. only)	0	In state provider	None	8860 CENTER DR	STE 330	LA MESA	CA	91942	7001	37	06073	32.78189749	-117.0075062	San Diego County
194820	Fee-for-Service	1740476829	1740476829	1	1	ESPINOSA, DAVID P OD INC	2/1/1990	193400000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	828 N IMPERIAL AVE	None	EL CENTRO	CA	92243	1916	13	06025	32.799681	-115.570058	Imperial County
194871	Fee-for-Service	1588901532	1588901532	1	37	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	11600 VENICE BLVD	None	LOS ANGELES	CA	90066	4014	19	06037	34.00891257	-118.423964	Los Angeles County
194889	Fee-for-Service	1376524645	1376524645	1	1	ENGELHARDT, JOHN T PSYD	1/9/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
194897	Fee-for-Service	1851479935	1851479935	1	1	EDWARDS, DYKE F MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	61416	01	General Practice	0	In state provider	None	1999 MOWRY AVE	None	FREMONT	CA	94538	1738	01	06001	37.55783419	-121.9808484	Alameda County
195097	Fee-for-Service	1396977914	1396977914	1	1	ERDOGAN, PARASTOO LMFT	6/25/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4199 CAMPUS DRIVE	STE 550	IRVINE	CA	92612	4694	30	06059	33.650775	-117.838296	Orange County
195104	Fee-for-Service	1346267093	1346267093	1	2	ELDIKA, SAMER S MD	12/15/2017	207R00000X	NA	Other	026	PHYSICIANS	150038	41	Internal Medicine	0	In state provider	None	8860 CENTER DR	STE 330	LA MESA	CA	91942	7001	37	06073	32.78189749	-117.0075062	San Diego County
195118	Fee-for-Service	1750670188	1750670188	1	1	EVANS, APRIL R MD	7/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138110	41	Internal Medicine	0	In state provider	None	1 HOAG DRIVE	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
195138	Fee-for-Service	1891793741	1891793741	1	1	ERNY, RAYMOND E MD	4/30/1990	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	52583	41	Internal Medicine	0	In state provider	None	104 LYNCH CREEK WAY	STE 12	PETALUMA	CA	94954	2387	49	06097	38.25218808	-122.6339241	Sonoma County
195160	Fee-for-Service	1588901532	1588901532	1	37	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	11600 VENICE BLVD	None	LOS ANGELES	CA	90066	4014	19	06037	34.00891257	-118.423964	Los Angeles County
195191	Fee-for-Service	1407267750	1407267750	1	1	EFTEKHARY, NIMA MD	2/22/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	162731	None	None	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
195216	Fee-for-Service	1972582062	1972582062	1	1	EVA WOJCIK, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2160 S 1ST AVE	None	MAYWOOD	IL	60153	3328	00	None	41.86025379	-87.83381752	Cook County
195270	Fee-for-Service	1184168775	1184168775	1	1	EPISCOPAL COMMUNITY SERVICES	2/22/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	Y CENTER	4443 30TH ST	None	SAN DIEGO	CA	92116	4288	37	06073	32.75815316	-117.130152	San Diego County
195302	Fee-for-Service	1407816911	1407816911	1	1	EZEANI, IFEOMA L OD	3/21/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	20763 AVALON BLVD	None	CARSON	CA	90746	3313	19	06037	33.84189058	-118.2628488	Los Angeles County
195350	Fee-for-Service	1053022277	1053022277	1	1	EXCEL PATHOLOGY	2/23/2023	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
195351	Fee-for-Service	1861983470	1861983470	1	1	EAST VALLEY COMMUNITY HEALTH	9/4/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	17800 RENAULT ST	None	LA PUENTE	CA	91744	5333	19	06037	34.01402677	-117.913238	Los Angeles County
195427	Fee-for-Service	1891793741	1891793741	1	1	ERNY, RAYMOND E MD	4/30/1990	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	52583	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	104 LYNCH CREEK WAY	STE 12	PETALUMA	CA	94954	2387	49	06097	38.25218808	-122.6339241	Sonoma County
195493	Fee-for-Service	1407332992	1407332992	1	1	ESCHAGARY, MONICA R AUD	10/11/2018	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2100 W 3RD ST	STE 100	LOS ANGELES	CA	90057	1971	19	06037	34.06308947	-118.2733326	Los Angeles County
195523	Fee-for-Service	1568171452	1568171452	1	1	EMERGENCY PHYSICIANS URGENT	5/22/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	24799 ALICIA PKWY	None	LAGUNA HILLS	CA	92653	4618	30	06059	33.60163541	-117.6914361	Orange County
195586	Fee-for-Service	1225082209	1225082209	1	1	EASTERN IDAHO HEALTH	4/20/2017	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SERVICES INC	3100 CHANNING WAY	None	IDAHO FALLS	ID	83404	7533	00	None	43.470198	-111.9901955	Bonneville County
195638	Fee-for-Service	1053022277	1053022277	1	1	EXCEL PATHOLOGY	2/23/2023	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
195640	Fee-for-Service	1861983470	1861983470	1	1	EAST VALLEY COMMUNITY HEALTH	9/4/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	17800 RENAULT ST	None	LA PUENTE	CA	91744	5333	19	06037	34.01402677	-117.913238	Los Angeles County
195786	Fee-for-Service	1467715516	1467715516	1	1	EMPIRE HOTEL ALCOHOLIC	11/16/2016	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION CENTER	1237 CALIFORNIA STREET	None	REDDING	CA	96001	0618	45	06089	40.58685254	-122.3932979	Shasta County
195843	Fee-for-Service	1003305236	1003305236	1	1	EAST BAY HAND MEDICAL CENTER	12/4/2018	174400000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	, INC	13690 E 14TH ST STE 200	None	SAN LEANDRO	CA	94578	2584	01	06001	37.71615361	-122.1438999	Alameda County
195876	Fee-for-Service	1225082209	1225082209	1	1	EASTERN IDAHO HEALTH	4/20/2017	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SERVICES INC	3100 CHANNING WAY	None	IDAHO FALLS	ID	83404	7533	00	None	43.470198	-111.9901955	Bonneville County
195989	Fee-for-Service	1215950829	1215950829	1	1	EL-KHOURY, GEORGE F MD	8/29/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	40394	05	Anesthesiology	0	In state provider	None	2650 ELM AVE	STE 218	LONG BEACH	CA	90806	1653	19	06037	33.805521	-118.1882945	Los Angeles County
196006	Fee-for-Service	1770570442	1770570442	1	1	EMENIKE, EMMANUEL O MD	7/28/2021	207R00000X	NA	Other	026	PHYSICIANS	92212	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	0001	39	06077	37.97026329	-121.2890849	San Joaquin County
196052	Fee-for-Service	1316041718	1316041718	1	1	ETEMADIAN, ALI M DO	7/26/1993	207R00000X	NA	Other	026	PHYSICIANS	6377	30	Radiology	0	In state provider	A PROFESSIONAL MED CORP	5343 RIVERSIDE DR	None	CHINO	CA	91710	4252	36	06071	34.01906153	-117.687852	San Bernardino County
196122	Fee-for-Service	1730361163	1730361163	1	1	EXPERIENCED VASCULAR IMAGING	10/22/2012	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	23135 MARKET ST	None	NEWHALL	CA	91321	3611	19	06037	34.37234037	-118.5336878	Los Angeles County
196123	Fee-for-Service	1003305236	1003305236	1	1	EAST BAY HAND MEDICAL CENTER	12/4/2018	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	, INC	13690 E 14TH ST STE 200	None	SAN LEANDRO	CA	94578	2584	01	06001	37.71615361	-122.1438999	Alameda County
196210	Fee-for-Service	1336405539	1336405539	1	1	ESKANDER, MICHAEL A A MD	1/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128540	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
196231	Fee-for-Service	1689076937	1689076937	1	1	EAKER, JULIE A PA-C	6/27/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	51928	-	NOT APPLICABLE	0	In state provider	None	9024 SNIKTAW LN	None	FORT JONES	CA	96032	9408	47	06093	41.59983924	-122.9748122	Siskiyou County
196325	Fee-for-Service	1124498357	1124498357	1	1	ENDOSCOPY CENTER OF INLAND E	7/8/2019	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	MPIRE LLC	40404 CALIFORNIA OAKS RD	STE A	MURRIETA	CA	92562	5786	33	06065	33.57857707	-117.1998797	Riverside County
196341	Fee-for-Service	1316041718	1316041718	1	1	ETEMADIAN, ALI M DO	7/26/1993	207R00000X	NA	Other	026	PHYSICIANS	6377	32	Radiation Therapy (D.O. only)	0	In state provider	A PROFESSIONAL MED CORP	5343 RIVERSIDE DR	None	CHINO	CA	91710	4252	36	06071	34.01906153	-117.687852	San Bernardino County
196440	Fee-for-Service	1760900617	1760900617	1	1	ELLER, NAN S	5/18/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	202 FASHION LN	STE 101	TUSTIN	CA	92780	3319	30	06059	33.7470725	-117.8179335	Orange County
196537	Fee-for-Service	1043248727	1043248727	1	1	EHRESMANN, GLENN R MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	27348	83	Rheumatology	0	In state provider	None	100 CONGRESS ST	None	PASADENA	CA	91105	0000	19	06037	34.13395172	-118.1534955	Los Angeles County
196559	Fee-for-Service	1588161137	1588161137	1	1	EINSTEIN, EVAN H MD	5/31/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	183739	None	None	0	In state provider	None	300 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
196569	Fee-for-Service	1386478238	1386478238	1	1	EMT HEALTH VOYAGE MEDICAL TR	8/31/2024	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ANSPORTATION LLC	394 RICHMOND DR	APT 6	MILLBRAE	CA	94030	1749	41	06081	37.60172415	-122.4005009	San Mateo County
196600	Fee-for-Service	1114161445	1114161445	1	2	EXCELLENCE HOME HEALTH	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PROVIDER INC	4050 KATELLA AVENUE	SUITE 204	LOS ALAMITOS	CA	90720	3477	30	06059	33.80296949	-118.061964	Orange County
196789	Fee-for-Service	1013626274	1013626274	1	1	EVERGREEN ADULT HOME CARE	9/21/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	362 N SWIDLER ST	None	ORANGE	CA	92869	2827	30	06059	33.792597	-117.815007	Orange County
196826	Fee-for-Service	1043248727	1043248727	1	1	EHRESMANN, GLENN R MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	27348	25	Physical Medicine and Rehabilitation	0	In state provider	None	100 CONGRESS ST	None	PASADENA	CA	91105	0000	19	06037	34.13395172	-118.1534955	Los Angeles County
196881	Fee-for-Service	1568436798	1568436798	2	1	ENCOMPASS HEALTH REHAB	1/1/2012	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL OF BAKERSFIELD	5001 COMMERCE DRIVE	None	BAKERSFIELD	CA	93309	0648	15	06029	35.36784468	-119.0578744	Kern County
197169	Fee-for-Service	1568436798	1568436798	2	1	ENCOMPASS HEALTH REHAB	1/1/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL OF BAKERSFIELD	5001 COMMERCE DRIVE	None	BAKERSFIELD	CA	93309	0648	15	06029	35.36784468	-119.0578744	Kern County
197176	Fee-for-Service	1295312197	1295312197	1	1	EAVERS DIALYSIS LLC	2/28/2022	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4679 W SPRUCE AVE	STE 101	FRESNO	CA	93722	8425	10	06019	36.8387854	-119.8761176	Fresno County
197243	Fee-for-Service	1154766475	1154766475	1	1	ESTES, ADRIENNE DPM	10/4/2017	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	795 E SECOND ST	SUITE 5	POMONA	CA	91766	2007	19	06037	34.05845654	-117.7423951	Los Angeles County
197309	Fee-for-Service	1316147382	1316147382	1	1	EVERETT, CHARLES K MD	7/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98566	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
197357	Fee-for-Service	1841047289	1841047289	1	1	EASTLAKE TRANSPORT LLC	5/4/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	12711 SNAKE RIVER DR	None	VICTORVILLE	CA	92392	6196	36	06071	34.48160471	-117.3401829	San Bernardino County
197394	Fee-for-Service	1518917913	1518917913	1	1	EMERGENCY SPECIALIST	6/30/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	PHYS MED ASSOCIATES, INC	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
197407	Fee-for-Service	1346799251	1346799251	1	1	ERICA L DICKSON DO INC	11/9/2016	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	14162	None	None	0	In state provider	None	11160 WARNER AVE	301	FOUNTAIN VALLEY	CA	92708	4008	30	06059	33.71630854	-117.934317	Orange County
197514	Fee-for-Service	1255698155	1255698155	1	1	ESTRADA, JOHANNA A MD	1/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127188	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
197547	Fee-for-Service	1225674294	1225674294	1	1	EDBER, ABIGAIL LMFT	2/14/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
197669	Fee-for-Service	1215437249	1215437249	2	1	EVOLVE RESTORATIVE CENTER	6/4/2021	208VP0014X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	220 CONCOURSE BLVD	None	SANTA ROSA	CA	95403	8210	49	06097	38.51395202	-122.7888221	Sonoma County
197671	Fee-for-Service	1376621086	1376621086	1	1	EVANS, DAVID L MD	1/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	59837	20	Orthopedic Surgery	0	In state provider	None	780 E GILBERT ST	None	SN BERNRDNO	CA	92415	1003	36	06071	34.1268333	-117.2705634	San Bernardino County
197771	Fee-for-Service	1952371460	1952371460	1	1	EGAN, CHARLES L DO	7/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16281	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
197958	Fee-for-Service	1215437249	1215437249	2	1	EVOLVE RESTORATIVE CENTER	8/3/2023	208VP0014X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	220 CONCOURSE BLVD	None	SANTA ROSA	CA	95403	8210	49	06097	38.51395202	-122.7888221	Sonoma County
198110	Fee-for-Service	1750665915	1750665915	1	1	ELPIDAMA, MARISSA G PSYD	9/19/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	DBA PSYCHTX	1720 E LOS ANGELES AVE	SUITE 221	SIMI VALLEY	CA	93065	5854	56	06111	34.2716455	-118.7653635	Ventura County
198187	Fee-for-Service	1780915678	1780915678	1	1	ELMESEWDY, DINAH NP	12/6/2012	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
198199	Fee-for-Service	1356952576	1356952576	1	1	ELLIS, TAYLOR PT	1/18/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	92 ARGONAUT	SUITE 170	ALISO VIEJO	CA	92656	0000	30	06059	33.59217762	-117.7242901	Orange County
198215	Fee-for-Service	1366995144	1366995144	1	1	ESSENTIAL MEDICAL SUPPLIES	10/30/2017	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2831 CAMINO DEL RIO S	STE 110	SAN DIEGO	CA	92102	3827	37	06073	32.77018113	-117.1334016	San Diego County
198243	Fee-for-Service	1215437249	1215437249	2	1	EVOLVE RESTORATIVE CENTER	10/5/2023	208VP0014X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	220 CONCOURSE BLVD	None	SANTA ROSA	CA	95403	8210	49	06097	38.51395202	-122.7888221	Sonoma County
198282	Fee-for-Service	1942343504	1942343504	1	1	ESQUIVEL, CARLOS O MD	2/8/1991	208600000X	NA	General Surgery	026	PHYSICIANS	32640	02	General Surgery	0	In state provider	None	2340 CLAY ST	# 604	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
198292	Fee-for-Service	1154683407	1154683407	2	1	ESPINO, CLAUDIA MD FACOG	12/11/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	155907	None	None	0	In state provider	None	2720 S BRISTOL ST	None	SANTA ANA	CA	92704	6207	30	06059	33.710463	-117.8854565	Orange County
198303	Fee-for-Service	1407377203	1407377203	1	1	ELKINANY, SHERIF M MD	5/26/2022	207R00000X	NA	Other	026	PHYSICIANS	169914	None	None	0	In state provider	None	400 PEPPER	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
198385	Fee-for-Service	1518282151	1518282151	1	1	ESCAMILLA, SEAN J	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
198522	Fee-for-Service	1487335709	1487335709	1	1	EVERGREEN LIFE CRE HMES, INC	10/24/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5633 N MAROA AVE	None	FRESNO	CA	93704	2007	10	06019	36.81982498	-119.7994116	Fresno County
198567	Fee-for-Service	1316412588	1316412588	1	1	EMERGENCY PHYSICIANS ASSOCIA	5/30/2019	207P00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	TES GILROY PC	9400 N NAME UNO	None	GILROY	CA	95020	3528	43	06085	37.03498475	-121.5729235	Santa Clara County
198597	Fee-for-Service	1174671069	1174671069	1	1	EHLERS, DONNA L MD	4/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	41692	36	Psychiatry	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
198729	Fee-for-Service	1972535581	1972535581	1	1	ETEDALI, ELAHEH DO	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	6701	08	Family Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
198841	Fee-for-Service	1306853452	1306853452	1	1	EYE MED CLIN OF FRESNO I	5/15/2019	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 E HERNDON AVE	STE 301	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
198855	Fee-for-Service	1316412588	1316412588	1	1	EMERGENCY PHYSICIANS ASSOCIA	11/28/2018	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	TES GILROY PC	9400 N NAME UNO	None	GILROY	CA	95020	3528	43	06085	37.03498475	-121.5729235	Santa Clara County
198906	Fee-for-Service	1467195073	1467195073	1	3	EMANATE HEALTH MEDICAL CARE	2/12/2024	261QH0100X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	203 W BADILLO ST	None	COVINA	CA	91723	1907	19	06037	34.0863243	-117.8924805	Los Angeles County
198926	Fee-for-Service	1174865455	1174865455	1	1	ELLEDGE, BRIAN E	4/20/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	14904	36	Psychiatry	0	In state provider	None	461 TENNESSEE ST	SUITE C	REDLANDS	CA	92373	8161	36	06071	34.058745	-117.2000975	San Bernardino County
198967	Fee-for-Service	1417343377	1417343377	1	1	ERIN AVONDET	1/17/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3741 W 12600 S	None	RIVERTON	UT	84065	7215	00	None	40.520232	-111.980151	Salt Lake County
198972	Fee-for-Service	1366759292	1366759292	1	2	EVERLOVING HOME HEALTH INC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6930 OWENSMOUTH AVE	SUITE 300	CANOGA PARK	CA	91303	2098	19	06037	34.19656125	-118.6015075	Los Angeles County
199000	Fee-for-Service	1760574164	1760574164	1	1	ELMZADEH, MAHSHID MD	9/6/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	73928	08	Family Practice	0	In state provider	None	15785 LAGUNA CANYON RD	STE 310	IRVINE	CA	92618	3178	30	06059	33.66542536	-117.7615537	Orange County
199085	Fee-for-Service	1215437249	1215437249	2	2	EVOLVE RESTORATIVE CENTER	7/11/2024	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	181 ANDRIEUX ST	STE 107	SONOMA	CA	95476	6932	49	06097	38.28809911	-122.4613026	Sonoma County
199126	Fee-for-Service	1306853452	1306853452	1	1	EYE MED CLIN OF FRESNO I	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1360 E HERNDON AVE	STE 301	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
199195	Fee-for-Service	1467195073	1467195073	1	3	EMANATE HEALTH MEDICAL CARE	2/12/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	203 W BADILLO ST	None	COVINA	CA	91723	1907	19	06037	34.0863243	-117.8924805	Los Angeles County
199216	Fee-for-Service	1295368322	1295368322	1	2	EAST BAY MEDICAL PROFESSIONA	9/29/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	None	67	Endocrinology	0	In state provider	SPREET KAUR MD	652 11TH	129	TRACY	CA	95376	3869	39	06077	37.73965047	-121.435452	San Joaquin County
199249	Fee-for-Service	1598395675	1598395675	1	1	EMERGENCY SERVICES MEDICAL C	6/2/2020	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	ORPORATION CORONADO	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
199262	Fee-for-Service	1740354422	1740354422	1	1	ELK GROVE COMM SRVC DSTR	4/15/1993	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ELK GROVE FIRE DEPT	8820 ELK GROVE BLVD	None	ELK GROVE	CA	95624	1876	34	06067	38.408733	-121.3747335	Sacramento County
199266	Fee-for-Service	1437195674	1437195674	1	1	ERICKSON, LARRY L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34164	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
199325	Fee-for-Service	1295838324	1295838324	1	1	ERKAN, ELIF	9/11/2021	2080P0210X	NA	Nephrology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	3333 BURNET AVENUE	None	CINCINNATI	OH	45229	3039	00	None	39.14105892	-84.50040782	Hamilton County
199369	Fee-for-Service	1932359494	1932359494	1	1	ELATRE, WAFFA A MD	12/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	92706	22	Pathology (M.D. only)	0	In state provider	None	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
199372	Fee-for-Service	1215437249	1215437249	2	2	EVOLVE RESTORATIVE CENTER	7/11/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	181 ANDRIEUX ST	STE 107	SONOMA	CA	95476	6932	49	06097	38.28809911	-122.4613026	Sonoma County
199392	Fee-for-Service	1790755700	1790755700	2	1	ELTERMAN, JOEL B MD	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	97542	02	General Surgery	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
199460	Fee-for-Service	1639580962	1639580962	1	1	EMMA RODRIGUEZ MD	5/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4493	00	None	29.508012	-98.578683	Bexar County
199481	Fee-for-Service	1467195073	1467195073	1	3	EMANATE HEALTH MEDICAL CARE	2/12/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	203 W BADILLO ST	None	COVINA	CA	91723	1907	19	06037	34.0863243	-117.8924805	Los Angeles County
199598	Fee-for-Service	1992708002	1992708002	1	1	ENYENIHI, HENRY N MD	9/14/2022	207R00000X	NA	Other	026	PHYSICIANS	50281	None	None	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
199618	Fee-for-Service	1841256963	1841256963	1	1	ENTWISLE, CHRISTOPHER R MD	8/20/2009	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	95043	41	Internal Medicine	0	In state provider	None	1133 E STANLEY BLVD	STE 207	LIVERMORE	CA	94550	4246	01	06001	37.67914693	-121.7810206	Alameda County
199623	Fee-for-Service	1033112313	1033112313	1	1	ESLAMI, BAHRAM MD	10/31/1987	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	42075	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
199634	Fee-for-Service	1588901532	1588901532	1	48	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2300 WILSHIRE BLVD	104	SANTA MONICA	CA	90403	5858	19	06037	34.0335691	-118.480443	Los Angeles County
199658	Fee-for-Service	1215437249	1215437249	2	2	EVOLVE RESTORATIVE CENTER	7/11/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	181 ANDRIEUX ST	STE 107	SONOMA	CA	95476	6932	49	06097	38.28809911	-122.4613026	Sonoma County
199743	Fee-for-Service	1598741191	1598741191	1	1	ELOUARDIGHI, BRAHIM MD	4/30/2024	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
199769	Fee-for-Service	1467195073	1467195073	1	3	EMANATE HEALTH MEDICAL CARE	2/12/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	203 W BADILLO ST	None	COVINA	CA	91723	1907	19	06037	34.0863243	-117.8924805	Los Angeles County
199884	Fee-for-Service	1740311513	1740311513	1	1	ELLIS, EUGENE CRNA	4/23/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
199906	Fee-for-Service	1497015085	1497015085	1	1	ESHAGHIAN, DANIEL MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131880	01	General Practice	0	In state provider	None	4312 WOODMAN AVE	SUITE 102	SHERMAN OAKS	CA	91423	5546	19	06037	34.148637	-118.4312035	Los Angeles County
199908	Fee-for-Service	1841256963	1841256963	1	1	ENTWISLE, CHRISTOPHER R MD	8/20/2009	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	95043	10	Gastroenterology (M.D. only)	0	In state provider	None	1133 E STANLEY BLVD	STE 207	LIVERMORE	CA	94550	4246	01	06001	37.67914693	-121.7810206	Alameda County
199923	Fee-for-Service	1588901532	1588901532	1	48	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2300 WILSHIRE BLVD	104	SANTA MONICA	CA	90403	5858	19	06037	34.0335691	-118.480443	Los Angeles County
199948	Fee-for-Service	1215437249	1215437249	2	2	EVOLVE RESTORATIVE CENTER	7/11/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	None	181 ANDRIEUX ST	STE 107	SONOMA	CA	95476	6932	49	06097	38.28809911	-122.4613026	Sonoma County
200119	Fee-for-Service	1336235365	1336235365	1	1	ESPIRITU, ROGER F MD	4/1/1999	207K00000X	NA	Other	026	PHYSICIANS	34956	01	General Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
200132	Fee-for-Service	1821564501	1821564501	1	1	ELEVATION PROSTHETICS AND OR	3/17/2020	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	THOTICS, INC.	106 N SUNRISE AVE	STE C8	ROSEVILLE	CA	95661	2914	31	06061	38.74517376	-121.2663355	Placer County
200147	Fee-for-Service	1922167519	1922167519	1	1	ESAGOFF, ABBEY F MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	58476	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
200151	Fee-for-Service	1104942127	1104942127	1	1	ENG, JOHN F OD	2/8/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	473 GRAND AVE	None	S SAN FRANCISCO	CA	94080	3635	41	06081	37.65632755	-122.4154845	San Mateo County
200211	Fee-for-Service	1588901532	1588901532	1	48	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2300 WILSHIRE BLVD	104	SANTA MONICA	CA	90403	5858	19	06037	34.0335691	-118.480443	Los Angeles County
200326	Fee-for-Service	1760786495	1760786495	1	1	ELMASRY, MARY L MD	1/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111175	78	Neoplastic Diseases/Oncology	0	In state provider	None	9090 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	1850	19	06037	34.06702873	-118.3894057	Los Angeles County
200327	Fee-for-Service	1265995260	1265995260	1	1	EZENWA, WINIFRED C NP	8/22/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	405 W MANCHESTER BLVD	SUITE A	INGLEWOOD	CA	90301	1196	19	06037	33.96175122	-118.3621356	Los Angeles County
200355	Fee-for-Service	1487335709	1487335709	1	3	EVERGREEN LIFE CRE HMES, INC	2/13/2025	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1415 W SCOTT AVE	None	FRESNO	CA	93711	3006	10	06019	36.81104066	-119.8178126	Fresno County
200374	Fee-for-Service	1508457177	1508457177	1	1	ELEVATE FAMILY COUNSELING CE	1/14/2022	261QM0801X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1588 HOMESTEAD RD.	SUITE A, M/B 5	SANTA CLARA	CA	95050	4783	43	06085	37.34637328	-121.9509049	Santa Clara County
200423	Fee-for-Service	1649617333	1649617333	1	1	EZZATI, ALI MD	5/31/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	174796	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
200433	Fee-for-Service	1922167519	1922167519	1	1	ESAGOFF, ABBEY F MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	58476	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
200498	Fee-for-Service	1588901532	1588901532	1	48	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2300 WILSHIRE BLVD	104	SANTA MONICA	CA	90403	5858	19	06037	34.0335691	-118.480443	Los Angeles County
200515	Fee-for-Service	1588901532	1588901532	1	59	EXER MEDICAL CORPORATION	2/24/2025	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7000 BOULDER AVE	103	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
200517	Fee-for-Service	1437931367	1437931367	1	1	ELIZABETH MCDADE	3/11/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CHOLOGIST, INC	2121 41ST AVE	SUITE 202	CAPITOLA	CA	95010	2058	44	06087	36.97929	-121.965096	Santa Cruz County
200613	Fee-for-Service	1760786495	1760786495	1	1	ELMASRY, MARY L MD	1/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111175	41	Internal Medicine	0	In state provider	None	9090 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	1850	19	06037	34.06702873	-118.3894057	Los Angeles County
200697	Fee-for-Service	1871525477	1871525477	1	1	EDDLEMON, EUGENE D MD	2/21/2020	2086S0129X	NA	General Surgery	026	PHYSICIANS	68376	89	Surgery-Traumatic	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
200786	Fee-for-Service	1588901532	1588901532	1	48	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2300 WILSHIRE BLVD	104	SANTA MONICA	CA	90403	5858	19	06037	34.0335691	-118.480443	Los Angeles County
200803	Fee-for-Service	1588901532	1588901532	1	59	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	7000 BOULDER AVE	103	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
200809	Fee-for-Service	1619926755	1619926755	1	1	EYE SURGERY CENTER OF	9/20/1999	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SOUTHERN CALIFORNIA	2023 W VISTA WAY	STE E	VISTA	CA	92083	6030	37	06073	33.18569169	-117.2846332	San Diego County
200822	Fee-for-Service	1164497954	1164497954	1	1	EDWARDS, PHYLLIS A MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	62111	33	Thoracic Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
200891	Fee-for-Service	1306890595	1306890595	1	1	ESTIOKO, NOEL MD	3/14/2024	207R00000X	NA	Other	026	PHYSICIANS	149325	None	None	0	In state provider	None	9041 MAGNOLIA AVE	301	RIVERSIDE	CA	92503	3957	33	06065	33.92541585	-117.4378266	Riverside County
200902	Fee-for-Service	1760786495	1760786495	1	1	ELMASRY, MARY L MD	1/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111175	68	Hematology	0	In state provider	None	9090 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	1850	19	06037	34.06702873	-118.3894057	Los Angeles County
200931	Fee-for-Service	1548256217	1548256217	1	1	ESPINOZA, ROLANDO C PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	INC	271 E WORKMAN ST	STE 206	COVINA	CA	91723	3549	19	06037	34.07534765	-117.8862217	Los Angeles County
200942	Fee-for-Service	1063765907	1063765907	1	1	ER PHYSICIANS MEDICAL GROUP	11/26/2012	193400000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	INC	4081 E OLYMPIC BLVD	EMERGENCY DEPARTMENT	LOS ANGELES	CA	90023	3330	19	06037	34.01891346	-118.186614	Los Angeles County
201074	Fee-for-Service	1992819528	1992819528	1	1	ENCARNACION, SOFIA M MD	5/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82472	36	Psychiatry	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
201079	Fee-for-Service	1518585280	1518585280	1	1	EDGSON, LUKE MD	7/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178994	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
201092	Fee-for-Service	1588901532	1588901532	1	59	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	7000 BOULDER AVE	103	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
201094	Fee-for-Service	1578027520	1578027520	1	2	EAGLE MEDICAL TRANSPORTATION	5/4/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	INC	6148 W PAUL AVE	None	FRESNO	CA	93722	3576	10	06019	36.83109998	-119.9028536	Fresno County
201111	Fee-for-Service	1164497954	1164497954	1	1	EDWARDS, PHYLLIS A MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	62111	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
201114	Fee-for-Service	1588702435	1588702435	1	1	ESCALON UNIFIED SD	3/12/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	1520 YOSEMITE AVE	None	ESCALON	CA	95320	1753	39	06077	37.79864982	-120.9946942	San Joaquin County
201151	Fee-for-Service	1942532619	1942532619	1	1	ELLISON, SHERRY PHD	12/7/2011	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	41750 RANCHO LAS PALMAS	L-4	RANCHO MIRAGE	CA	92270	3800	33	06065	33.74239866	-116.4106945	Riverside County
201162	Fee-for-Service	1588901532	1588901532	1	23	EXER MEDICAL CORPORATION	10/20/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	19	06037	34.13998921	-118.7070142	Los Angeles County
201229	Fee-for-Service	1851672703	1851672703	1	1	ETO, JENNIE OT	9/8/2023	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3413 W PACIFIC AVE	100, 200	BURBANK	CA	91505	1555	19	06037	34.18839272	-118.3485967	Los Angeles County
201286	Fee-for-Service	1740496009	1740496009	1	1	EDWARDS, TODD M LMFT	9/13/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
201380	Fee-for-Service	1588901532	1588901532	1	59	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	7000 BOULDER AVE	103	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
201402	Fee-for-Service	1588702435	1588702435	1	1	ESCALON UNIFIED SD	3/28/1994	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1520 YOSEMITE AVE	None	ESCALON	CA	95320	1753	39	06077	37.79864982	-120.9946942	San Joaquin County
201407	Fee-for-Service	1093971459	1093971459	1	1	ESTRADA PAZ, OSCAR A MD	6/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	116880	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
201436	Fee-for-Service	1194788422	1194788422	1	1	ENG, JEN M MD	11/1/1996	207R00000X	NA	Other	026	PHYSICIANS	55257	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
201451	Fee-for-Service	1588901532	1588901532	1	23	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	19	06037	34.13998921	-118.7070142	Los Angeles County
201577	Fee-for-Service	1295361525	1295361525	1	1	EDNA HOME HEALTH INC	4/9/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14621 TITUS ST	STE 124	PANORAMA CITY	CA	91402	4904	19	06037	34.21972652	-118.451799	Los Angeles County
201651	Fee-for-Service	1235565524	1235565524	1	1	EVANS, CARRIE N NP	7/14/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
201656	Fee-for-Service	1144231093	1144231093	1	1	EBILANE, ANANIAS E MD	1/1/1979	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	34021	01	General Practice	0	In state provider	INC	13429 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5803	19	06037	33.91025923	-118.352777	Los Angeles County
201661	Fee-for-Service	1053391169	1053391169	1	1	ENDOSCOPY CENTER OF S BAY	1/14/2011	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	23560 MADISON ST	#109	TORRANCE	CA	90505	4709	19	06037	33.81145007	-118.3479265	Los Angeles County
201715	Fee-for-Service	1790727162	1790727162	1	1	EDALAT, KEIVAN MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67803	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1145 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3511	19	06037	33.89242734	-118.2947128	Los Angeles County
201724	Fee-for-Service	1588901532	1588901532	1	34	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2006 S LINCOLN BLVD	None	VENICE	CA	90291	3949	19	06037	33.99552056	-118.4557214	Los Angeles County
201734	Fee-for-Service	1790865830	1790865830	1	1	EDWARDS, ROBERT A MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79439	22	Pathology (M.D. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
201738	Fee-for-Service	1588901532	1588901532	1	23	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	19	06037	34.13998921	-118.7070142	Los Angeles County
201883	Fee-for-Service	1093974065	1093974065	1	1	ELICA HEALTH CENTERS	2/4/2011	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	3701 J ST	STE 201	SACRAMENTO	CA	95816	5542	34	06067	38.571237	-121.4566245	Sacramento County
201939	Fee-for-Service	1578636643	1578636643	1	1	EDWARDS, SAUNDRA J LMFT	11/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1225 W 190TH ST	310	GARDENA	CA	90248	4320	19	06037	33.85835623	-118.2987754	Los Angeles County
201972	Fee-for-Service	1811458417	1811458417	1	1	EVANS, JONATHAN A MD	6/27/2022	207R00000X	NA	Other	026	PHYSICIANS	178621	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
202013	Fee-for-Service	1588901532	1588901532	1	34	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2006 S LINCOLN BLVD	None	VENICE	CA	90291	3949	19	06037	33.99552056	-118.4557214	Los Angeles County
202023	Fee-for-Service	1588901532	1588901532	1	23	EXER MEDICAL CORPORATION	10/20/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	19	06037	34.13998921	-118.7070142	Los Angeles County
202082	Fee-for-Service	1669414207	1669414207	1	1	ENGSTROM, RAY H MD	1/31/1988	207L00000X	NA	Other	026	PHYSICIANS	58046	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	# A200	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
202092	Fee-for-Service	1316346232	1316346232	1	1	ECKSTEIN, MITCHELL LCSW	7/4/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1700 S AMPHLETT BLVD	STE 250I	SAN MATEO	CA	94402	2728	41	06081	37.55866811	-122.3017488	San Mateo County
202112	Fee-for-Service	1457892598	1457892598	1	1	EXPERT MRI, P.C.	2/4/2020	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9500 ARTESIA BLVD	None	BELLFLOWER	CA	90706	6511	19	06037	33.87471149	-118.1315655	Los Angeles County
202170	Fee-for-Service	1093974065	1093974065	1	1	ELICA HEALTH CENTERS	2/4/2011	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 J ST	STE 201	SACRAMENTO	CA	95816	5542	34	06067	38.571237	-121.4566245	Sacramento County
202299	Fee-for-Service	1588901532	1588901532	1	34	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2006 S LINCOLN BLVD	None	VENICE	CA	90291	3949	19	06037	33.99552056	-118.4557214	Los Angeles County
202316	Fee-for-Service	1588901532	1588901532	1	23	EXER MEDICAL CORPORATION	10/20/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	19	06037	34.13998921	-118.7070142	Los Angeles County
202336	Fee-for-Service	1952563678	1952563678	1	1	EDWARDS, JOHN M MD	8/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119927	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
202353	Fee-for-Service	1215229869	1215229869	1	1	ELDER, STEPHEN W DC	7/1/1980	193400000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	CHIROPRACTIC CORPORATION	2020 NILES ST	STE A	BAKERSFIELD	CA	93305	5006	15	06029	35.37689765	-118.9695472	Kern County
202395	Fee-for-Service	1942703798	1942703798	1	1	ESCOBAR, JOSE A MD	5/31/2023	207R00000X	NA	Other	026	PHYSICIANS	165021	None	None	0	In state provider	None	4201 TORRANCE BLVD	SUITE 520	TORRANCE	CA	90503	4009	19	06037	33.8375955	-118.358748	Los Angeles County
202414	Fee-for-Service	1326115197	1326115197	1	1	ENDO, NORMAN M	10/1/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4760 SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
202430	Fee-for-Service	1316684707	1316684707	1	1	ERASTUS, VERONICA N	5/26/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6387 POMEGRANATE CT	None	EASTVALE	CA	92880	7203	33	06065	33.97212	-117.560838	Riverside County
202460	Fee-for-Service	1093974065	1093974065	1	1	ELICA HEALTH CENTERS	2/4/2011	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	3701 J ST	STE 201	SACRAMENTO	CA	95816	5542	34	06067	38.571237	-121.4566245	Sacramento County
202491	Fee-for-Service	1154861979	1154861979	1	1	ELIZABETH SUPPORTIVE MEDICAL	4/23/2025	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	SPECIALISTS, A MEDICAL	27720 JEFFERSON	SUITE 200	TEMECULA	CA	92590	2610	33	06065	33.51188961	-117.1586219	Riverside County
202520	Fee-for-Service	1891814174	1891814174	1	1	ELLIS, AMY R MFT	8/24/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	40536	-	NOT APPLICABLE	0	In state provider	None	101 CIRBY HILLS DRIVE	None	ROSEVILLE	CA	95678	4360	31	06061	38.7303989	-121.2872592	Placer County
202531	Fee-for-Service	1790878585	1790878585	1	1	ESQUIVIAS, JOSE A LMFT	9/16/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
202571	Fee-for-Service	1841234903	1841234903	1	1	ELLIOTT, JOHN MD	10/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1700 E 19TH ST	None	THE DALLES	OR	97058	3317	00	None	45.58806554	-121.164498	Wasco County
202575	Fee-for-Service	1760467260	1760467260	1	1	ELFERING, MARGARET E MD	9/1/1997	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	14909	20	Orthopedic Surgery	0	In state provider	CENTRAL COAST MEDICAL	201 N COLLEGE DR	STE 101	SANTA MARIA	CA	93454	4614	42	06083	34.954461	-120.424836	Santa Barbara County
202588	Fee-for-Service	1588901532	1588901532	1	34	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2006 S LINCOLN BLVD	None	VENICE	CA	90291	3949	19	06037	33.99552056	-118.4557214	Los Angeles County
202591	Fee-for-Service	1093861239	1093861239	1	1	ESPINOSA-MELENDEZ	7/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	42745	41	Internal Medicine	0	In state provider	ENRIQUE MD	3802 NATIONAL AVE	None	SAN DIEGO	CA	92113	3223	37	06073	32.69606684	-117.1122885	San Diego County
202597	Fee-for-Service	1922010867	1922010867	1	1	ECKSTEIN, MARC K MD MPH	11/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	69852	None	None	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
202608	Fee-for-Service	1477090447	1477090447	1	1	ELROD, LEAHA E	8/7/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	865 ANCHORAGE PLACE	None	CHULA VISTA	CA	91914	4535	37	06073	32.65523447	-116.9575942	San Diego County
202633	Fee-for-Service	1003031238	1003031238	1	1	ESPOSTO FRANKLIN, LESA	2/8/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	536 AMERICANO WAY	None	FAIRFIELD	CA	94533	7212	48	06095	38.28791109	-122.0281354	Solano County
202713	Fee-for-Service	1831164607	1831164607	1	1	ELLIS, BRADLEY C MD	8/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107115	41	Internal Medicine	0	In state provider	None	1180 E SHAW AVE	STE 101	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
202719	Fee-for-Service	1316684707	1316684707	1	1	ERASTUS, VERONICA N	5/26/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6387 POMEGRANATE CT	None	EASTVALE	CA	92880	7203	33	06065	33.97212	-117.560838	Riverside County
202777	Fee-for-Service	1154861979	1154861979	1	1	ELIZABETH SUPPORTIVE MEDICAL	5/24/2023	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	SPECIALISTS, A MEDICAL	27720 JEFFERSON	SUITE 200	TEMECULA	CA	92590	2610	33	06065	33.51188961	-117.1586219	Riverside County
202874	Fee-for-Service	1588901532	1588901532	1	34	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2006 S LINCOLN BLVD	None	VENICE	CA	90291	3949	19	06037	33.99552056	-118.4557214	Los Angeles County
202889	Fee-for-Service	1366402976	1366402976	1	1	ESSAIAN, INESSA MD	11/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	72748	36	Psychiatry	0	In state provider	None	1560 E CHEVY CHASE DR	130	GLENDALE	CA	91206	4140	19	06037	34.15290734	-118.2302295	Los Angeles County
202917	Fee-for-Service	1891755732	1891755732	1	1	ERBURU, LISA A MD	2/28/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	61639	40	Pediatrics	0	In state provider	None	9999 MIRA MESA BLVD	STE 102	SAN DIEGO	CA	92131	1006	37	06073	32.91668328	-117.1118001	San Diego County
203007	Fee-for-Service	1144664764	1144664764	1	1	ESFAHANIAN, MOHAMMAD MD	6/20/2019	207L00000X	NA	Other	026	PHYSICIANS	134135	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
203026	Fee-for-Service	1205841947	1205841947	1	1	ELLY M.J. XENAKIS, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4402	00	None	29.508012	-98.578683	Bexar County
203067	Fee-for-Service	1154861979	1154861979	1	1	ELIZABETH SUPPORTIVE MEDICAL	10/6/2020	207RH0002X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	38	Geriatrics	0	In state provider	SPECIALISTS, A MEDICAL	27720 JEFFERSON	SUITE 200	TEMECULA	CA	92590	2610	33	06065	33.51188961	-117.1586219	Riverside County
203098	Fee-for-Service	1588901532	1588901532	1	8	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	3215 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2453	19	06037	33.898797	-118.396126	Los Angeles County
203111	Fee-for-Service	1215060488	1215060488	1	1	EL DORADO COUNTY CCS	2/20/1996	No Taxonomy Provided	NA	None	046	REHABILITATION CLINIC	-	-	NOT APPLICABLE	0	In state provider	WINNIE WAKELEY MTU	3060 SNOWS RD	None	CAMINO	CA	95709	9578	09	06017	38.732832	-120.6789435	El Dorado County
203148	Fee-for-Service	1528162690	1528162690	1	1	EYECARE SPECIALISTS MEDICAL	9/25/2023	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ATLANTIS EYECARE	5991 E SPRING ST	None	LONG BEACH	CA	90808	3752	19	06037	33.81062147	-118.1154555	Los Angeles County
203305	Fee-for-Service	1477624138	1477624138	1	1	EICHENFIELD, LAWRENCE MD	6/21/2000	207N00000X	NA	Dermatology	026	PHYSICIANS	69132	07	Dermatology	0	In state provider	None	8001 FROST ST	None	SAN DIEGO	CA	92123	2746	37	06073	32.802147	-117.151371	San Diego County
203363	Fee-for-Service	1760552228	1760552228	1	1	EICHHORN, JENS MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78345	42	Nuclear Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
203386	Fee-for-Service	1588901532	1588901532	1	8	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3215 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2453	19	06037	33.898797	-118.396126	Los Angeles County
203433	Fee-for-Service	1528162690	1528162690	1	1	EYECARE SPECIALISTS MEDICAL	10/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ATLANTIS EYECARE	5991 E SPRING ST	None	LONG BEACH	CA	90808	3752	19	06037	33.81062147	-118.1154555	Los Angeles County
203591	Fee-for-Service	1750588810	1750588810	1	1	ELISHA, SASSOON M CRNA	5/1/2000	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
203648	Fee-for-Service	1760552228	1760552228	1	1	EICHHORN, JENS MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78345	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
203674	Fee-for-Service	1588901532	1588901532	1	8	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	3215 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2453	19	06037	33.898797	-118.396126	Los Angeles County
203719	Fee-for-Service	1669177192	1669177192	1	1	ELITE AESTHETICS & DERMATOLO	8/15/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GY	3409 CALLOWAY DR	SUITE 602	BAKERSFIELD	CA	93312	2534	15	06029	35.39132551	-119.11007	Kern County
203809	Fee-for-Service	1124214374	1124214374	1	1	EDMONDS, LANCE D MD	7/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108694	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
203962	Fee-for-Service	1912199787	1912199787	1	1	EBBERS, CHRISTINE DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 E 28TH ST	None	MINNEAPOLIS	MN	55407	3723	00	None	44.95428	-93.2614155	Hennepin County
203964	Fee-for-Service	1588901532	1588901532	1	8	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3215 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2453	19	06037	33.898797	-118.396126	Los Angeles County
203966	Fee-for-Service	1952969008	1952969008	1	1	ENEMMUO, IFEATU B NP	11/9/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
204024	Fee-for-Service	1447763867	1447763867	1	1	ELY, RACHEL E NP	10/19/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
204063	Fee-for-Service	1629152798	1629152798	1	1	EWING, EBERLE MD	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54389	66	Emergency Medicine (Urgent Care)	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
204071	Fee-for-Service	1275803868	1275803868	1	1	EXCELLENCE PHYSICAL THERAPY	7/18/2013	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	9191 WESTMINSTER AVE	STE 202	GARDEN GROVE	CA	92844	2751	30	06059	33.75946879	-117.9688437	Orange County
204079	Fee-for-Service	1720164874	1720164874	1	2	ENRIGHT, STEFANIE H LCSW	9/10/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	791 EIGHTH STREET	SUITE F	ARCATA	CA	95521	6234	12	06023	40.86820448	-124.0869718	Humboldt County
204096	Fee-for-Service	1437197985	1437197985	1	1	ERIE COUNTY MEDICAL CENTER	12/19/2013	273R00000X	NA	Other	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORPORATION	462 GRIDER STREET	None	BUFFALO	NY	14215	3021	00	None	42.9272673	-78.82927825	Erie County
204101	Fee-for-Service	1528209459	1528209459	1	1	ETO, JAMIE E MD	8/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99257	05	Anesthesiology	0	In state provider	None	3330 WEST LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
204123	Fee-for-Service	1326507435	1326507435	1	1	ESWARAPPA, CHETHANA MD	8/17/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	176955	None	None	0	In state provider	None	8110 LAGUNA BLVD	None	ELK GROVE	CA	95758	7904	34	06067	38.421306	-121.408173	Sacramento County
204126	Fee-for-Service	1669775847	1669775847	1	1	ENCINO CARE PHARMACY INC	6/13/2011	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16001 VENTURA BOULEVARD	SUITE 135	ENCINO	CA	91436	4490	19	06037	34.15611957	-118.4817702	Los Angeles County
204179	Fee-for-Service	1861692667	1861692667	1	1	ELSAYEGH, ASHRAF M MD	1/29/2008	207RP1001X	NA	Pulmonology	026	PHYSICIANS	77236	41	Internal Medicine	0	In state provider	PROFESSIONAL CORPORATION	2080 CENTURY PARK EAST	SUITE 608	LOS ANGELES	CA	90067	2080	19	06037	34.05887194	-118.4122914	Los Angeles County
204200	Fee-for-Service	1386948628	1386948628	1	1	ESTRADA-SAMANIEGO, CHRISTINA	5/17/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	C LMFT	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
204251	Fee-for-Service	1588901532	1588901532	1	8	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3215 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2453	19	06037	33.898797	-118.396126	Los Angeles County
204378	Fee-for-Service	1366465981	1366465981	1	1	ENGLUND, PAUL V MD	2/8/1999	207L00000X	NA	Other	026	PHYSICIANS	32014	05	Anesthesiology	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
204384	Fee-for-Service	1437197985	1437197985	1	1	ERIE COUNTY MEDICAL CENTER	12/19/2013	273R00000X	NA	Other	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORPORATION	462 GRIDER STREET	None	BUFFALO	NY	14215	3021	00	None	42.9272673	-78.82927825	Erie County
204464	Fee-for-Service	1902996028	1902996028	1	1	ELLIOT HOSP	8/10/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 ELLIOT WAY	None	MANCHESTER	NH	03103	0000	00	None	42.98264972	-71.43486814	Hillsborough County
204465	Fee-for-Service	1861692667	1861692667	1	1	ELSAYEGH, ASHRAF M MD	1/29/2008	207RP1001X	NA	Pulmonology	026	PHYSICIANS	77236	29	Pulmonary Diseases (M.D. only)	0	In state provider	PROFESSIONAL CORPORATION	2080 CENTURY PARK EAST	SUITE 608	LOS ANGELES	CA	90067	2080	19	06037	34.05887194	-118.4122914	Los Angeles County
204505	Fee-for-Service	1801972161	1801972161	1	1	ERIC BELANGER	8/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 N 7TH ST	None	BISMARCK	ND	58501	4439	00	None	46.808109	-100.782261	Burleigh County
204516	Fee-for-Service	1760411151	1760411151	1	1	EL-SHAHAWY, MOHAMED ALI	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	42315	41	Internal Medicine	0	In state provider	None	2250 ALCAZAR ST	STE 126	LOS ANGELES	CA	90089	0274	19	06037	34.06313563	-118.1997071	Los Angeles County
204587	Fee-for-Service	1427411172	1427411172	1	1	ETESAM, ARSHIA MD	4/1/2025	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	192364	25	Physical Medicine and Rehabilitation	0	In state provider	None	2181 CITRACADO PARKWAY	None	ESCONDIDO	CA	92029	4159	37	06073	33.11995854	-117.1204723	San Diego County
204604	Fee-for-Service	1588901532	1588901532	1	31	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	11560 W PICO BLVD	None	LOS ANGELES	CA	90064	1520	19	06037	34.03288018	-118.4432057	Los Angeles County
204663	Fee-for-Service	1467195073	1467195073	1	10	EMANATE HEALTH MEDICAL CARE	8/21/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	1305 WEST ARROW HWY	104	SAN DIMAS	CA	91773	2336	19	06037	34.10677063	-117.8334375	Los Angeles County
204722	Fee-for-Service	1003067141	1003067141	1	1	ECHETA, ALICE C NP	5/27/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3634 ELIZABETH ST	None	RIVERSIDE	CA	92506	2506	33	06065	33.95782448	-117.3904065	Riverside County
204730	Fee-for-Service	1508153636	1508153636	1	1	ESLAO, NELSON J MD	12/4/2015	390200000X	NA	Other	026	PHYSICIANS	129400	40	Pediatrics	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
204753	Fee-for-Service	1760447536	1760447536	1	1	ENGLES, MARY LYDIA	2/8/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4120 W POINT LOMA BLVD	None	SAN DIEGO	CA	92110	5605	37	06073	32.75335292	-117.2246698	San Diego County
204821	Fee-for-Service	1992355911	1992355911	1	1	EVOLUTION SUPPORT SERVICES	11/1/2019	No Taxonomy Provided	NA	None	069	PROFESSIONAL CORPORATION	-	-	NOT APPLICABLE	0	In state provider	LLC	9344 E ZAYANTE RD	None	FELTON	CA	95018	2017	44	06087	37.08701291	-122.0469105	Santa Cruz County
204841	Fee-for-Service	1316192826	1316192826	1	1	EL DORADO SURGERY CENTED LLC	11/1/2008	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4300 GOLDEN CENTER DR	STE E	PLACERVILLE	CA	95667	6278	09	06017	38.70657265	-120.82856	El Dorado County
204890	Fee-for-Service	1588901532	1588901532	1	28	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	22855 LAKE FOREST DR	A	LAKE FOREST	CA	92630	1656	30	06059	33.63038524	-117.7153185	Orange County
204898	Fee-for-Service	1104272657	1104272657	1	1	ERSOFF, RACHEL E AU	11/19/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	550 WATER ST	SUITE A	SANTA CRUZ	CA	95060	4126	44	06087	36.98046158	-122.018718	Santa Cruz County
204928	Fee-for-Service	1306994132	1306994132	1	1	ESTERSON MARC H MD	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77917	05	Anesthesiology	0	In state provider	ATTN MGA OFFICE	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
204949	Fee-for-Service	1467195073	1467195073	1	10	EMANATE HEALTH MEDICAL CARE	8/21/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1305 WEST ARROW HWY	104	SAN DIMAS	CA	91773	2336	19	06037	34.10677063	-117.8334375	Los Angeles County
204969	Fee-for-Service	1801197876	1801197876	1	1	EMERGENCY MEDICINE PHYSICIAN	1/1/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS OF SACRAMENTO	6501 COYLE AVENUE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
205084	Fee-for-Service	1831571736	1831571736	1	1	ELIAS, REBECCA PHD	10/8/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
205183	Fee-for-Service	1588901532	1588901532	1	28	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	22855 LAKE FOREST DR	A	LAKE FOREST	CA	92630	1656	30	06059	33.63038524	-117.7153185	Orange County
205217	Fee-for-Service	1285763029	1285763029	1	1	EYE SURGICAL MED GRP OF	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	SANTA BARBARA INC	533 E MICHELTORENA ST	STE 103	SANTA BARBARA	CA	93103	2260	42	06083	34.43233822	-119.701775	Santa Barbara County
205218	Fee-for-Service	1306994132	1306994132	1	1	ESTERSON MARC H MD	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77917	70	Clinic (mixed specialty)	0	In state provider	ATTN MGA OFFICE	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
205240	Fee-for-Service	1467195073	1467195073	1	10	EMANATE HEALTH MEDICAL CARE	8/21/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1305 WEST ARROW HWY	104	SAN DIMAS	CA	91773	2336	19	06037	34.10677063	-117.8334375	Los Angeles County
205256	Fee-for-Service	1487866992	1487866992	1	1	EDWARDS, MICHELLE M DO	10/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	10099	84	Surgery-Head and Neck	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
205268	Fee-for-Service	1194393694	1194393694	1	1	EGUILOS, RODERICK B DO	8/1/2024	390200000X	NA	Other	026	PHYSICIANS	23195	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
205300	Fee-for-Service	1932583770	1932583770	1	1	EAGERTON, ERIKA PHD	8/26/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5080 N FRUIT AVE	102	FRESNO	CA	93711	3062	10	06019	36.80974442	-119.8173823	Fresno County
205395	Fee-for-Service	1942293782	1942293782	1	1	EVANS, MISTY V. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9225 N 3RD ST	STE 304	PHOENIX	AZ	85020	0000	00	None	33.57054	-112.0692465	Maricopa County
205398	Fee-for-Service	1932249828	1932249828	1	1	ELSBACH, JAN K MD	5/31/1989	207P00000X	NA	Other	026	PHYSICIANS	66941	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
205467	Fee-for-Service	1588901532	1588901532	1	31	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	11560 W PICO BLVD	None	LOS ANGELES	CA	90064	1520	19	06037	34.03288018	-118.4432057	Los Angeles County
205480	Fee-for-Service	1679772693	1679772693	1	1	EVANS, JACOB R DO	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	9697	08	Family Practice	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
205483	Fee-for-Service	1144974890	1144974890	1	1	EMERGENCY PHYSICIANS URGENT	3/14/2022	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4108 EDISON AVE	SUITE 112	CHINO	CA	91710	8418	36	06071	33.9972783	-117.7147771	San Bernardino County
205526	Fee-for-Service	1467195073	1467195073	1	10	EMANATE HEALTH MEDICAL CARE	8/21/2024	261QH0100X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1305 WEST ARROW HWY	104	SAN DIMAS	CA	91773	2336	19	06037	34.10677063	-117.8334375	Los Angeles County
205586	Fee-for-Service	1255910519	1255910519	1	1	ELEVATED HEALTH INC	3/20/2020	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	18800 DELAWARE ST	800	HUNTINGTON BEACH	CA	92648	6019	30	06059	33.68911733	-117.9931535	Orange County
205600	Fee-for-Service	1134394117	1134394117	1	1	EKO, FREDERICK N MD	9/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120873	24	Plastic Surgery	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
205621	Fee-for-Service	1326126087	1326126087	1	1	ERRERA, TIMOTHY MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63810	40	Pediatrics	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
205664	Fee-for-Service	1588901532	1588901532	1	9	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	235 E 17TH ST	None	COSTA MESA	CA	92627	3831	30	06059	33.63461138	-117.9176798	Orange County
205688	Fee-for-Service	1932249828	1932249828	1	1	ELSBACH, JAN K MD	5/31/1989	207P00000X	NA	Other	026	PHYSICIANS	66941	41	Internal Medicine	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
205710	Fee-for-Service	1518996412	1518996412	1	1	ELLMAN, MEGAN M MD	12/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	91250	41	Internal Medicine	0	In state provider	None	901 OAK PARK BLVD	SUITE 101	PISMO BEACH	CA	93449	3409	40	06079	35.13460775	-120.6050814	San Luis Obispo County
205743	Fee-for-Service	1174580328	1174580328	1	1	EASTHOPE, JOHN L JR MD	4/5/1996	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	25402	06	Cardiovascular Disease (M.D. only)	0	In state provider	INC	800 FAIRMOUNT AVE	STE 215	PASADENA	CA	91105	3152	19	06037	34.13193177	-118.1517805	Los Angeles County
205760	Fee-for-Service	1588901532	1588901532	1	28	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	22855 LAKE FOREST DR	A	LAKE FOREST	CA	92630	1656	30	06059	33.63038524	-117.7153185	Orange County
205772	Fee-for-Service	1144974890	1144974890	1	1	EMERGENCY PHYSICIANS URGENT	6/21/2022	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4108 EDISON AVE	SUITE 112	CHINO	CA	91710	8418	36	06071	33.9972783	-117.7147771	San Bernardino County
205808	Fee-for-Service	1982785671	1982785671	3	1	EL TEJON PHARMACYCARE INC	10/2/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2819 N CHESTER AVE	None	BAKERSFIELD	CA	93308	1587	15	06029	35.431848	-119.021399	Kern County
205843	Fee-for-Service	1588901532	1588901532	1	12	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	25548 THE OLD RD	U1	STEVENSON RANCH	CA	91381	1705	19	06037	34.38496571	-118.5717524	Los Angeles County
205909	Fee-for-Service	1326126087	1326126087	1	1	ERRERA, TIMOTHY MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63810	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
205921	Fee-for-Service	1245765809	1245765809	1	1	ELEZABY, ALY MD	4/25/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	157100	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
205948	Fee-for-Service	1396227427	1396227427	1	1	ECKERT JUAREZ, CATHY L NP	5/24/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	820 S AKERS ST	STE 120	VISALIA	CA	93277	8306	54	06107	36.323757	-119.3491755	Tulare County
205953	Fee-for-Service	1588901532	1588901532	1	9	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	235 E 17TH ST	None	COSTA MESA	CA	92627	3831	30	06059	33.63461138	-117.9176798	Orange County
205958	Fee-for-Service	1437475563	1437475563	1	1	EMAMAULLEE, JULIET A MD	8/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150691	02	General Surgery	0	In state provider	None	1510 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
206044	Fee-for-Service	1588901532	1588901532	1	31	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11560 W PICO BLVD	None	LOS ANGELES	CA	90064	1520	19	06037	34.03288018	-118.4432057	Los Angeles County
206131	Fee-for-Service	1588901532	1588901532	1	12	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	25548 THE OLD RD	U1	STEVENSON RANCH	CA	91381	1705	19	06037	34.38496571	-118.5717524	Los Angeles County
206141	Fee-for-Service	1053423384	1053423384	1	2	ELLIOTT, ANDREW J MD	10/5/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	86851	-	NOT APPLICABLE	0	In state provider	None	2085 RUSTIN AVE	None	RIVERSIDE	CA	92507	2498	33	06065	33.99323085	-117.3355363	Riverside County
206181	Fee-for-Service	1568020592	1568020592	1	1	ENDO, ZAYN C MD	11/1/2024	207R00000X	NA	Other	026	PHYSICIANS	181933	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
206210	Fee-for-Service	1245765809	1245765809	1	1	ELEZABY, ALY MD	4/25/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	157100	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
206218	Fee-for-Service	1346463163	1346463163	1	1	EVANS, PAULA A LMFT	8/15/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2522 GRAND CANAL BLVD	SUITE 1	STOCKTON	CA	95207	8150	39	06077	37.98353982	-121.3388944	San Joaquin County
206242	Fee-for-Service	1588901532	1588901532	1	9	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	235 E 17TH ST	None	COSTA MESA	CA	92627	3831	30	06059	33.63461138	-117.9176798	Orange County
206306	Fee-for-Service	1639231327	1639231327	1	1	EL-SHAHAWY, MOHAMED A MD	11/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	42315	41	Internal Medicine	0	In state provider	ACADEMIC MEDICAL RESEARC	1510 S CENTRAL AVE	STE 210	GLENDALE	CA	91204	2500	19	06037	34.12709764	-118.2577911	Los Angeles County
206331	Fee-for-Service	1588901532	1588901532	1	31	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	11560 W PICO BLVD	None	LOS ANGELES	CA	90064	1520	19	06037	34.03288018	-118.4432057	Los Angeles County
206396	Fee-for-Service	1780755694	1780755694	1	1	ELLISON, EDWARD M JR MD	2/28/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	52524	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
206413	Fee-for-Service	1588901532	1588901532	1	12	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	25548 THE OLD RD	U1	STEVENSON RANCH	CA	91381	1705	19	06037	34.38496571	-118.5717524	Los Angeles County
206469	Fee-for-Service	1568020592	1568020592	1	1	ENDO, ZAYN C MD	11/1/2024	207R00000X	NA	Other	026	PHYSICIANS	181933	77	Infectious Disease	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
206528	Fee-for-Service	1588901532	1588901532	1	9	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	235 E 17TH ST	None	COSTA MESA	CA	92627	3831	30	06059	33.63461138	-117.9176798	Orange County
206595	Fee-for-Service	1043269194	1043269194	1	1	ENAYATI, ALI J MD	1/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	73998	41	Internal Medicine	0	In state provider	None	2080 CENTURY PARK E	STE 1609	LOS ANGELES	CA	90067	2019	19	06037	34.05887194	-118.4122914	Los Angeles County
206619	Fee-for-Service	1588901532	1588901532	1	31	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11560 W PICO BLVD	None	LOS ANGELES	CA	90064	1520	19	06037	34.03288018	-118.4432057	Los Angeles County
206630	Fee-for-Service	1942226345	1942226345	1	1	EHYA, NILOUFAR A MD	7/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89489	05	Anesthesiology	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
206634	Fee-for-Service	1063610434	1063610434	1	1	EASLEY, ALICIA L MD	7/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	70767	40	Pediatrics	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
206645	Fee-for-Service	1659421626	1659421626	1	1	EDWARDS, ALEESHA R LMFT	6/30/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	47645	-	NOT APPLICABLE	0	In state provider	None	1506 MARKET STREET	None	REDDING	CA	96001	1023	45	06089	40.58403672	-122.3908469	Shasta County
206669	Fee-for-Service	1437767118	1437767118	1	1	EXPRESS HOME HEALTH INC	2/4/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5122 KATELLA AVE	STE 304	LOS ALAMITOS	CA	90720	2831	30	06059	33.80290311	-118.0433422	Orange County
206687	Fee-for-Service	1629270699	1629270699	1	1	EVERGREEN HOSPICE CARE, INC	3/6/2008	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	17215 STUDEBAKER RD	STE 100	CERRITOS	CA	90703	2521	19	06037	33.874686	-118.0998595	Los Angeles County
206704	Fee-for-Service	1184347940	1184347940	1	1	EKEJIUBA, NNENNA I NP	10/20/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
206707	Fee-for-Service	1588901532	1588901532	1	12	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25548 THE OLD RD	U1	STEVENSON RANCH	CA	91381	1705	19	06037	34.38496571	-118.5717524	Los Angeles County
206741	Fee-for-Service	1245332923	1245332923	1	1	EDWARDS, ELLEN E DO	3/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8613	41	Internal Medicine	0	In state provider	None	15025 INNOVATION DR	None	SAN DIEGO	CA	92128	3409	37	06073	32.98956795	-117.0767228	San Diego County
206818	Fee-for-Service	1588901532	1588901532	1	9	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	235 E 17TH ST	None	COSTA MESA	CA	92627	3831	30	06059	33.63461138	-117.9176798	Orange County
206881	Fee-for-Service	1538231360	1538231360	1	1	EL-DIWANY, SEHAM D MD	8/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	42073	01	General Practice	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
206905	Fee-for-Service	1275895641	1275895641	1	1	ELDRINGHOFF, DAVID MD	10/18/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	155404	None	None	0	In state provider	None	741 S ORANGE AVE	STE 200	WEST COVINA	CA	91790	2662	19	06037	34.07079634	-117.9445034	Los Angeles County
206917	Fee-for-Service	1588901532	1588901532	1	28	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	22855 LAKE FOREST DR	A	LAKE FOREST	CA	92630	1656	30	06059	33.63038524	-117.7153185	Orange County
206931	Fee-for-Service	1235327107	1235327107	1	1	ENDESHAW, FREHIWOT W. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7383 E TANQUE VERDE RD	None	TUCSON	AZ	85715	3475	00	None	32.251788	-110.8349325	Pima County
206934	Fee-for-Service	1912043969	1912043969	1	1	EIDAL, SUSANNE A PT	10/28/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2251 COUNTRY CLUB LN	None	SELMA	CA	93662	3859	10	06019	36.5662241	-119.5996308	Fresno County
206950	Fee-for-Service	1396312880	1396312880	1	1	EDER HOME HEALTH CARE INC	11/9/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	15125 VENTURA BLVD	SUITE 2-7	SHERMAN OAKS	CA	91403	3306	19	06037	34.15324933	-118.4626202	Los Angeles County
206972	Fee-for-Service	1124434261	1124434261	1	2	EASY SPEECH PATHOLOGY, INC.	11/20/2023	261QM1300X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
206974	Fee-for-Service	1629270699	1629270699	1	1	EVERGREEN HOSPICE CARE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	17215 STUDEBAKER RD	STE 100	CERRITOS	CA	90703	2521	19	06037	33.874686	-118.0998595	Los Angeles County
206992	Fee-for-Service	1588901532	1588901532	1	12	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	25548 THE OLD RD	U1	STEVENSON RANCH	CA	91381	1705	19	06037	34.38496571	-118.5717524	Los Angeles County
207013	Fee-for-Service	1568729184	1568729184	1	1	ESHAGHIAN, RAYAN MD	2/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	127905	02	General Surgery	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
207151	Fee-for-Service	1346669009	1346669009	1	1	EVANS, ADAM R MD	2/22/2018	207P00000X	NA	Other	026	PHYSICIANS	140591	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
207198	Fee-for-Service	1588901532	1588901532	1	28	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	22855 LAKE FOREST DR	A	LAKE FOREST	CA	92630	1656	30	06059	33.63038524	-117.7153185	Orange County
207251	Fee-for-Service	1861459869	1861459869	1	1	ELLENI WOLDESENBET	5/13/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3132 MATLOCK RD	STE 309	ARLINGTON	TX	76015	2922	00	None	32.693436	-97.11502797	Tarrant County
207261	Fee-for-Service	1124434261	1124434261	1	2	EASY SPEECH PATHOLOGY, INC.	11/20/2023	261QM1300X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
207323	Fee-for-Service	1316321912	1316321912	1	1	ETNIEL, MONICA OD	5/1/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	52565 CESAR CHAVEZ ST	#105	COACHELLA	CA	92236	1534	33	06065	33.66690605	-116.1817556	Riverside County
207324	Fee-for-Service	1841694361	1841694361	1	1	ELBO, WINCHELL R	4/16/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2651 S C ST	200	OXNARD	CA	93033	3560	56	06111	34.17497898	-119.1811966	Ventura County
207400	Fee-for-Service	1245806918	1245806918	1	1	ESMAEILI, ALI A MD	5/5/2024	390200000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	4955 VAN NUYS BLVD	SUITE 308	SHERMAN OAKS	CA	91403	1811	19	06037	34.160805	-118.4487295	Los Angeles County
207415	Fee-for-Service	1831243625	1831243625	1	2	EAST VALLEY COMM HLTH	7/27/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4368 SANTA ANITA AVE	None	EL MONTE	CA	91731	1606	19	06037	34.08572956	-118.0293405	Los Angeles County
207511	Fee-for-Service	1174942569	1174942569	1	1	ERNST, YIZHOU D DO	2/18/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	-	15	Obstetrics (D.O. only)	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
207540	Fee-for-Service	1295175651	1295175651	1	1	EVERSON, NEAL E DO	8/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	6719 ALVARDO RD	STE 200	SAN DIEGO	CA	92120	5256	37	06073	32.77684978	-117.055137	San Diego County
207548	Fee-for-Service	1124434261	1124434261	1	2	EASY SPEECH PATHOLOGY, INC.	11/20/2023	261QM1300X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
207597	Fee-for-Service	1457938193	1457938193	1	1	EDWARDS, ALEXANDER	12/18/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	33423 N 32ND AVE	None	PHOENIX	AZ	85085	8874	00	None	33.786909	-112.129047	Maricopa County
207613	Fee-for-Service	1407268931	1407268931	1	1	ECHEVERRIA, JOHN W CRNA	5/27/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
207701	Fee-for-Service	1831243625	1831243625	1	2	EAST VALLEY COMM HLTH	8/16/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4368 SANTA ANITA AVE	None	EL MONTE	CA	91731	1606	19	06037	34.08572956	-118.0293405	Los Angeles County
207739	Fee-for-Service	1588901532	1588901532	1	57	EXER MEDICAL CORPORATION	3/6/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2968 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5826	19	06037	33.9731851	-118.215729	Los Angeles County
207804	Fee-for-Service	1174942569	1174942569	1	1	ERNST, YIZHOU D DO	2/18/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	-	09	Gynecology (D.O. only)	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
207838	Fee-for-Service	1124434261	1124434261	1	2	EASY SPEECH PATHOLOGY, INC.	11/20/2023	261QM1300X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
207911	Fee-for-Service	1699853796	1699853796	1	1	EVERETT, NANCY A MD	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	41924	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3000 LAS POSTIAS	None	LIVERMORE	CA	94551	9627	01	06001	37.69960369	-121.7628917	Alameda County
207949	Fee-for-Service	1033353149	1033353149	1	1	ENGEL, ROBYN A LCSW	9/26/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1430 EAST AVE	STE 4B	CHICO	CA	95926	1610	04	06007	39.76116577	-121.8188568	Butte County
207964	Fee-for-Service	1962664789	1962664789	1	1	EVANS, JAMIE L MD	3/5/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	159601	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
207991	Fee-for-Service	1831243625	1831243625	1	2	EAST VALLEY COMM HLTH	7/27/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4368 SANTA ANITA AVE	None	EL MONTE	CA	91731	1606	19	06037	34.08572956	-118.0293405	Los Angeles County
207993	Fee-for-Service	1174565493	1174565493	1	1	ESSER, ADAM C MD	11/13/2007	207ND0101X	NA	Dermatology	026	PHYSICIANS	91108	07	Dermatology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
208044	Fee-for-Service	1811147531	1811147531	1	1	ESMAEILI, KEYVAN MD INC	4/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	72887	01	General Practice	0	In state provider	None	215 S HICKORY STREET	STE 118	ESCONDIDO	CA	92025	4304	37	06073	33.12335985	-117.0753842	San Diego County
208099	Fee-for-Service	1447221742	1447221742	1	1	EASTERN NEW MEXICO	4/1/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER	405 W COUNTRY CLUB RD	None	ROSWELL	NM	88201	5209	00	None	33.42332853	-104.5286841	Chaves County
208125	Fee-for-Service	1124434261	1124434261	1	2	EASY SPEECH PATHOLOGY, INC.	11/20/2023	261QM1300X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
208162	Fee-for-Service	1568997062	1568997062	1	1	EL-BABA, FIRAS M	6/21/2023	207R00000X	NA	Other	026	PHYSICIANS	172636	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
208311	Fee-for-Service	1689715674	1689715674	2	2	EGIDA HOME HEALTH CARE INC	12/1/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	13701 RIVERSIDE DR	SUITE 316	SHERMAN OAKS	CA	91423	2447	19	06037	34.15762986	-118.4316325	Los Angeles County
208326	Fee-for-Service	1740353432	1740353432	1	1	EVAN W. LEE JR. D.O.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3-3420 KUHIO HWY, STE B	None	LIHUE	HI	96766	1098	00	None	21.98560043	-159.3663628	Kauai County
208356	Fee-for-Service	1932429453	1932429453	1	1	EMILIANO VALLES, M.D.	7/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2719	00	None	35.08771808	-106.6192188	Bernalillo County
208373	Fee-for-Service	1861814089	1861814089	1	3	ENLOE MEDICAL CENTER	11/4/2021	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	LLIATIVE CARE	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
208384	Fee-for-Service	1386677656	1386677656	1	1	EVAN BRATHWAITE	2/26/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 OCEAN PKWY	None	BROOKLYN	NY	11235	7745	00	None	40.586031	-73.9657305	Kings County
208389	Fee-for-Service	1447221742	1447221742	1	1	EASTERN NEW MEXICO	4/1/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER	405 W COUNTRY CLUB RD	None	ROSWELL	NM	88201	5209	00	None	33.42332853	-104.5286841	Chaves County
208413	Fee-for-Service	1881629509	1881629509	1	1	EL-FARRA, NEVEEN S MD	10/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84756	None	None	0	In state provider	None	200 MED PLAZA STE 420	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
208486	Fee-for-Service	1396166815	1396166815	1	1	ELLEFSON, JAY A CRNA	1/16/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 CHESTER AVENUE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
208510	Fee-for-Service	1760566434	1760566434	1	1	ELLIOTT, BRIAN E OD	2/16/1993	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	RIVERBANK OPTOMETRIC CEN	6331 JACKSON AVE	None	RIVERBANK	CA	95367	2733	50	06099	37.73193803	-120.9495947	Stanislaus County
208522	Fee-for-Service	1801963996	1801963996	1	1	EPSTEIN, ERVIN JR MD	8/28/1973	207N00000X	NA	Dermatology	026	PHYSICIANS	22751	07	Dermatology	0	In state provider	None	400 30TH ST	STE 205	OAKLAND	CA	94609	3305	01	06001	37.81907725	-122.2648838	Alameda County
208570	Fee-for-Service	1053477273	1053477273	1	1	EL DORADO UNION HIGH SD	2/28/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	4675 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6816	09	06017	38.69478233	-120.823793	El Dorado County
208641	Fee-for-Service	1154593069	1154593069	1	1	ESPINOZA, ROBERT MD	12/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104675	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
208660	Fee-for-Service	1861814089	1861814089	1	3	ENLOE MEDICAL CENTER	11/4/2021	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	LLIATIVE CARE	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
208742	Fee-for-Service	1184702680	1184702680	1	1	EDILLON, PAMELA A MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75883	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
208775	Fee-for-Service	1053377077	1053377077	1	1	EQUILS, OZLEM MD	10/1/1999	174400000X	NA	Other	026	PHYSICIANS	55302	77	Infectious Disease	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
208870	Fee-for-Service	1932239159	1932239159	1	1	EARLES, KERISHA N LMFT	5/24/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	12021 S. WILMINGTON AVE	STE 301, BUILDING #18	LOS ANGELES	CA	90059	3019	19	06037	33.922575	-118.2391785	Los Angeles
208959	Fee-for-Service	1710935028	1710935028	1	1	EWING, CHERYL A MD	3/8/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86024	02	General Surgery	0	In state provider	None	1600 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3010	38	06075	37.78475261	-122.43973	San Francisco County
208995	Fee-for-Service	1588901532	1588901532	1	53	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	3932 LONG BEACH BLVD	STE A	LONG BEACH	CA	90807	2615	19	06037	33.830325	-118.1893215	Los Angeles County
209027	Fee-for-Service	1356375497	1356375497	1	1	ESPARZA, EZEQUIEL T MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54507	36	Psychiatry	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
209063	Fee-for-Service	1053377077	1053377077	1	1	EQUILS, OZLEM MD	10/1/1999	174400000X	NA	Other	026	PHYSICIANS	55302	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
209083	Fee-for-Service	1225366305	1225366305	1	2	EVANGELINE G ROXAS-BUTLIG MD	3/1/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	INC	1727 CRENSHAW BLVD	None	TORRANCE	CA	90501	3312	19	06037	33.830388	-118.328628	Los Angeles County
209109	Fee-for-Service	1215294087	1215294087	1	1	EL NAGA, ASHRAF N MD	6/12/2017	390200000X	NA	Other	026	PHYSICIANS	148284	20	Orthopedic Surgery	0	In state provider	None	1001 POTRERO AVE	RM 3A36	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
209283	Fee-for-Service	1588901532	1588901532	1	53	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	3932 LONG BEACH BLVD	STE A	LONG BEACH	CA	90807	2615	19	06037	33.830325	-118.1893215	Los Angeles County
209315	Fee-for-Service	1356375497	1356375497	1	1	ESPARZA, EZEQUIEL T MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54507	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
209360	Fee-for-Service	1427272459	1427272459	1	1	EL DORADO COUNTY	12/1/1977	No Taxonomy Provided	NA	None	048	COUNTY CLINICS NOT ASSOCIATED WITH HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HEALTH DEPARTMENT	931 SPRING ST	None	PLACERVILLE	CA	95667	4543	09	06017	38.73225478	-120.802205	El Dorado County
209399	Fee-for-Service	1871809822	1871809822	1	1	EMOTIONAL WELLNESS	11/9/2010	2084P0800X	NA	Psychiatry	026	PHYSICIANS	93922	36	Psychiatry	0	In state provider	MANAGEMENT INC	468 N CAMDEN DR	STE 353	BEVERLY HILLS	CA	90210	4507	19	06037	34.06975095	-118.4051608	Los Angeles County
209570	Fee-for-Service	1588901532	1588901532	1	53	EXER MEDICAL CORPORATION	3/25/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3932 LONG BEACH BLVD	STE A	LONG BEACH	CA	90807	2615	19	06037	33.830325	-118.1893215	Los Angeles County
209589	Fee-for-Service	1801977327	1801977327	1	1	ENGLE, TIMOTHY A PHD	3/20/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1440 N HARBOR BLVD	SUITE 900	FULLERTON	CA	92835	4122	30	06059	33.88513341	-117.926041	Orange County
209720	Fee-for-Service	1588901532	1588901532	1	39	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	215 N ALLEN AVE	None	PASADENA	CA	91106	1601	19	06037	34.149798	-118.113208	Los Angeles County
209787	Fee-for-Service	1669075735	1669075735	1	2	EZ RIDE LLC	6/15/2023	347C00000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3400 RICHMOND PKWY	#1410	RICHMOND	CA	94806	5220	07	06013	37.98933893	-122.3228269	Contra Costa County
209860	Fee-for-Service	1588901532	1588901532	1	53	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3932 LONG BEACH BLVD	STE A	LONG BEACH	CA	90807	2615	19	06037	33.830325	-118.1893215	Los Angeles County
209865	Fee-for-Service	1386154623	1386154623	1	1	ESQUIVEL, ELIZABETH LMFT	5/9/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13601 WHITTIER BLVD	STE 208	WHITTIER	CA	90605	1955	19	06037	33.96101144	-118.0289736	Los Angeles County
210008	Fee-for-Service	1588901532	1588901532	1	39	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	215 N ALLEN AVE	None	PASADENA	CA	91106	1601	19	06037	34.149798	-118.113208	Los Angeles County
210021	Fee-for-Service	1588901532	1588901532	1	16	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	8985 VENICE BLVD	A3B	LOS ANGELES	CA	90034	3344	19	06037	34.02720362	-118.392374	Los Angeles County
210028	Fee-for-Service	1679538235	1679538235	1	1	EDMUND B ROWLAND	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	660 GOLDEN RIDGE RD	STE 250	GOLDEN	CO	80401	9541	00	None	39.72722727	-105.2061064	Jefferson County
210067	Fee-for-Service	1255996658	1255996658	1	1	EYONG, AGNES K NP	10/30/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	30427 DELTA DRIVE	None	NUEVO	CA	92567	9470	33	06065	33.80923068	-117.1322903	Riverside County
210187	Fee-for-Service	1831162205	1831162205	1	1	ERICKSON, JON A MD	11/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	56879	01	General Practice	0	In state provider	SUITE B	3257 PROFESSIONAL DR	None	AUBURN	CA	95602	2460	31	06061	38.943405	-121.1008195	Placer County
210296	Fee-for-Service	1588901532	1588901532	1	39	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	215 N ALLEN AVE	None	PASADENA	CA	91106	1601	19	06037	34.149798	-118.113208	Los Angeles County
210307	Fee-for-Service	1588901532	1588901532	1	16	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	8985 VENICE BLVD	A3B	LOS ANGELES	CA	90034	3344	19	06037	34.02720362	-118.392374	Los Angeles County
210352	Fee-for-Service	1891220299	1891220299	1	1	EGINLI, ARIANA N MD	10/11/2021	207N00000X	NA	Dermatology	026	PHYSICIANS	174341	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
210356	Fee-for-Service	1255996658	1255996658	1	1	EYONG, AGNES K NP	10/30/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	30427 DELTA DRIVE	None	NUEVO	CA	92567	9470	33	06065	33.80923068	-117.1322903	Riverside County
210446	Fee-for-Service	1144647520	1144647520	1	1	EARLEY, SAMANTHA Q DO	8/29/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	23218	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
210501	Fee-for-Service	1578585576	1578585576	1	1	ENRICO BALCOS MEDICAL INC	2/24/2011	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4619 ROSEMEAD BLVD	None	ROSEMEAD	CA	91770	1478	19	06037	34.08871316	-118.073569	Los Angeles County
210582	Fee-for-Service	1588901532	1588901532	1	39	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	215 N ALLEN AVE	None	PASADENA	CA	91106	1601	19	06037	34.149798	-118.113208	Los Angeles County
210586	Fee-for-Service	1750399622	1750399622	1	1	ESHOM, JAMES L MD	10/31/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	45229	41	Internal Medicine	0	In state provider	None	612 W DUARTE RD	STE 502	ARCADIA	CA	91007	9207	19	06037	34.12647805	-118.051994	Los Angeles County
210596	Fee-for-Service	1588901532	1588901532	1	16	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	8985 VENICE BLVD	A3B	LOS ANGELES	CA	90034	3344	19	06037	34.02720362	-118.392374	Los Angeles County
210673	Fee-for-Service	1144343435	1144343435	1	1	ERIC HOGAN DO	1/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1800 W UNIVERSITY BLVD	None	DURANT	OK	74701	3006	00	None	34.007364	-96.393519	Bryan County
210756	Fee-for-Service	1205937646	1205937646	1	1	EISENBERG, PETER D MD	6/18/1988	193200000X	NA	Other	026	PHYSICIANS	31825	41	Internal Medicine	0	In state provider	None	599 SIR FRANCIS DRAKE BL	# 30	GREENBRAE	CA	94904	1712	21	06041	37.95026531	-122.5332546	Marin County
210790	Fee-for-Service	1811978992	1811978992	1	1	EKLUND, BONNIE L NP	2/19/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
210800	Fee-for-Service	1376587709	1376587709	1	1	ENSLEY, WILLIAM B	4/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84832	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
210872	Fee-for-Service	1588901532	1588901532	1	39	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	215 N ALLEN AVE	None	PASADENA	CA	91106	1601	19	06037	34.149798	-118.113208	Los Angeles County
210873	Fee-for-Service	1750399622	1750399622	1	1	ESHOM, JAMES L MD	10/31/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	45229	66	Emergency Medicine (Urgent Care)	0	In state provider	None	612 W DUARTE RD	STE 502	ARCADIA	CA	91007	9207	19	06037	34.12647805	-118.051994	Los Angeles County
210882	Fee-for-Service	1588901532	1588901532	1	16	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8985 VENICE BLVD	A3B	LOS ANGELES	CA	90034	3344	19	06037	34.02720362	-118.392374	Los Angeles County
210888	Fee-for-Service	1952482390	1952482390	1	1	ESTRIN, WILLIAM J MD	3/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	53425	13	Neurology (M.D. only)	0	In state provider	None	450 SUTTER ST	SUITE 1324	SAN FRANCISCO	CA	94108	4007	38	06075	37.78934929	-122.4077786	San Francisco County
210907	Fee-for-Service	1144213141	1144213141	1	1	EMRICK, FRED G. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	307 HIGHLAND BLVD	None	NATCHEZ	MS	39120	4610	00	None	31.52132107	-91.39911001	Adams County
210977	Fee-for-Service	1457654832	1457654832	1	1	ENG, JAMIE S MD	6/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114931	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
211012	Fee-for-Service	1649501305	1649501305	1	1	ENG, JESSICA R	5/16/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
211013	Fee-for-Service	1932247087	1932247087	1	1	ESHLEMAN, ALAN M MD	3/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	45734	41	Internal Medicine	0	In state provider	None	1450 MEDICAL CENTER DRIV	None	ROHNERT PARK	CA	94928	2924	49	06097	38.34758366	-122.6816633	Sonoma County
211128	Fee-for-Service	1316680168	1316680168	1	1	ESPANOLA, LESLEY Y PT	9/9/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
211159	Fee-for-Service	1568657724	1568657724	1	1	EDWARD F SISSON	11/10/2010	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	165 RIO LINDA AVE	#100	CHICO	CA	95926	1909	04	06007	39.75297631	-121.8565982	Butte County
211172	Fee-for-Service	1588901532	1588901532	1	16	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	8985 VENICE BLVD	A3B	LOS ANGELES	CA	90034	3344	19	06037	34.02720362	-118.392374	Los Angeles County
211204	Fee-for-Service	1508970435	1508970435	1	1	ELIZABETH CHRISTENSEN & ASSO	6/7/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CIATES INC	3171 LOS FELIZ BLVD	STE 200	LOS ANGELES	CA	90039	1536	19	06037	34.12369709	-118.2682266	Los Angeles County
211303	Fee-for-Service	1760554570	1760554570	1	1	ELLIS, JENNIFER A MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80980	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
211473	Fee-for-Service	1851753115	1851753115	1	1	ESCANDON, MARTIN MD	9/22/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	150832	08	Family Practice	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
211483	Fee-for-Service	1558659714	1558659714	1	1	EL PASO CHILDRENS HOSPITAL	3/20/2012	282NC2000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORPORATION	4845 ALAMEDA AVE	None	EL PASO	TX	79905	2705	00	None	31.77075303	-106.4346393	El Paso County
211506	Fee-for-Service	1235151242	1235151242	2	1	EVERETTE, RACHEL M MD	1/7/2025	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	9300 W SUNSET RD	None	LAS VEGAS	NV	89148	4844	00	None	36.072729	-115.295094	Clark County
211508	Fee-for-Service	1821187055	1821187055	1	1	EDWARDS, ALLYSON J	6/20/2014	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4151 FOOTHILL ROAD	None	SANTA BARBARA	CA	93110	1110	42	06083	34.45144647	-119.7604485	Santa Barbara County
211635	Fee-for-Service	1780130039	1780130039	1	1	ESTRELLA, LELAND R CNP	7/1/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	520 WEST I ST	None	LOS BANOS	CA	95616	6201	24	06047	37.06346603	-120.8593647	Merced County
211771	Fee-for-Service	1558659714	1558659714	1	1	EL PASO CHILDRENS HOSPITAL	3/20/2012	282NC2000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORPORATION	4845 ALAMEDA AVE	None	EL PASO	TX	79905	2705	00	None	31.77075303	-106.4346393	El Paso County
211906	Fee-for-Service	1891038055	1891038055	1	1	ESTREMERA, GABRIEL MD	9/1/2020	2086S0127X	NA	General Surgery	026	PHYSICIANS	163081	02	General Surgery	0	In state provider	None	160 E. ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	19	06037	34.07556833	-117.7507835	Los Angeles County
211967	Fee-for-Service	1285689133	1285689133	1	1	EAST TEXAS MED CTR JACKSONVI	1/10/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	501 S RAGSDALE ST	None	JACKSONVILLE	TX	75766	2434	00	None	31.96068839	-95.27020112	Cherokee County
211992	Fee-for-Service	1750782249	1750782249	1	1	ELYSSA J. FEINBERG, MD PC	12/21/2020	208600000X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	20103 LAKE CHABOT RD.	None	CASTRO VALLEY	CA	94546	4062	01	06001	37.698264	-122.090112	Alameda County
212139	Fee-for-Service	1548464076	1548464076	1	1	ELDER OPTIONS, INC	2/7/2006	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	None	630 MAIN STREET	None	PLACERVILLE	CA	95667	5704	09	06017	38.72927258	-120.7948761	El Dorado County
212193	Fee-for-Service	1891038055	1891038055	1	1	ESTREMERA, GABRIEL MD	9/1/2020	2086S0127X	NA	General Surgery	026	PHYSICIANS	163081	89	Surgery-Traumatic	0	In state provider	None	160 E. ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	19	06037	34.07556833	-117.7507835	Los Angeles County
212258	Fee-for-Service	1285689133	1285689133	1	1	EAST TEXAS MED CTR JACKSONVI	4/26/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	501 S RAGSDALE ST	None	JACKSONVILLE	TX	75766	2434	00	None	31.96068839	-95.27020112	Cherokee County
212285	Fee-for-Service	1780107797	1780107797	1	18	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	3300 WEBSTER STREET	STE 710	OAKLAND	CA	94609	4122	01	06001	37.82132826	-122.2621843	Alameda County
212292	Fee-for-Service	1386675015	1386675015	1	1	EMERGENCY PHYSICIANS MED	5/31/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	ASSOCIATES OF LONG BEACH	1720 TERMINO AVE	None	LONG BEACH	CA	90804	2104	19	06037	33.78889871	-118.1458784	Los Angeles County
212365	Fee-for-Service	1952936643	1952936643	1	1	ESCEND HOSPICE LLC	6/9/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6621 VAN NUYS BLVD	STE 104	VAN NUYS	CA	91405	4673	19	06037	34.19138471	-118.4487668	Los Angeles County
212424	Fee-for-Service	1548464076	1548464076	1	1	ELDER OPTIONS, INC	9/1/2009	No Taxonomy Provided	NA	None	069	PROFESSIONAL CORPORATION	-	-	NOT APPLICABLE	0	In state provider	None	630 MAIN STREET	None	PLACERVILLE	CA	95667	5704	09	06017	38.72927258	-120.7948761	El Dorado County
212427	Fee-for-Service	1346315199	1346315199	1	1	ELAM, NANCY R	6/13/2003	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	191 BURTON MESA BLVD	STE B	LOMPOC	CA	93436	1400	42	06083	34.70401649	-120.4647615	Santa Barbara County
212574	Fee-for-Service	1780107797	1780107797	1	18	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	3300 WEBSTER STREET	STE 710	OAKLAND	CA	94609	4122	01	06001	37.82132826	-122.2621843	Alameda County
212620	Fee-for-Service	1164159489	1164159489	1	1	EVANS, CHRISTINA LCSW	8/29/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	308 W STATE ST	STE 3D	REDLANDS	CA	92373	4653	36	06071	34.05649746	-117.18603	San Bernardino County
212653	Fee-for-Service	1952936643	1952936643	1	1	ESCEND HOSPICE LLC	6/9/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6621 VAN NUYS BLVD	STE 104	VAN NUYS	CA	91405	4673	19	06037	34.19138471	-118.4487668	Los Angeles County
212655	Fee-for-Service	1508100389	1508100389	1	2	EYE SMART OPTOMETRY, INC	2/14/2013	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9200 BOLSA AVE	#119A	WESTMINSTER	CA	92683	5500	30	06059	33.74474049	-117.9686809	Orange County
212657	Fee-for-Service	1538125620	1538125620	1	1	EUSTERBROCK, THOMAS MD	5/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	41036	40	Pediatrics	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
212714	Fee-for-Service	1073127189	1073127189	1	1	EROS HOME HEALTH CARE INC	6/15/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	9795 CABRINI DR	STE 203	BURBANK	CA	91504	1739	19	06037	34.20957984	-118.3438935	Los Angeles County
212759	Fee-for-Service	1447615638	1447615638	1	1	EXPRESS TRANSPORTATION	4/30/2018	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	AGENCY	10032 COMMERCE AVE	None	TUJUNGA	CA	91042	2304	19	06037	34.25114558	-118.2886064	Los Angeles County
212808	Fee-for-Service	1104818137	1104818137	2	1	ESPIRITU, JOCELYN I MD	4/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	64533	None	None	0	In state provider	None	1524 MCHENRY AVENUE	SUITE 100	MODESTO	CA	95350	4566	50	06099	37.666233	-120.993933	Stanislaus County
212863	Fee-for-Service	1780107797	1780107797	1	18	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	3300 WEBSTER STREET	STE 710	OAKLAND	CA	94609	4122	01	06001	37.82132826	-122.2621843	Alameda County
212913	Fee-for-Service	1295295723	1295295723	1	1	EXUME, DOMINIQUE MD	9/26/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	188306	None	None	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
213196	Fee-for-Service	1710955182	1710955182	1	1	ENRIQUE BENIQUEZ NIEVES	10/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	125 W HAGUE RD	STE 590	EL PASO	TX	79902	5808	00	None	31.77017683	-106.4996599	El Paso County
213227	Fee-for-Service	1174501225	1174501225	1	1	EXUM, JANICE M	6/26/2004	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	66570	None	None	0	In state provider	None	555 W COMPTON BLVD	STE 202	COMPTON	CA	90220	3092	19	06037	33.89593853	-118.233513	Los Angeles County
213291	Fee-for-Service	1245224252	1245224252	1	1	ELLEN MARY MCMANUS, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	555 S 18TH STREET	None	COLUMBUS	OH	43205	2654	00	None	39.95323846	-82.9765048	Franklin County
213305	Fee-for-Service	1659875847	1659875847	1	1	ESCOBAR, DOMENIQUE MD	7/9/2024	208800000X	NA	Other	026	PHYSICIANS	163638	34	Urology and Urological Surgery	0	In state provider	None	1520 SAN PABLO ST	STE 1000A	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
213322	Fee-for-Service	1003988676	1003988676	1	1	ELIXAIR MEDICAL, INC	3/14/2006	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	12035 BURKE ST	None	SANTA FE SPRINGS	CA	90670	8633	19	06037	33.96185527	-118.059891	Los Angeles County
213383	Fee-for-Service	1720432248	1720432248	1	1	EARL-ROYAL, EMILY MD	4/11/2022	207P00000X	NA	Other	026	PHYSICIANS	150716	None	None	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
213442	Fee-for-Service	1750707667	1750707667	1	1	ENGLAND, LINDA LMFT	10/29/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1611 S PACIFIC COAST HWY	STE 204	REDONDO BEACH	CA	90277	5611	19	06037	33.81973754	-118.3853919	Los Angeles County
213538	Fee-for-Service	1144494642	1144494642	1	1	EASTON-CARR, RAUL B MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110827	66	Emergency Medicine (Urgent Care)	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
213541	Fee-for-Service	1457709321	1457709321	1	1	ENTABI, ANAS MD INC	8/4/2016	207R00000X	NA	Other	026	PHYSICIANS	89044	None	None	0	In state provider	None	38925 TRADE CENTER DR	STE H	PALMDALE	CA	93551	3655	19	06037	34.59028112	-118.1433053	Los Angeles County
213592	Fee-for-Service	1366417305	1366417305	1	1	ENGLE, KRISTEN L MD	8/24/2016	208600000X	NA	General Surgery	026	PHYSICIANS	76696	02	General Surgery	0	In state provider	None	2615 CHESTER AVENUE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
213814	Fee-for-Service	1992322168	1992322168	1	1	EBERHART, TESSIE L NP	11/17/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
213847	Fee-for-Service	1861852030	1861852030	1	1	EVERGREEN PHARMACY INC	11/20/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2365 QUIMBY RD	STE 150	SAN JOSE	CA	95122	1337	43	06085	37.325106	-121.8094335	Santa Clara County
213878	Fee-for-Service	1245519651	1245519651	1	1	EPIC MEDICAL CENTER	9/3/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 HOSPITAL DR	None	EUFAULA	OK	74432	4010	00	None	35.30852688	-95.59287941	McIntosh County
213930	Fee-for-Service	1174638530	1174638530	1	1	EISNER, DAVID MD	1/31/1984	207P00000X	NA	Other	026	PHYSICIANS	48001	None	None	0	In state provider	None	3828 HUGHES AVE	None	CULVER CITY	CA	90232	2716	19	06037	34.02263554	-118.3982389	Los Angeles County
214016	Fee-for-Service	1245494822	1245494822	1	1	ELDRIDGE, CHARLES D MD	2/8/2015	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	29613	04	Otology, Laryngology, Rhinology	0	In state provider	None	3313 MISSION DR	None	SANTA CRUZ	CA	95065	1827	44	06087	36.99102829	-121.9802419	Santa Cruz County
214095	Fee-for-Service	1467577023	1467577023	1	1	ESPINO, SYLVIA LCSW	11/13/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1338 CENTER COURT DR	SUITE 211	COVINA	CA	91724	3681	19	06037	34.0724419	-117.8624967	Los Angeles County
214118	Fee-for-Service	1619109378	1619109378	1	1	ESHRAGHI, RAUZ A MD	4/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116804	None	None	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
214129	Fee-for-Service	1316576895	1316576895	1	1	ELPERIN, JASON DO	10/31/2023	208M00000X	NA	Other	026	PHYSICIANS	20257	None	None	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
214174	Fee-for-Service	1891174785	1891174785	1	1	ENTWISTLE, WILLIAM M MD	10/5/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	153095	08	Family Practice	0	In state provider	None	220 E 13TH ST	None	MERCED	CA	95340	6242	24	06047	37.29309532	-120.4748791	Merced County
214212	Fee-for-Service	1194306878	1194306878	1	1	EASTERBROOK, SIMONE DO	1/10/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21144	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
214225	Fee-for-Service	1770710196	1770710196	1	1	EL-KHOURY, BASHIR MD	7/3/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	120670	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
214269	Fee-for-Service	1053647453	1053647453	1	1	ELIZARRARAS, MARISOL	6/13/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
214344	Fee-for-Service	1902496946	1902496946	1	1	EHLER, ALEXIS M CNP	3/18/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16773 BERNARDO CENTER DR	None	SAN DIEGO	CA	92128	2525	37	06073	33.01874412	-117.0752752	San Diego County
214353	Fee-for-Service	1407807100	1407807100	1	1	ETTYREADY, MOHAN MD	9/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82879	05	Anesthesiology	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
214471	Fee-for-Service	1093921959	1093921959	1	1	ELDER, REBECCA N	8/19/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3840 HOMESTEAD RD	None	SANTA CLARA	CA	95051	4542	43	06085	37.33774954	-122.002065	Santa Clara County
214504	Fee-for-Service	1184676785	1184676785	1	1	ELSAKR, MAGDY S.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	45724	41	Internal Medicine	0	In state provider	None	1401 SPANOS COUTE	STE 207	MODESTO	CA	95355	0000	50	06099	37.66975543	-120.9724048	Stanislaus County
214566	Fee-for-Service	1164089801	1164089801	1	1	ESCOBAR-DIAZ, GISSELLE PT	3/5/2020	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1301 W ARROW HWY	130	SAN DIMAS	CA	91773	2330	19	06037	34.10677054	-117.8331379	Los Angeles County
214604	Fee-for-Service	1356427512	1356427512	2	1	ELSHEIKH, HUSAM Y MD	2/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	41651	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5565 GROSSMONT CENTER DR	SUITE 227	LA MESA	CA	91942	3026	37	06073	32.77978322	-117.0094766	San Diego County
214634	Fee-for-Service	1194786079	1194786079	1	1	ELIZABETH FOSTER MD	5/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	811 13TH ST	None	HOOD RIVER	OR	97031	1204	00	None	45.70453292	-121.5251149	Hood River County
214710	Fee-for-Service	1730935784	1730935784	1	1	EDIGER, TRAVIS PT	1/18/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1340 LAKE BLVD	None	DAVIS	CA	95616	2619	57	06113	38.55491538	-121.7876886	Yolo County
214765	Fee-for-Service	1487649521	1487649521	1	1	ERIC ANDING	3/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5121 S COTTONWOOD ST	None	MURRAY	UT	84107	5701	00	None	40.659588	-111.891798	Salt Lake County
214814	Fee-for-Service	1851471775	1851471775	1	1	ELIZABETH M DORN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	325 9TH AVE	None	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
214829	Fee-for-Service	1013981554	1013981554	1	1	EISENHOWER MEDICAL CENTER	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	BUSINESS OFFICE	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
214893	Fee-for-Service	1356427512	1356427512	2	1	ELSHEIKH, HUSAM Y MD	2/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	41651	10	Gastroenterology (M.D. only)	0	In state provider	None	5565 GROSSMONT CENTER DR	SUITE 227	LA MESA	CA	91942	3026	37	06073	32.77978322	-117.0094766	San Diego County
214913	Fee-for-Service	1467530014	1467530014	1	1	EATON, CHRISTOPHER L MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	83805	36	Psychiatry	0	In state provider	None	1330 CUTTING BLVD	None	RICHMOND	CA	94804	2555	07	06013	37.92518651	-122.3564715	Contra Costa County
214943	Fee-for-Service	1245650563	1245650563	1	1	EISENBUD, LAUREN E MD	9/18/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	144434	68	Hematology	0	In state provider	None	23823 VALENCIA BLVD	STE 250	SANTA CLARITA	CA	91355	9512	19	06037	34.41347743	-118.5523087	Los Angeles County
214978	Fee-for-Service	1932141421	1932141421	1	1	ELALI, IBRAHIM	11/7/2023	207RN0300X	NA	Nephrology	026	PHYSICIANS	86653	None	None	0	In state provider	None	21840 S NORMANDIE AVE	STE 100A	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
215064	Fee-for-Service	1194985481	1194985481	1	1	ENG, KATHARINE T MD	11/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	109805	10	Gastroenterology (M.D. only)	0	In state provider	None	28078 BAXTER RD	STE 530	MURRIETA	CA	92563	1405	33	06065	33.615	-117.1670265	Riverside County
215135	Fee-for-Service	1336589290	1336589290	1	1	ELLIS, DESTI AMBER LCSW	8/15/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	80994	-	NOT APPLICABLE	0	In state provider	None	801 11TH STREET	None	MODESTO	CA	95354	2324	50	06099	37.63952026	-120.9974274	Stanislaus County
215142	Fee-for-Service	1659350858	1659350858	1	1	ELMARIAH, SAMMY MD	11/23/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	183269	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
215372	Fee-for-Service	1285975516	1285975516	1	1	EWING, STACEY M	8/1/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1340 LAKE BLVD	None	DAVIS	CA	95616	5673	57	06113	38.55491538	-121.7876886	Yolo County
215451	Fee-for-Service	1770953143	1770953143	1	1	EGU, KAREN C PSYD	10/20/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
215567	Fee-for-Service	1588943898	1588943898	1	1	ELIAS, GEORGE R MD	7/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134990	36	Psychiatry	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5313	19	06037	34.06269295	-118.2030006	Los Angeles County
215568	Fee-for-Service	1346311388	1346311388	1	1	EVANS, ALAN D MD	1/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74274	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
215678	Fee-for-Service	1417434176	1417434176	2	1	EPIDAURUS	1/21/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2260 WATSON WAY	None	VISTA	CA	92083	7924	37	06073	33.1646328	-117.2222831	San Diego County
215692	Fee-for-Service	1043461239	1043461239	1	1	EBERHARDT, ROXANNE L	9/30/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	330 FLUME ST	STE 100	CHICO	CA	95928	5400	04	06007	39.73048207	-121.8372333	Butte County
215706	Fee-for-Service	1013981554	1013981554	1	32	EISENHOWER MEDICAL CENTER	10/27/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	39700 BOB HOPE DRIVE	SUITE 203	RANCHO MIRAGE	CA	92270	7122	33	06065	33.760683	-116.4080645	Riverside County
215768	Fee-for-Service	1962770065	1962770065	1	1	EARLIMART ELEMENTARY SCHOOL	7/1/2011	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	785 EAST CENTER AVENUE	None	EARLIMART	CA	93219	0000	54	06107	35.88618721	-119.2683895	Tulare County
215771	Fee-for-Service	1285741124	1285741124	1	1	EILENBERG, STEVEN S	9/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	68022	30	Radiology	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
215991	Fee-for-Service	1376598425	1376598425	1	1	EISENSTEIN, ISAAC MD	5/31/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3650 SOUTH ST	STE 310	LAKEWOOD	CA	90712	1519	19	06037	33.86019847	-118.149255	Los Angeles County
216010	Fee-for-Service	1851649842	1851649842	1	1	ESTIPONA, BRIAN V OT	3/1/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94603	2037	41	06081	37.48948529	-122.2232468	San Mateo County
216032	Fee-for-Service	1558973446	1558973446	1	1	ELEGANT HOSPICE CARE	10/31/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4869 TOPANGA CANYON BLVD	STE 11	WOODLAND HILLS	CA	91364	4261	19	06037	34.156404	-118.605838	Los Angeles County
216109	Fee-for-Service	1760828909	1760828909	1	1	ESTRELLADO, AIMEE G MD	11/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135273	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
216141	Fee-for-Service	1144725466	1144725466	1	1	EINBINDER, SAMUEL M MD	3/2/2022	207R00000X	NA	Other	026	PHYSICIANS	175523	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
216270	Fee-for-Service	1013981554	1013981554	1	31	EISENHOWER MEDICAL CENTER	6/18/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	415 SOUTH PALM CANYON DR	2ND FLOOR, SUITE 201	PALM SPRINGS	CA	92262	7303	33	06065	33.817446	-116.5468195	Riverside County
216323	Fee-for-Service	1558973446	1558973446	1	1	ELEGANT HOSPICE CARE	10/31/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4869 TOPANGA CANYON BLVD	STE 11	WOODLAND HILLS	CA	91364	4261	19	06037	34.156404	-118.605838	Los Angeles County
216324	Fee-for-Service	1083278220	1083278220	1	1	ELIZONDO-FESSLER, AMANDA	10/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
216349	Fee-for-Service	1679620462	1679620462	1	1	ENGEL, DENA L MD	5/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127691	34	Urology and Urological Surgery	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
216441	Fee-for-Service	1427326677	1427326677	1	1	ENCINITAS ENDOSCOPY CENTER	12/30/2011	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	700 GARDEN VIEW	SUITE 101	ENCINITAS	CA	92024	2478	37	06073	33.05922419	-117.260629	San Diego County
216583	Fee-for-Service	1699748731	1699748731	1	1	EL-SABAWI, RASHAD M MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	51480	05	Anesthesiology	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
216585	Fee-for-Service	1669573218	1669573218	1	1	EDDY-BERTRAND, ELIZABETH	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	80676	08	Family Practice	0	In state provider	MD	18350 ROSCOE BLVD	STE 600	NORTHRIDGE	CA	91325	4187	19	06037	34.22071855	-118.5341175	Los Angeles County
216588	Fee-for-Service	1881379980	1881379980	1	1	ESPANOL, MATTHEW C PT	9/19/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39650 LIBERTY ST	SUITE 140	FREMONT	CA	94538	2225	01	06001	37.54662058	-121.9736002	Alameda County
216627	Fee-for-Service	1790073385	1790073385	1	1	EHSAN, AMIRPASHA MD	4/27/2022	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	123790	None	None	0	In state provider	None	101 E VALENCIA MESA DR.	None	FULLERTON	CA	92835	3809	30	06059	33.89356031	-117.9271656	Orange County
216649	Fee-for-Service	1114144649	1114144649	1	1	EVENS, ALEXANDER R DO	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	9461	77	Infectious Disease	0	In state provider	None	100 A DRAKES LANDING RD	SUITE 225	GREENBRAE	CA	94904	3119	21	06041	37.94379317	-122.5182162	Marin County
216666	Fee-for-Service	1255591228	1255591228	1	1	EAPEN, BINAY C MD	7/15/2021	207R00000X	NA	Other	026	PHYSICIANS	171827	None	None	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
216692	Fee-for-Service	1467447037	1467447037	1	1	ENSIGN PANORAMA, LLC	9/1/2000	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9541 VAN NUYS BLVD	None	PANORAMA CITY	CA	91402	1315	19	06037	34.24404639	-118.4502683	Los Angeles County
216935	Fee-for-Service	1114144649	1114144649	1	1	EVENS, ALEXANDER R DO	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	9461	41	Internal Medicine	0	In state provider	None	100 A DRAKES LANDING RD	SUITE 225	GREENBRAE	CA	94904	3119	21	06041	37.94379317	-122.5182162	Marin County
216952	Fee-for-Service	1437676020	1437676020	1	1	ELLIS, ASHLI	6/20/2022	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2131 CAPITOL AVE	SUITE 206	SACRAMENTO	CA	95816	5755	34	06067	38.573073	-121.4788005	Sacramento County
217015	Fee-for-Service	1053442285	1053442285	1	1	EARL, BRIDGET M LMFT	5/15/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	288 W 9TH ST	None	UPLAND	CA	91786	5949	36	06071	34.0960435	-117.6548445	San Bernardino County
217082	Fee-for-Service	1720228406	1720228406	1	1	EBORN, TREVR W CRNA	1/1/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	450 GREENFIELD AVENUE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
217173	Fee-for-Service	1134653298	1134653298	1	1	ECKHERT, ERIK MD	8/11/2023	207RH0000X	NA	Hematology	026	PHYSICIANS	158953	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
217204	Fee-for-Service	1073588711	1073588711	1	1	EDWARD W SPARROW HOSPITAL	8/8/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ASSOCIATION	1215 E MICHIGAN AVE	None	LANSING	MI	48912	1811	00	None	42.73359353	-84.5352135	Ingham County
217218	Fee-for-Service	1538208236	1538208236	1	1	ESTRELLA, GUSTAVO E MD	7/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	62006	08	Family Practice	0	In state provider	None	1250 N AVALON BLVD	None	WILMINGTON	CA	90744	2602	19	06037	33.78817201	-118.2630512	Los Angeles County
217379	Fee-for-Service	1114538782	1114538782	2	1	ELEVATE PHYSICAL THERAPY	3/1/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1920 BARNEY RD	None	ANDERSON	CA	96007	4337	45	06089	40.43891956	-122.290538	Shasta County
217436	Fee-for-Service	1790747814	1790747814	1	1	ESCONDIDO UROLOGY MED	2/1/1990	208800000X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	GROUP, INC	303 S JUNIPER ST	None	ESCONDIDO	CA	92025	4924	37	06073	33.12109232	-117.0774574	San Diego County
217492	Fee-for-Service	1073588711	1073588711	1	1	EDWARD W SPARROW HOSPITAL	8/8/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ASSOCIATION	1215 E MICHIGAN AVE	None	LANSING	MI	48912	1811	00	None	42.73359353	-84.5352135	Ingham County
217499	Fee-for-Service	1083058416	1083058416	1	1	ENGLAND, JASMIN T MD	11/7/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	133644	40	Pediatrics	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
217515	Fee-for-Service	1902844939	1902844939	1	1	EZZAT, MONA M MD	7/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76556	08	Family Practice	0	In state provider	None	1455 MONTEGO	STE 205	WALNUT CREEK	CA	94598	2957	07	06013	37.91046956	-122.0418669	Contra Costa County
217602	Fee-for-Service	1073935664	1073935664	1	1	EXCELCARE HOSPICE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	937 VIA LATA	SUITE 200	COLTON	CA	92324	3971	36	06071	34.0553925	-117.3070187	San Bernardino County
217648	Fee-for-Service	1710919899	1710919899	1	1	EDELMAN, JONATHAN S MD	3/23/2020	207L00000X	NA	Other	026	PHYSICIANS	153720	05	Anesthesiology	0	In state provider	None	1205 E NORTH ST	None	MANTECA	CA	95336	4932	39	06077	37.80110374	-121.1974853	San Joaquin County
217683	Fee-for-Service	1497235915	1497235915	1	1	EIKAMP, VERONICA T RCP	9/24/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
217775	Fee-for-Service	1669611299	1669611299	1	1	EATON, AUDREY L NP	1/21/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
217822	Fee-for-Service	1689722621	1689722621	1	1	ECKLUND, HUNG N MD	8/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86530	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
217849	Fee-for-Service	1376577387	1376577387	1	1	EYAD ABOCHALE	11/24/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	STE 900	LITTLE ROCK	AR	72205	6331	00	None	34.744437	-92.3813595	Pulaski County
217851	Fee-for-Service	1033545801	1033545801	1	1	ECKFELD, ARIEL J PHD	11/15/2019	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVE	SUITE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
217889	Fee-for-Service	1073935664	1073935664	1	1	EXCELCARE HOSPICE, INC	6/22/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	937 VIA LATA	SUITE 200	COLTON	CA	92324	3971	36	06071	34.0553925	-117.3070187	San Bernardino County
217937	Fee-for-Service	1821118837	1821118837	1	1	EZZAT, WALEED H MD	7/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113010	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
218090	Fee-for-Service	1932769684	1932769684	1	1	EXCEL SPECIALTY PHARMACY LLC	5/7/2020	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	604 N MAGNOLIA AVENUE	105	CLOVIS	CA	93611	9205	10	06019	36.83939464	-119.6661479	Fresno County
218146	Fee-for-Service	1013981554	1013981554	1	33	EISENHOWER MEDICAL CENTER	5/22/2017	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	39000 BOB HOPE DRIVE	SUITE 405	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
218207	Fee-for-Service	1235298852	1235298852	1	1	EBBA, JOANNE H MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38048	04	Otology, Laryngology, Rhinology	0	In state provider	None	1100 PACIFIC COAST HWY	None	HARBOR CITY	CA	90710	3511	19	06037	33.7899001	-118.2974971	Los Angeles County
218232	Fee-for-Service	1073088514	1073088514	1	1	EZ ACCESS TRANSPORT CORPORAT	8/26/2021	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ION	24328 S VERMONT AVE	SUITE #313	HARBOR CITY	CA	90710	0000	19	06037	33.80332668	-118.2902866	Los Angeles County
218240	Fee-for-Service	1689968042	1689968042	2	1	EASTSIDE MEDICAL SUPPLY INC	7/24/2013	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2720 E PALMDALE BLVD	STE 124	PALMDALE	CA	93550	4930	19	06037	34.58012347	-118.0800855	Los Angeles County
218248	Fee-for-Service	1689122681	1689122681	1	1	EXCEL HOSPICE INC	4/28/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	29970 TECHNOLOGY DR	SUITE 211	MURRIETA	CA	92563	2649	33	06065	33.5604702	-117.1370275	Riverside County
218292	Fee-for-Service	1750558193	1750558193	1	1	ENEMCHUKWU, EKENE A MD	10/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136792	34	Urology and Urological Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
218502	Fee-for-Service	1548302482	1548302482	1	1	EL-SAYED, YASSER Y MD	8/31/1993	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	73151	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
218532	Fee-for-Service	1295140887	1295140887	1	1	ELLIS, DESTA C MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145794	08	Family Practice	0	In state provider	None	1633 SOUTH COURT STREET	None	VISALIA	CA	93277	4945	54	06107	36.315972	-119.292237	Tulare County
218536	Fee-for-Service	1689122681	1689122681	1	1	EXCEL HOSPICE INC	4/28/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	29970 TECHNOLOGY DR	SUITE 211	MURRIETA	CA	92563	2649	33	06065	33.5604702	-117.1370275	Riverside County
218593	Fee-for-Service	1881824316	1881824316	1	1	ENG, JESSICA A MD	9/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116951	41	Internal Medicine	0	In state provider	None	1 HOAG DRIVE	None	NEWPORT BEACH	CA	92663	3663	30	06059	33.62421676	-117.9309656	Orange County
218614	Fee-for-Service	1699711556	1699711556	2	1	ESCNC LLC	3/15/2013	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	5959 GREENBACK LANE	STE 310	CITRUS HEIGHTS	CA	95621	4700	34	06067	38.681397	-121.322682	Sacramento County
218730	Fee-for-Service	1578669560	1578669560	1	1	EYE CARE ASSOCIATES OF SAN	2/17/2010	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	FRANCISCO, A MEDICAL GRP	490 POST ST	STE 640	SAN FRANCISCO	CA	94102	1418	38	06075	37.78812774	-122.4096884	San Francisco County
218758	Fee-for-Service	1962463901	1962463901	1	1	EAVES, DORCAS M MD	6/20/2019	207PE0004X	NA	Other	026	PHYSICIANS	33534	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2075 SAN JOAQUIN HILLS R	None	NEWPORT BEACH	CA	92660	6505	30	06059	33.61676129	-117.869325	Orange County
218778	Fee-for-Service	1891777124	1891777124	1	1	EGERTER, DANIEL ALLEN MD	11/30/1985	207ZC0500X	NA	Other	026	PHYSICIANS	56649	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	# 5H	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
218791	Fee-for-Service	1407965155	1407965155	1	1	EVANS, AMY E MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	86426	40	Pediatrics	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
218830	Fee-for-Service	1619130713	1619130713	1	1	ERNST, TEO D PSYD	4/20/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
218877	Fee-for-Service	1679634398	1679634398	1	1	ESCHBACH, KRISTA L MD	8/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	79	Neurology-Child	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
218881	Fee-for-Service	1336299072	1336299072	1	1	EXECUTIVE MEDICAL & SURGICAL	12/12/2019	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	900 E WASHINGTON ST	SUITE 300	COLTON	CA	92324	8182	36	06071	34.04820662	-117.3128102	San Bernardino County
218929	Fee-for-Service	1609093608	1609093608	1	1	EIDE, BROOK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	353 FAIRMONT BLVD	None	RAPID CITY	SD	57701	7375	00	None	44.05854729	-103.2246985	Pennington County
218948	Fee-for-Service	1366766123	1366766123	1	1	ESPIRITU, ALBEMAR M DPM	6/15/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
219064	Fee-for-Service	1285067306	1285067306	1	1	EVERHART, SAMANTHA A PHD	11/10/2021	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVE	SUITE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
219104	Fee-for-Service	1154764215	1154764215	1	1	ESPINO, KAREEN Y MD	8/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132469	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
219139	Fee-for-Service	1750754230	1750754230	1	1	ELIEH, ANET F	4/2/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	280 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
219172	Fee-for-Service	1588901532	1588901532	1	40	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4200 E PACIFIC COAST HWY	150	LONG BEACH	CA	90804	2107	19	06037	33.78981346	-118.1439033	Los Angeles County
219263	Fee-for-Service	1568030260	1568030260	1	1	EYE SPECIALTIES MEDICAL GROU	5/12/2022	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	P INC.	20046 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5304	01	06001	37.69862821	-122.0873733	Alameda County
219346	Fee-for-Service	1508836313	1508836313	1	1	ECKHARDT,WILLIAM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1850 N CENTRAL AVE	STE 1600	PHOENIX	AZ	85004	4633	00	None	33.468345	-112.0745205	Maricopa County
219388	Fee-for-Service	1679561971	1679561971	1	1	ESWARA, MARTHANDA S MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50038	01	General Practice	0	In state provider	GENETICARE MEDICAL ASSOC	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
219404	Fee-for-Service	1053664912	1053664912	1	1	EPPS, TIFFANY L NP	7/6/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
219443	Fee-for-Service	1659637080	1659637080	1	1	ESQUIVEL, MICAELA M MD	7/9/2019	208600000X	NA	General Surgery	026	PHYSICIANS	126990	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
219461	Fee-for-Service	1588901532	1588901532	1	40	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4200 E PACIFIC COAST HWY	150	LONG BEACH	CA	90804	2107	19	06037	33.78981346	-118.1439033	Los Angeles County
219517	Fee-for-Service	1588849749	1588849749	1	1	EHTESHAMI-HUNT, ELHAM LMFT	11/17/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 CORPORATE DRIVE	SUITE 260	LADERA RANCH	CA	92694	2180	30	06059	33.55836094	-117.6292574	Orange County
219678	Fee-for-Service	1679561971	1679561971	1	1	ESWARA, MARTHANDA S MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50038	40	Pediatrics	0	In state provider	GENETICARE MEDICAL ASSOC	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
219744	Fee-for-Service	1104845569	1104845569	1	1	ELLIOTT, MICHAEL J	7/1/1998	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	75995	40	Pediatrics	0	In state provider	None	3030 CHILDRENS WAY	STE 410	SAN DIEGO	CA	92123	4228	37	06073	32.798889	-117.150826	San Diego County
219753	Fee-for-Service	1588901532	1588901532	1	40	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	4200 E PACIFIC COAST HWY	150	LONG BEACH	CA	90804	2107	19	06037	33.78981346	-118.1439033	Los Angeles County
219827	Fee-for-Service	1811408933	1811408933	1	1	ETHICS AMERICA INC	11/29/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	23151 ALCALDE DR	SUITE C-2	LAGUNA HILLS	CA	92653	1448	30	06059	33.62269518	-117.7261532	Orange County
219917	Fee-for-Service	1558504852	1558504852	1	1	EMAM, OMID MD	11/19/2013	390200000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	5330 S HWY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
219967	Fee-for-Service	1376617084	1376617084	1	1	ESPINOZA, SYLVIA MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65563	40	Pediatrics	0	In state provider	None	569 ARGUELLO ST	None	REDWOOD CITY	CA	94063	0000	41	06081	37.48741191	-122.2337257	San Mateo County
220013	Fee-for-Service	1043643851	1043643851	1	1	ENGLAND, JOSEPH R MD	5/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132372	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
220038	Fee-for-Service	1538157953	1538157953	1	1	ESTOESTA, BENEDICTO M MD	4/14/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	INC APC	55 S HIGHWAY 26	STE 1	VALLEY SPRINGS	CA	95252	8422	05	06009	38.19099952	-120.8281672	Calaveras County
220039	Fee-for-Service	1588901532	1588901532	1	40	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	4200 E PACIFIC COAST HWY	150	LONG BEACH	CA	90804	2107	19	06037	33.78981346	-118.1439033	Los Angeles County
220048	Fee-for-Service	1346678000	1346678000	1	1	ELAKABAWI, SHARIF F CRNA	6/9/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2040 PACIFIC COAST HWY	None	LOMITA	CA	90717	2660	19	06037	33.78948351	-118.316493	Los Angeles County
220092	Fee-for-Service	1366954695	1366954695	1	1	ENDLESS HOME HEALTH INC	4/26/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	225 E BROADWAY	UNIT 305B	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
220111	Fee-for-Service	1922511187	1922511187	1	1	EVERETT, COREY NP	9/11/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16955 VANOWEN	None	VAN NUYS	CA	91406	4542	19	06037	34.19389751	-118.503342	Los Angeles County
220219	Fee-for-Service	1972505857	1972505857	1	1	EMERGENCY CARE DYNAMICS INC	12/1/1998	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3434 MIDWAY DR	STE 1002	SAN DIEGO	CA	92110	4924	37	06073	32.75065153	-117.2126147	San Diego County
220317	Fee-for-Service	1538157953	1538157953	1	1	ESTOESTA, BENEDICTO M MD	4/14/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INC APC	55 S HIGHWAY 26	STE 1	VALLEY SPRINGS	CA	95252	8422	05	06009	38.19099952	-120.8281672	Calaveras County
220322	Fee-for-Service	1700191137	1700191137	1	1	EN SOLEIL PHARMACY INC	11/19/2010	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5735 EL CAMINO REAL	SUITE H	ATASCADERO	CA	93422	3350	40	06079	35.48999881	-120.6716402	San Luis Obispo County
220324	Fee-for-Service	1588901532	1588901532	1	40	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	4200 E PACIFIC COAST HWY	150	LONG BEACH	CA	90804	2107	19	06037	33.78981346	-118.1439033	Los Angeles County
220338	Fee-for-Service	1215165527	1215165527	1	2	ENVOY HEALTH CARE INC	9/27/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3151 CAHUENGA BLVD WEST	SUITE 320	LOS ANGELES	CA	90068	1768	19	06037	34.12773725	-118.346538	Los Angeles County
220476	Fee-for-Service	1366997801	1366997801	1	1	ELLIOTT, FIELDING T NP	10/29/2021	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
220565	Fee-for-Service	1730966623	1730966623	1	1	ENTERPRISE ELEMENTARY SCHOOL	11/22/2024	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	1155 MISTLETOE LANE	None	REDDING	CA	96002	0000	45	06089	40.57839055	-122.349897	Shasta County
220589	Fee-for-Service	1770896169	1770896169	1	1	ERICKSON, KELLY T MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120327	30	Radiology	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
220666	Fee-for-Service	1497784243	1497784243	1	1	ELDADAH, MAHER K MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	42855	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7060 N RECREATION AVE	STE 101	FRESNO	CA	93720	8022	10	06019	36.8388	-119.7404335	Fresno County
220684	Fee-for-Service	1528105293	1528105293	1	1	EAST LA DIALYSIS CENTER	2/19/2007	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	5830 E WHITTIER BLVD	None	LOS ANGELES	CA	90022	4302	19	06037	34.01782693	-118.1452428	Los Angeles County
220799	Fee-for-Service	1992729461	1992729461	1	1	EAST ADAMS RURAL HOSPITAL	5/15/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	903 S ADAMS ST	None	RITZVILLE	WA	99169	2227	00	None	47.12103402	-118.3723179	Adams County
220831	Fee-for-Service	1376594978	1376594978	1	1	EISENBERG, DANNY MD	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
220877	Fee-for-Service	1770896169	1770896169	1	1	ERICKSON, KELLY T MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120327	78	Neoplastic Diseases/Oncology	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
220906	Fee-for-Service	1093914376	1093914376	1	1	ELIAS, ELIZABETH S LCSW	12/29/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 W WHITTER BOULEVARD	None	MONTEBELLO	CA	90640	4737	19	06037	34.01042334	-118.1099428	Los Angeles County
220955	Fee-for-Service	1497784243	1497784243	1	1	ELDADAH, MAHER K MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	42855	40	Pediatrics	0	In state provider	None	7060 N RECREATION AVE	STE 101	FRESNO	CA	93720	8022	10	06019	36.8388	-119.7404335	Fresno County
221001	Fee-for-Service	1538191507	1538191507	1	1	ESHRAGHI, SHERVIN MD	10/28/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	172941	None	None	0	In state provider	None	18133 VENTURA BLVD	300 3RD FLOOR	TARZANA	CA	91356	3612	19	06037	34.1657808	-118.5283188	Los Angeles County
221004	Fee-for-Service	1427081165	1427081165	1	1	EAST BAY PEDIATRIC	8/1/2002	193400000X	NA	Other	022	PHYSICIANS GROUP	-	35	Pediatric Cardiology (M.D. only)	0	In state provider	CARDIOLOGY MED GRP INC	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
221024	Fee-for-Service	1518047851	1518047851	1	1	ENCISO, JOSEPHINE M MD	8/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98123	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	BLDG 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
221077	Fee-for-Service	1245529841	1245529841	1	1	EIKERMANN, ERIC S MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123898	05	Anesthesiology	0	In state provider	None	3626 RUFFIN ROAD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
221100	Fee-for-Service	1053372904	1053372904	1	1	ELLISON, STEFANIE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	UNIVERSITY PHY ASSOC	2301 HOLMES ST	None	KANSAS CITY	MO	64108	0000	00	None	39.08455286	-94.57578107	Jackson County
221137	Fee-for-Service	1962744631	1962744631	1	1	EMPIRE PODIATRY, INC	5/7/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	24640 JEFFERSON AVE	STE 109	MURRIETA	CA	92562	9027	33	06065	33.56027016	-117.2095112	Riverside County
221193	Fee-for-Service	1164587895	1164587895	1	1	EPSTEIN, FLAVIO R PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
221271	Fee-for-Service	1033597687	1033597687	1	1	ELIA, GREGORY MD	10/7/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	171846	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
221311	Fee-for-Service	1417051566	1417051566	1	1	ELK CITY AMBULANCE SERVICES	9/26/2021	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	65 AMERICAN RIVER RD	None	ELK CITY	ID	83525	0000	00	None	45.82738253	-115.4365252	Idaho County
221443	Fee-for-Service	1396155982	1396155982	1	1	ESSILFIE, ANTHONY MD	10/18/2021	163WX0800X	NA	Other	026	PHYSICIANS	138394	None	None	0	In state provider	None	25455 BARTON RD	101B 102B 104B 106B 108B	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
221473	Fee-for-Service	1881054997	1881054997	1	1	EMANATE HEALTH MEDICAL GROUP	4/25/2018	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS	1135 S SUNSET AVE	STE 408	WEST COVINA	CA	91790	3964	19	06037	34.06215064	-117.9453997	Los Angeles County
221474	Fee-for-Service	1780107797	1780107797	1	15	EPIC CARE	4/24/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	106 LA CASA VIA	STE 200	WALNUT CREEK	CA	94598	3012	07	06013	37.91255783	-122.0428047	Contra Costa County
221492	Fee-for-Service	1073788816	1073788816	1	1	EVANS, GREGORY MD	2/21/2025	207LC0200X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
221519	Fee-for-Service	1821266008	1821266008	1	1	EBRAHIMI, KAMYAR Y MD	3/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91899	34	Urology and Urological Surgery	0	In state provider	None	11370 ANDERSON STREET	STE 1100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
221564	Fee-for-Service	1154682367	1154682367	1	1	EL-MENSHAWI, YOSRA A DO	2/11/2019	2084P0804X	NA	Psychiatry	026	PHYSICIANS	13340	36	Psychiatry	0	In state provider	None	2250 HAYES ST	STE 302	SAN FRANCISCO	CA	94117	1078	38	06075	37.77302042	-122.45342	San Francisco County
221629	Fee-for-Service	1841500253	1841500253	1	1	EASTSIDE DIABETES CARE	12/28/2010	207RE0101X	NA	Endocrinology	026	PHYSICIANS	33652	41	Internal Medicine	0	In state provider	MEDICAL CLINIC INC	5836 E BEVERLY BLVD	None	LOS ANGELES	CA	90022	2824	19	06037	34.02566641	-118.1429993	Los Angeles County
221638	Fee-for-Service	1972693539	1972693539	1	1	ELSER, JOSEPH M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4301 W MARKHAM STREET	SLOT 783	LITTLE ROCK	AR	72202	7101	00	None	34.749009	-92.320101	Pulaski County
221639	Fee-for-Service	1902876683	1902876683	1	1	ELSAADI, MAGDI MD	5/31/1991	207R00000X	NA	Other	026	PHYSICIANS	49507	41	Internal Medicine	0	In state provider	None	1786 N RIVERSIDE AVE	STE 1	RIALTO	CA	92376	8059	36	06071	34.132068	-117.3704665	San Bernardino County
221671	Fee-for-Service	1497346134	1497346134	1	1	ELIZABETH DANDENELL MARRIAGE	12/28/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	RELIEF	2223 SANTA CLARA AVE	STE B5	ALAMEDA	CA	94501	4469	01	06001	37.76685808	-122.2452973	Alameda County
221704	Fee-for-Service	1538214036	1538214036	1	1	ELISABETH JAPPY	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SALEM HOSPITAL	665 WINTER ST SE	None	SALEM	OR	97301	0000	00	None	44.933211	-123.0355125	Marion County
221714	Fee-for-Service	1407969116	1407969116	1	1	EDELBLUTE, TIMOTHY MD	2/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	665 WINTER ST	None	SALEM	OR	97301	0000	00	None	44.933211	-123.0355125	Marion County
221764	Fee-for-Service	1780107797	1780107797	1	15	EPIC CARE	4/24/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	106 LA CASA VIA	STE 200	WALNUT CREEK	CA	94598	3012	07	06013	37.91255783	-122.0428047	Contra Costa County
221904	Fee-for-Service	1275690562	1275690562	1	1	EL CAMINO PED MED GRP IN	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	None	477 N EL CAMINO REAL	None	ENCINITAS	CA	92024	1328	37	06073	33.05700866	-117.262449	San Diego County
221916	Fee-for-Service	1104139104	1104139104	1	1	ENFIELD, FAITH M OD	4/28/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2150 N WATERMAN AVE	STE 201	SAN BERNARDINO	CA	92404	4811	36	06071	34.134705	-117.2787865	San Bernardino County
221918	Fee-for-Service	1841500253	1841500253	1	1	EASTSIDE DIABETES CARE	12/28/2010	207RE0101X	NA	Endocrinology	026	PHYSICIANS	33652	67	Endocrinology	0	In state provider	MEDICAL CLINIC INC	5836 E BEVERLY BLVD	None	LOS ANGELES	CA	90022	2824	19	06037	34.02566641	-118.1429993	Los Angeles County
221941	Fee-for-Service	1043837784	1043837784	1	1	EBOKA, NKECHIYERE N DO	2/10/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21353	08	Family Practice	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
222036	Fee-for-Service	1437262474	1437262474	1	1	ESPOSO, ORIENTE M MD	12/1/2003	174400000X	NA	Other	026	PHYSICIANS	42316	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1524 27TH ST	STE 201	BAKERSFIELD	CA	93301	2056	15	06029	35.38387747	-119.0197575	Kern County
222052	Fee-for-Service	1780107797	1780107797	1	15	EPIC CARE	4/24/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	106 LA CASA VIA	STE 200	WALNUT CREEK	CA	94598	3012	07	06013	37.91255783	-122.0428047	Contra Costa County
222084	Fee-for-Service	1235120767	1235120767	1	1	ERIKSEN, LEIF D MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85576	66	Emergency Medicine (Urgent Care)	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
222150	Fee-for-Service	1891291506	1891291506	1	1	ELKIN, DAVID MD	7/28/2022	207P00000X	NA	Other	026	PHYSICIANS	174573	None	None	0	In state provider	None	1100 BUTTE STREET	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
222163	Fee-for-Service	1366080517	1366080517	1	1	ENOMOTO, ALLISON K CNP	3/23/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25272 MARGUERITE PKWY	None	MISSION VIEJO	CA	92692	2901	30	06059	33.59591616	-117.6586221	Orange County
222181	Fee-for-Service	1396797809	1396797809	1	1	ENNA, MATTHEW J MD	8/20/2009	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	100628	20	Orthopedic Surgery	0	In state provider	None	215 PESETAS LANE	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
222192	Fee-for-Service	1275690562	1275690562	1	1	EL CAMINO PED MED GRP IN	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	477 N EL CAMINO REAL	None	ENCINITAS	CA	92024	1328	37	06073	33.05700866	-117.262449	San Diego County
222217	Fee-for-Service	1588901532	1588901532	1	5	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	6440 PLATT AVE	None	WEST HILLS	CA	91307	3216	19	06037	34.18784988	-118.6427021	Los Angeles County
222218	Fee-for-Service	1588901532	1588901532	1	27	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3160 E DEL MAR BLVD	101	PASADENA	CA	91107	4649	19	06037	34.14217551	-118.085292	Los Angeles County
222239	Fee-for-Service	1558382986	1558382986	1	1	EDGECOMB, CORYDON G OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1287 BROADWAY	None	PLACERVILLE	CA	95667	5805	09	06017	38.73166761	-120.783958	El Dorado County
222310	Fee-for-Service	1972827731	1972827731	2	1	ERICA K RAPP	2/13/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
222378	Fee-for-Service	1720184716	1720184716	1	1	EAST BAY PULMONARY MED	8/13/1981	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2070 CLINTON AVE	None	ALAMEDA	CA	94501	4320	01	06001	37.76333626	-122.253868	Alameda County
222481	Fee-for-Service	1700863081	1700863081	1	1	EWING, HOPE H MD	12/31/1989	2083P0011X	NA	Other	026	PHYSICIANS	36227	08	Family Practice	0	In state provider	None	300 FLORENCE AVE	None	MONTEREY PARK	CA	91755	2055	19	06037	34.06507958	-118.1105711	Los Angeles County
222504	Fee-for-Service	1588901532	1588901532	1	14	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	18700 VENTURA BLVD	220	TARZANA	CA	91356	3303	19	06037	34.1707476	-118.5409795	Los Angeles County
222507	Fee-for-Service	1588901532	1588901532	1	27	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	3160 E DEL MAR BLVD	101	PASADENA	CA	91107	4649	19	06037	34.14217551	-118.085292	Los Angeles County
222538	Fee-for-Service	1043420912	1043420912	1	1	ESCOBAR, ANDRES F MD	2/21/2019	207RP1001X	NA	Pulmonology	026	PHYSICIANS	102420	41	Internal Medicine	0	In state provider	None	12462 PUTMAN STREET	SUITE 208	WHITTIER	CA	90602	1049	19	06037	0	0	None
222581	Fee-for-Service	1538695879	1538695879	1	1	ENRIQUEZ, VIVIAN LMFT	7/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	45445 PORTOLA AVE	SUITE 1	PALM DESERT	CA	92260	4844	33	06065	33.7186073	-116.3737698	Riverside County
222666	Fee-for-Service	1720184716	1720184716	1	1	EAST BAY PULMONARY MED	8/13/1981	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2070 CLINTON AVE	None	ALAMEDA	CA	94501	4320	01	06001	37.76333626	-122.253868	Alameda County
222735	Fee-for-Service	1487744819	1487744819	1	1	EL-SANADI, RAEF MD	4/30/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53042	41	Internal Medicine	0	In state provider	None	23340 MOULTON PKWY	None	LAGUNA HILLS	CA	92653	1211	30	06059	33.62338392	-117.7309615	Orange County
222794	Fee-for-Service	1588901532	1588901532	1	5	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	6440 PLATT AVE	None	WEST HILLS	CA	91307	3216	19	06037	34.18784988	-118.6427021	Los Angeles County
222796	Fee-for-Service	1588901532	1588901532	1	27	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	3160 E DEL MAR BLVD	101	PASADENA	CA	91107	4649	19	06037	34.14217551	-118.085292	Los Angeles County
222821	Fee-for-Service	1962503623	1962503623	1	1	EMANUEL, ABRAHAM MD	2/1/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	51787	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8871 VAN NUYS BLVD	None	PANORAMA CITY	CA	91402	2406	19	06037	34.23148572	-118.4503203	Los Angeles County
222826	Fee-for-Service	1043420912	1043420912	1	1	ESCOBAR, ANDRES F MD	2/21/2019	207RP1001X	NA	Pulmonology	026	PHYSICIANS	102420	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	12462 PUTMAN STREET	SUITE 208	WHITTIER	CA	90602	1049	19	06037	0	0	None
222854	Fee-for-Service	1174513113	1174513113	1	1	ELIASON, B CLAIR MD	10/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	36519	08	Family Practice	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
222994	Fee-for-Service	1043256175	1043256175	2	1	EDELSTEIN, ARTHUR J MD	6/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	18506	18	Ophthalmology	0	In state provider	None	3737 MLK JR BLVD	STE 340	LYNWOOD	CA	90262	0000	19	06037	33.92872742	-118.2006921	Los Angeles County
222999	Fee-for-Service	1255408027	1255408027	1	1	ELSE, VERONICA NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	22550 E SAVI RANCH PKWY	None	YORBA LINDA	CA	92887	4670	30	06059	33.87448406	-117.7441707	Orange County
223083	Fee-for-Service	1588901532	1588901532	1	5	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	6440 PLATT AVE	None	WEST HILLS	CA	91307	3216	19	06037	34.18784988	-118.6427021	Los Angeles County
223084	Fee-for-Service	1588901532	1588901532	1	27	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3160 E DEL MAR BLVD	101	PASADENA	CA	91107	4649	19	06037	34.14217551	-118.085292	Los Angeles County
223100	Fee-for-Service	1275525776	1275525776	1	1	EINHORN, DANIEL MD	9/7/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	52088	67	Endocrinology	0	In state provider	None	9850 GENESEE AVE	STE 415	LA JOLLA	CA	92037	1208	37	06073	32.882913	-117.226341	San Diego County
223150	Fee-for-Service	1528298445	1528298445	1	1	EARP, RYAN D MD	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	121287	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
223364	Fee-for-Service	1629348313	1629348313	1	1	EYE 2 EYE FAMILY OPTOMETRY	5/15/2012	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PC	5732 WATT AVE	None	NORTH HIGHLANDS	CA	95660	4752	34	06067	38.671281	-121.3824195	Sacramento County
223369	Fee-for-Service	1588901532	1588901532	1	14	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	18700 VENTURA BLVD	220	TARZANA	CA	91356	3303	19	06037	34.1707476	-118.5409795	Los Angeles County
223371	Fee-for-Service	1588901532	1588901532	1	27	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3160 E DEL MAR BLVD	101	PASADENA	CA	91107	4649	19	06037	34.14217551	-118.085292	Los Angeles County
223388	Fee-for-Service	1275525776	1275525776	1	1	EINHORN, DANIEL MD	9/7/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	52088	41	Internal Medicine	0	In state provider	None	9850 GENESEE AVE	STE 415	LA JOLLA	CA	92037	1208	37	06073	32.882913	-117.226341	San Diego County
223422	Fee-for-Service	1881846434	1881846434	1	1	EHDAIE, ASHKAN MD	3/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111796	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
223488	Fee-for-Service	1861612772	1861612772	1	1	EAPEN, ROSE J MD PC	9/26/2022	207YP0228X	NA	ENT/Otolaryngology	026	PHYSICIANS	154556	None	None	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
223525	Fee-for-Service	1093730277	1093730277	1	1	ELLSWORTH, RICHARD K	1/31/1989	204D00000X	NA	Other	026	PHYSICIANS	4614	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	460 GREENFIELD AVE	STE 1	HANFORD	CA	93230	3500	16	06031	36.3296463	-119.6581535	Kings County
223566	Fee-for-Service	1851445589	1851445589	1	1	ELATROZY, MOHAMED Y MD	2/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	80506	36	Psychiatry	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
223630	Fee-for-Service	1437121183	1437121183	1	1	ESCONDIDO CARD ASSOC INC	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	MEDICAL GROUP	488 E VALLEY PKWY	STE 201	ESCONDIDO	CA	92025	3398	37	06073	33.12523814	-117.0769715	San Diego County
223640	Fee-for-Service	1609361260	1609361260	3	1	ER CARE GROUP GARFIELD A MED	12/10/2021	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ICAL CORPORATION	525 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
223658	Fee-for-Service	1588901532	1588901532	1	14	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18700 VENTURA BLVD	220	TARZANA	CA	91356	3303	19	06037	34.1707476	-118.5409795	Los Angeles County
223668	Fee-for-Service	1982777835	1982777835	1	1	ELBAUM, DAVID J MD	6/25/2018	174400000X	NA	Other	026	PHYSICIANS	46033	07	Dermatology	0	In state provider	None	2323 16TH ST	STE 204	BAKERSFIELD	CA	93301	3453	15	06029	35.37238027	-119.0288508	Kern County
223710	Fee-for-Service	1881846434	1881846434	1	1	EHDAIE, ASHKAN MD	3/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111796	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
223785	Fee-for-Service	1124288907	1124288907	1	1	ESMAIL, FATEMA Q MD	3/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126363	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	SUITE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
223831	Fee-for-Service	1235636713	1235636713	1	1	ESTRELLA, CARLYN J MD	9/8/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173580	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
223852	Fee-for-Service	1851445589	1851445589	1	1	ELATROZY, MOHAMED Y MD	2/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	80506	26	Psychiatry (child)	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
223883	Fee-for-Service	1154350049	1154350049	1	1	EDGERTON HOSPITAL & HOSP	10/16/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11101 N SHERMAN RD	None	EDGERTON	WI	53534	9002	00	None	42.83463076	-89.04308317	Rock County
223898	Fee-for-Service	1821114687	1821114687	1	1	EL MONTE CITY SCHOOL DIS	7/1/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	3540 LEXINGTON AVE	None	EL MONTE	CA	91731	2608	19	06037	34.07340013	-118.0393261	Los Angeles County
223916	Fee-for-Service	1629009071	1629009071	1	1	ENDOSCOPY CENTER OF	7/6/2004	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SANTA MONICA INC	12400 WILSHIRE BLVD	STE 100	LOS ANGELES	CA	90025	1067	19	06037	34.04150435	-118.4706154	Los Angeles County
223946	Fee-for-Service	1588901532	1588901532	1	14	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	18700 VENTURA BLVD	220	TARZANA	CA	91356	3303	19	06037	34.1707476	-118.5409795	Los Angeles County
224127	Fee-for-Service	1861471369	1861471369	1	1	EASTLACK, ROBERT K MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73162	20	Orthopedic Surgery	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
224174	Fee-for-Service	1154350049	1154350049	1	1	EDGERTON HOSPITAL & HOSP	5/18/2006	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11101 N SHERMAN RD	None	EDGERTON	WI	53534	9002	00	None	42.83463076	-89.04308317	Rock County
224186	Fee-for-Service	1821114687	1821114687	1	1	EL MONTE CITY SCHOOL DIS	11/1/2018	No Taxonomy Provided	NA	None	101	UNIFIED SCHOOL DISTRICT	-	-	NOT APPLICABLE	0	In state provider	None	3540 LEXINGTON AVE	None	EL MONTE	CA	91731	2608	19	06037	34.07340013	-118.0393261	Los Angeles County
224193	Fee-for-Service	1376379826	1376379826	1	1	ENHANCED MINDFULNESS SOLUTIO	3/22/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	30941 AGOURA ROAD	STE. 210	WESTLAKE VILLAGE	CA	91361	4658	19	06037	34.14489451	-118.795374	Los Angeles County
224233	Fee-for-Service	1588901532	1588901532	1	5	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	6440 PLATT AVE	None	WEST HILLS	CA	91307	3216	19	06037	34.18784988	-118.6427021	Los Angeles County
224277	Fee-for-Service	1386649499	1386649499	1	1	EVARISTO, CATHERINE	1/26/2023	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	50 N HILL AVE	302	PASADENA	CA	91106	1903	19	06037	34.146963	-118.121344	Los Angeles County
224358	Fee-for-Service	1023443587	1023443587	1	1	ELIAS, ALEXANDRA W MD	12/20/2021	208C00000X	NA	General Surgery	026	PHYSICIANS	172962	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
224415	Fee-for-Service	1861471369	1861471369	1	1	EASTLACK, ROBERT K MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73162	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
224520	Fee-for-Service	1588901532	1588901532	1	14	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	18700 VENTURA BLVD	220	TARZANA	CA	91356	3303	19	06037	34.1707476	-118.5409795	Los Angeles County
224610	Fee-for-Service	1972816106	1972816106	1	1	EVANS, KENYATTA K MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123575	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2615 CHESTER AVENUE	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38333823	-119.0188872	Kern County
224692	Fee-for-Service	1902350150	1902350150	1	1	EAST LA PHARMACY CORP	4/23/2020	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4968 WHITTIER BLVD	None	LOS ANGELES	CA	90022	3130	19	06037	34.02136951	-118.1621088	Los Angeles County
224750	Fee-for-Service	1164662193	1164662193	1	1	EHRLICH, WENDY J PHD	7/30/2018	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
224812	Fee-for-Service	1588901532	1588901532	1	5	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6440 PLATT AVE	None	WEST HILLS	CA	91307	3216	19	06037	34.18784988	-118.6427021	Los Angeles County
224845	Fee-for-Service	1114086956	1114086956	1	1	EBY, THOMAS E PHD	12/2/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	9067	-	NOT APPLICABLE	0	In state provider	None	2743 ORANGE STREET	None	RIVERSIDE	CA	92501	2538	33	06065	33.99108079	-117.3667042	Riverside County
224879	Fee-for-Service	1215930995	1215930995	1	1	EISENBERG VILLAGE OF THE LOS	3/1/1966	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	ANGELES JEWISH HOME FOR	18855 VICTORY BLVD	None	RESEDA	CA	91335	6445	19	06037	34.18660752	-118.5441525	Los Angeles County
224924	Fee-for-Service	1053423384	1053423384	1	1	ELLIOTT, ANDREW J	2/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86851	None	None	0	In state provider	None	555 E TACHEVAH DR	STE 1W106	PALM SPRINGS	CA	92262	5772	33	06065	33.83753681	-116.5424435	Riverside County
224995	Fee-for-Service	1548771132	1548771132	1	1	EMPIRE BEHAVIORAL HEALTH A P	11/25/2018	103TB0200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SYCHOLOGICAL CORPORATION	16465 SIERRA LAKES PKWY	145	FONTANA	CA	92336	1242	36	06071	34.13805177	-117.4457839	San Bernardino County
225017	Fee-for-Service	1770618027	1770618027	1	1	EMERGENCY MEDICAL ASSOC	5/11/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	OF CHILDRENS HOSPITAL	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
225075	Fee-for-Service	1881054997	1881054997	1	2	EMANATE HEALTH MEDICAL GROUP	9/17/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	PARTNERS	1135 S SUNSET AVE	STE 200	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
225141	Fee-for-Service	1013981554	1013981554	1	15	EISENHOWER MEDICAL CENTER	12/18/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	4791 EAST PALM CANYON DR	None	PALM SPRINGS	CA	92264	5220	33	06065	33.7928376	-116.4933915	Riverside County
225158	Fee-for-Service	1821076308	1821076308	1	1	ELITE MEDICAL SUPPLY OF NEW	12/9/2020	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	YORK, LLC	1900 RIDGE RD	125	WEST SENECA	NY	14224	3332	00	None	42.829074	-78.782976	Erie County
225185	Fee-for-Service	1225463029	1225463029	1	1	ESTANTE, MARIA R LMFT	1/15/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
225282	Fee-for-Service	1831255611	1831255611	1	1	EDWARDS, ELIZABETH B CNM	10/2/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
225352	Fee-for-Service	1679779243	1679779243	1	1	EUBANKS, SABINA LMFT	8/27/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
225361	Fee-for-Service	1881054997	1881054997	1	2	EMANATE HEALTH MEDICAL GROUP	2/21/2020	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PARTNERS	1135 S SUNSET AVE	STE 200	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
225374	Fee-for-Service	1881054997	1881054997	1	6	EMANATE HEALTH MEDICAL GROUP	2/17/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1125 VIA VERDE	None	SAN DIMAS	CA	91773	4400	19	06037	34.07402699	-117.829182	Los Angeles County
225578	Fee-for-Service	1790218063	1790218063	1	1	EGAN, ANNA B MD	8/8/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	172767	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
225648	Fee-for-Service	1881054997	1881054997	1	2	EMANATE HEALTH MEDICAL GROUP	9/17/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	PARTNERS	1135 S SUNSET AVE	STE 200	WEST COVINA	CA	91790	3937	19	06037	34.06215064	-117.9453997	Los Angeles County
225723	Fee-for-Service	1598817397	1598817397	1	1	EDEN, CYNTHIA C MD	7/15/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78521	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
225726	Fee-for-Service	1003852666	1003852666	1	1	ELM HOLDINGS, LLC	9/1/2000	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LA MESA HEALTHCARE CTR	3780 MASSACHUSETTS AVE	None	LA MESA	CA	91941	7638	37	06073	32.745816	-117.042827	San Diego County
225735	Fee-for-Service	1407107055	1407107055	1	1	EKHLASPOUR, LAYA MD	4/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146587	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
225750	Fee-for-Service	1205298205	1205298205	1	1	ESSAW, BETHEL MD	9/30/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	158590	None	None	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
225847	Fee-for-Service	1902218621	1902218621	1	1	EMERY, LETTY R MD	10/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148870	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
225960	Fee-for-Service	1962444703	1962444703	1	1	EVA, PEDRO MD	2/12/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	90222	None	None	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
226008	Fee-for-Service	1679855076	1679855076	1	1	EAST BAY RETINA CONSULTANTS	9/15/2011	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL GROUP	5924 STONERIDGE DR	#201	PLEASANTON	CA	94588	2887	01	06001	37.69132593	-121.8988844	Alameda County
226027	Fee-for-Service	1396137576	1396137576	1	1	EDWARDS, DANNESSE	12/4/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
226127	Fee-for-Service	1467530006	1467530006	1	1	EADES, WALTER G MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	32892	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
226140	Fee-for-Service	1811174220	1811174220	1	1	ESBJORN-HARGENS, VIPASSA	2/14/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PHD	4715 VIEWRIDGE AVE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
226177	Fee-for-Service	1033612270	1033612270	1	1	ESQUIVEL, HARRIET LMFT	4/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
226374	Fee-for-Service	1427435825	1427435825	1	1	EPPERSON, KATRINA L MD	9/1/2024	2080P0210X	NA	Nephrology	026	PHYSICIANS	144308	45	Nephrology (Renal-Kidney)	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
226384	Fee-for-Service	1417908914	1417908914	1	1	EDWARD L OLEARY MD	5/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MEDICAL	None	OMAHA	NE	68198	7400	00	None	0	0	None
226430	Fee-for-Service	1134164882	1134164882	1	1	EL MONTE EMERGENCY	5/3/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL ASSOCIATES INC	1701 SANTA ANITA AVE	None	SOUTH EL MONTE	CA	91733	3482	19	06037	34.04810648	-118.0424794	Los Angeles County
226442	Fee-for-Service	1326368176	1326368176	1	2	ESKAROS, STEPHEN M MD INC	10/23/2018	207L00000X	NA	Other	026	PHYSICIANS	104081	05	Anesthesiology	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3113	30	06059	33.80318353	-118.0666665	Orange County
226478	Fee-for-Service	1831199058	1831199058	1	1	EL-HAJJAOUI, ZOHEIR R MD	3/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53356	41	Internal Medicine	0	In state provider	None	15576 MAIN ST	None	HESPERIA	CA	92345	3482	36	06071	34.42464781	-117.322468	San Bernardino County
226498	Fee-for-Service	1346769080	1346769080	1	1	EMERGENCY PHYSICIANS URGENT	9/18/2018	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	2400 K ST	None	BAKERSFIELD	CA	93301	4030	15	06029	35.38124435	-119.0175196	Kern County
226515	Fee-for-Service	1306917232	1306917232	1	1	EWING, VICKI S MD	8/24/2004	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	63747	08	Family Practice	0	In state provider	None	3010 W ORANGE AVE	STE 405	ANAHEIM	CA	92804	3173	30	06059	33.82472315	-117.994133	Orange County
226536	Fee-for-Service	1861525016	1861525016	1	1	ENAYATI, DANIEL MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	55940	01	General Practice	0	In state provider	None	207 N ALMONT DR	APT 2	BEVERLY HILLS	CA	90211	1633	19	06037	34.069563	-118.387746	Los Angeles County
226660	Fee-for-Service	1427435825	1427435825	1	1	EPPERSON, KATRINA L MD	9/1/2024	2080P0210X	NA	Nephrology	026	PHYSICIANS	144308	40	Pediatrics	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
226663	Fee-for-Service	1437169083	1437169083	1	1	ENTRICAN, MARY L LMFT	5/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
226691	Fee-for-Service	1851790513	1851790513	1	1	ESTEVEZ, GILDA LMFT	6/14/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2810 E DEL MAR BLVD	None	PASADENA	CA	91107	4320	19	06037	34.14212984	-118.092328	Los Angeles County
226784	Fee-for-Service	1346769080	1346769080	1	1	EMERGENCY PHYSICIANS URGENT	9/29/2020	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2400 K ST	None	BAKERSFIELD	CA	93301	4030	15	06029	35.38124435	-119.0175196	Kern County
226838	Fee-for-Service	1790956209	1790956209	1	1	ESPENSEN, ERIC H DPM	3/25/2008	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	201 S BUEN0 VISTA	SUITE # 325	BURBANK	CA	91505	4571	19	06037	34.15978726	-118.3289164	Los Angeles County
226880	Fee-for-Service	1851461123	1851461123	1	1	ENHANCE BY LINDA REIB INC.	2/28/2018	222Z00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	4811 CHIPPENDALE DRIVE	SUITE 208	SACRAMENTO	CA	95841	2551	34	06067	38.663046	-121.352472	Sacramento County
226927	Fee-for-Service	1689995771	1689995771	1	1	ECHEVERRY, GERMAN MD	2/16/2022	207L00000X	NA	Other	026	PHYSICIANS	118748	None	None	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
227058	Fee-for-Service	1851559041	1851559041	1	1	EINAV, ELDAD U MD	11/27/2024	207R00000X	NA	Other	026	PHYSICIANS	151846	41	Internal Medicine	0	In state provider	None	150 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	2142	19	06037	34.06812722	-118.3837146	Los Angeles County
227078	Fee-for-Service	1689317208	1689317208	1	1	EXCELLE ANESTHESIA SERVICES,	11/20/2023	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	INC.	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
227105	Fee-for-Service	1023403730	1023403730	1	1	ENDSLEY, MARIA O MD	3/13/2019	208M00000X	NA	Other	026	PHYSICIANS	157203	41	Internal Medicine	0	In state provider	None	3865 JACKSON ST	None	RIVERSIDE	CA	92503	3919	33	06065	33.92617009	-117.4404151	Riverside County
227165	Fee-for-Service	1013462779	1013462779	1	1	EARWOOD, CHRISTINE CRNA	4/18/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	975 MAPLE STREET	None	REDWOOD CITY	CA	94063	2057	41	06081	37.48822836	-122.2226601	San Mateo County
227191	Fee-for-Service	1861814089	1861814089	1	1	ENLOE MEDICAL CENTER	2/28/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	560 COHASSET ROAD	None	CHICO	CA	95926	2212	04	06007	39.7519137	-121.8477606	Butte County
227201	Fee-for-Service	1730145814	1730145814	1	1	EDWARD L ANDRADA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	ST EDWARD MERCY CLINIC	7301 ROGERS AVE	None	FORT SMITH	AR	72903	0000	00	None	35.35551	-94.35276	Sebastian County
227256	Fee-for-Service	1154523389	1154523389	1	1	EDULJEE, ARISH Y MD	1/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119196	13	Neurology (M.D. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
227364	Fee-for-Service	1689317208	1689317208	1	1	EXCELLE ANESTHESIA SERVICES,	7/11/2023	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	INC.	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
227376	Fee-for-Service	1215016878	1215016878	1	1	ELIA, GIOVANNI MD	6/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	49978	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
227400	Fee-for-Service	1528027448	1528027448	1	1	ERIC KINDER MD	8/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1550 N 115TH ST	None	SEATTLE	WA	98133	8401	00	None	47.714643	-122.337108	King County
227406	Fee-for-Service	1568794824	1568794824	1	1	EAPEN, BLESSEN C MD	3/7/2023	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	153716	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
227418	Fee-for-Service	1316913650	1316913650	1	1	EATON, JEFFREY S MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	61523	04	Otology, Laryngology, Rhinology	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
227471	Fee-for-Service	1437129939	1437129939	1	2	EASTMAN, WILFRED W MD JR	2/8/2015	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	1121 OAK VALLEY DRIVE	None	YREKA	CA	96097	9120	47	06093	41.66605788	-122.6301463	Siskiyou County
227548	Fee-for-Service	1679719058	1679719058	1	1	EDELSON, NAOMI PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3772 HOWE STREET	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
227607	Fee-for-Service	1659427854	1659427854	1	1	ERICSON, VIRGINIA LMFT	7/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1211 MARICOPA HWY	STE 231	OJAI	CA	93023	3160	56	06111	34.44201622	-119.2632073	Ventura County
227712	Fee-for-Service	1497216485	1497216485	1	1	EUGENIO, CORINNE	6/16/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	176866	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
227839	Fee-for-Service	1295802643	1295802643	1	1	ENG, CALVIN T MD	10/5/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	850 S ATLANTIC BLVD	STE 301	MONTEREY PARK	CA	91754	4729	19	06037	34.05097684	-118.1379979	Los Angeles County
227841	Fee-for-Service	1558498683	1558498683	1	1	EPIPHANY CARE HOMES, INC	12/16/2005	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3224 WILMOT ST	None	SIMI VALLEY	CA	93063	2656	56	06111	34.27483668	-118.7346224	Ventura County
227854	Fee-for-Service	1306095021	1306095021	1	1	EKERUO, IJEOMA A MD	1/7/2020	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6410 FANNIN STREET	SUITE 1500	HOUSTON	TX	77030	5306	00	None	29.71419639	-95.39755562	Harris County
227883	Fee-for-Service	1649324443	1649324443	1	1	EAST VALLEY COMMUNITY HEALTH	6/2/2014	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	1555 SOUTH GAREY AVE	None	POMONA	CA	91766	5222	19	06037	34.04317024	-117.7497127	Los Angeles County
227905	Fee-for-Service	1871802207	1871802207	1	1	ESQUIVEL, LAURA LMFT	8/8/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
227970	Fee-for-Service	1780107797	1780107797	1	14	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3003 OAK RD	STE 103 & 104	WALNUT CREEK	CA	94597	4500	07	06013	37.92940805	-122.0581829	Contra Costa County
228076	Fee-for-Service	1992230478	1992230478	1	1	EASTERLING, TRACEY M NP	5/3/2023	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
228096	Fee-for-Service	1720298326	1720298326	1	1	ELADH, L.P.	9/1/1999	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	EAST LA DOCTORS HOSP	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
228127	Fee-for-Service	1295802643	1295802643	1	1	ENG, CALVIN T MD	5/20/2010	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	850 S ATLANTIC BLVD	STE 301	MONTEREY PARK	CA	91754	4729	19	06037	34.05097684	-118.1379979	Los Angeles County
228166	Fee-for-Service	1366154668	1366154668	1	1	ENJOY TRANSPORTATION LLC	12/5/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	21151 S. WESTERN AVE	148	TORRANCE	CA	90501	1724	19	06037	33.83695304	-118.3092655	Los Angeles County
228172	Fee-for-Service	1649324443	1649324443	1	1	EAST VALLEY COMMUNITY HEALTH	5/1/1997	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	1555 SOUTH GAREY AVE	None	POMONA	CA	91766	5222	19	06037	34.04317024	-117.7497127	Los Angeles County
228184	Fee-for-Service	1598832313	1598832313	1	1	ESEKOGW, ILOBA O V MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	62674	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16237 VENTURA BLVD	None	ENCINO	CA	91436	2201	19	06037	34.15686987	-118.4871369	Los Angeles County
228320	Fee-for-Service	1578547683	1578547683	1	1	EDDOW, JIM J PT	3/27/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2815 MAIN ST.,	SUITE 205	CORONA	CA	92882	0000	33	06065	33.84741266	-117.570694	Riverside County
228396	Fee-for-Service	1457387144	1457387144	1	1	ESCUTIN, RODOLFO O JR MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	51106	None	None	0	In state provider	None	11234 ANDERSON ST	STE 3401	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
228460	Fee-for-Service	1649324443	1649324443	1	1	EAST VALLEY COMMUNITY HEALTH	5/1/1997	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	1555 SOUTH GAREY AVE	None	POMONA	CA	91766	5222	19	06037	34.04317024	-117.7497127	Los Angeles County
228484	Fee-for-Service	1629126354	1629126354	1	1	EINSTEIN JILL S MD	2/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	65163	41	Internal Medicine	0	In state provider	None	3801 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1625	38	06075	37.78707021	-122.4555217	San Francisco County
228532	Fee-for-Service	1467871509	1467871509	1	1	ELAINE ODIASE	8/9/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 CHILDRENS WAY	# 653	LITTLE ROCK	AR	72202	3500	00	None	34.742745	-92.2927905	Pulaski County
228616	Fee-for-Service	1962553248	1962553248	1	1	EASTSIDE UNION SD	9/5/1999	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	ATTN: FISCAL SERVICES	44938 N 30TH ST E	None	LANCASTER	CA	93535	2815	19	06037	34.699941	-118.0770008	Los Angeles County
228622	Fee-for-Service	1942562798	1942562798	1	1	EDEN HOSPICE CARE INC	7/29/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3333 S BREA CANYON RD	SUITE 107	DIAMOND BAR	CA	91765	3782	19	06037	33.96679922	-117.8485622	Los Angeles County
228657	Fee-for-Service	1457840498	1457840498	1	2	ESTES, TAMMY M LMFT	6/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
228710	Fee-for-Service	1366021834	1366021834	1	1	EMERGENCY PHYSICIANS OF SAN	6/1/2021	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	GABRIEL VALLEY	438 W LAS TUNAS DR	None	SAN GABRIEL	CA	91776	1216	19	06037	34.10243051	-118.105902	Los Angeles County
228735	Fee-for-Service	1174943195	1174943195	1	1	EDIRIWICKREMA, ASIRI S MD	1/5/2022	207RH0000X	NA	Hematology	026	PHYSICIANS	137674	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
228753	Fee-for-Service	1114987096	1114987096	1	1	ESTHER, JAMES B MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75843	30	Radiology	0	In state provider	None	3921 WARING RD	STE A	OCEANSIDE	CA	92056	4456	37	06073	33.18776771	-117.2893136	San Diego County
228910	Fee-for-Service	1942562798	1942562798	1	1	EDEN HOSPICE CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3333 S BREA CANYON RD	SUITE 107	DIAMOND BAR	CA	91765	3782	19	06037	33.96679922	-117.8485622	Los Angeles County
228958	Fee-for-Service	1811350549	1811350549	1	1	EL-KHATIB, NORA MD INC	10/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140794	18	Ophthalmology	0	In state provider	None	233 LEWIS ST	None	SAN DIEGO	CA	92103	2122	37	06073	32.75182998	-117.1624746	San Diego County
228978	Fee-for-Service	1699114397	1699114397	1	1	ELMI, AZADEH MD	10/8/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	160307	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
229013	Fee-for-Service	1629227335	1629227335	1	1	ELDER-CHRISTENSEN, SALISHA A	9/22/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2530 ATLANTIC AVE	STE D	LONG BEACH	CA	90806	2741	19	06037	33.803172	-118.185004	Los Angeles County
229064	Fee-for-Service	1679510960	1679510960	1	1	ECKELS, JOHN C MD	2/1/1998	207L00000X	NA	Other	026	PHYSICIANS	41636	05	Anesthesiology	0	In state provider	None	100 S SAN MATEO DR	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
229094	Fee-for-Service	1033417308	1033417308	1	1	EISENHOWER, NANCY E LMFT	9/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	46650 ADAMS ST	STE 101	LA QUINTA	CA	92253	4532	33	06065	33.71077068	-116.2861321	Riverside County
229147	Fee-for-Service	1134184807	1134184807	1	1	EMERSON, GEORGE A MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	77695	None	None	0	In state provider	None	1600 N ROSE AVE	None	OXNARD	CA	93030	3722	56	06111	34.21700406	-119.1582582	Ventura County
229152	Fee-for-Service	1376556506	1376556506	1	1	ECHEVERRI, JORGE M MD	3/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52822	01	General Practice	0	In state provider	None	6011 PACIFIC BLVD	STE 116	HUNTINGTON PARK	CA	90255	2959	19	06037	33.9869767	-118.2252886	Los Angeles County
229182	Fee-for-Service	1952509630	1952509630	1	1	ERIC B ENGLAND, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	234 GOODMAN ST	None	CINCINNATI	OH	45219	2364	00	None	39.13677965	-84.5023814	Hamilton County
229303	Fee-for-Service	1205939832	1205939832	1	1	EHLERS, ROLF MD	4/21/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	50260	41	Internal Medicine	0	In state provider	None	3405 KENYON ST	STE 411	SAN DIEGO	CA	92110	5007	37	06073	32.74866031	-117.2135544	San Diego County
229389	Fee-for-Service	1497007496	1497007496	1	1	EXPRESS ANESTHESIA	12/5/2013	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CONSULTANTS	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63347961	-122.0897735	Alameda County
229392	Fee-for-Service	1942961933	1942961933	1	2	EAGLE STAR TRANSPORTATION CO	6/1/2022	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	RP	43612 JACKSON ST	STE #1	INDIO	CA	92201	2546	33	06065	33.732261	-116.216353	Riverside County
229407	Fee-for-Service	1336384163	1336384163	1	1	EBANKS-BUTLER, SHANA L LMFT	1/5/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	102284	-	NOT APPLICABLE	0	In state provider	None	1874 BUSINESS CENTER DR	SUITE B	SAN BERNARDINO	CA	92408	3457	36	06071	34.06853739	-117.2814025	San Bernardino County
229438	Fee-for-Service	1376556506	1376556506	1	1	ECHEVERRI, JORGE M MD	3/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52822	08	Family Practice	0	In state provider	None	6011 PACIFIC BLVD	STE 116	HUNTINGTON PARK	CA	90255	2959	19	06037	33.9869767	-118.2252886	Los Angeles County
229596	Fee-for-Service	1619566528	1619566528	1	1	ESSENTIAL HOME HEALTH CARE	8/9/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CORP	18344 OXNARD ST	SUITE 204	TARZANA	CA	91356	6773	19	06037	34.18005817	-118.5324607	Los Angeles County
229606	Fee-for-Service	1073036208	1073036208	1	1	ERICKSON, CAROL L	9/1/2017	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	56970 YUCCA TRAIL	STE 102	YUCCA VALLEY	CA	92284	7911	36	06071	34.12059645	-116.420985	San Bernardino County
229621	Fee-for-Service	1831979145	1831979145	1	1	EINFALT, BLAIRE PT	3/11/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
229692	Fee-for-Service	1346710050	1346710050	1	1	EVERY WOMAN OBSTETRICS & GYN	4/8/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	ECOLOGY INC	44241 15TH ST W	STE 303	LANCASTER	CA	93534	5502	19	06037	34.68712999	-118.1569096	Los Angeles County
229844	Fee-for-Service	1457768566	1457768566	1	1	EIDELSON, JOEL R MD	11/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145569	01	General Practice	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
229845	Fee-for-Service	1588901532	1588901532	1	56	EXER MEDICAL CORPORATION	3/7/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	524 COLORADO AVE	None	SANTA MONICA	CA	90401	2408	19	06037	34.01489915	-118.490472	Los Angeles County
229962	Fee-for-Service	1376902544	1376902544	1	1	ELEET TRANSPORTATION SERVICE	9/13/2022	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	7484 UNIVERSITY AVE	SUITE 330	LA MESA	CA	91942	6063	37	06073	32.75856212	-117.0361153	San Diego County
229965	Fee-for-Service	1396404067	1396404067	1	1	ESPIRITU, NEIL F MD	1/17/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	3612 DALE RD	None	MODESTO	CA	95356	0500	50	06099	37.69097901	-121.0498748	Stanislaus County
230007	Fee-for-Service	1124187950	1124187950	1	1	EHLING, RICHARD E MD	2/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	76885	41	Internal Medicine	0	In state provider	None	2710 MIDDLEFIELD RD	None	REDWOOD CITY	CA	94063	3404	41	06081	37.47644946	-122.2110919	San Mateo County
230115	Fee-for-Service	1043648355	1043648355	1	2	EBAID, SAMER S MD	1/11/2022	208600000X	NA	General Surgery	026	PHYSICIANS	136332	None	None	0	In state provider	None	200 MEDICAL PLAZA	265	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
230133	Fee-for-Service	1588901532	1588901532	1	56	EXER MEDICAL CORPORATION	4/22/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	524 COLORADO AVE	None	SANTA MONICA	CA	90401	2408	19	06037	34.01489915	-118.490472	Los Angeles County
230207	Fee-for-Service	1770839839	1770839839	1	1	EWERT, KRISTY L PT	10/16/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
230230	Fee-for-Service	1649280272	1649280272	1	1	EFTEKHARI, HESSAM S DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	9311	05	Anesthesiology	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
230256	Fee-for-Service	1396404067	1396404067	1	1	ESPIRITU, NEIL F MD	1/17/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	3612 DALE RD	None	MODESTO	CA	95356	0500	50	06099	37.69097901	-121.0498748	Stanislaus County
230304	Fee-for-Service	1659946275	1659946275	1	1	EBADAT, KIAVASH LMFT	7/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	77564 COUNTRY CLUB DR	201	PALM DESERT	CA	92211	0484	33	06065	33.75833451	-116.3114325	Riverside County
230422	Fee-for-Service	1588901532	1588901532	1	56	EXER MEDICAL CORPORATION	3/7/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	524 COLORADO AVE	None	SANTA MONICA	CA	90401	2408	19	06037	34.01489915	-118.490472	Los Angeles County
230445	Fee-for-Service	1629242854	1629242854	1	2	EDMONDS, MATHEW S MD	1/25/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	118791	08	Family Practice	0	In state provider	None	7365 CARNELIAN ST	240	RANCHO CUCAMONGA	CA	91730	1158	36	06071	34.12038413	-117.6160525	San Bernardino County
230449	Fee-for-Service	1942420542	1942420542	1	1	EXCEL HEALTHCARE, INC	1/30/2002	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	WEST COVINA ADHC CTR	1633 N HACIENDA BLVD	None	LA PUENTE	CA	91744	1137	19	06037	34.04901253	-117.9456567	Los Angeles County
230703	Fee-for-Service	1588901532	1588901532	1	44	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2195 SEPULVEDA BLVD	None	TORRANCE	CA	90501	4616	19	06037	33.8200833	-118.3195115	Los Angeles County
230709	Fee-for-Service	1588901532	1588901532	1	56	EXER MEDICAL CORPORATION	3/7/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	524 COLORADO AVE	None	SANTA MONICA	CA	90401	2408	19	06037	34.01489915	-118.490472	Los Angeles County
230747	Fee-for-Service	1750394151	1750394151	1	1	ERIK H KISA M.D.	11/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	736 BATTLEFIELD BLVD N	None	CHESAPEAKE	VA	23320	4941	00	None	36.74619744	-76.24489616	Chesapeake city
230750	Fee-for-Service	1306807300	1306807300	1	2	EMERY, GARRETT J MD	10/5/2018	207PE0004X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	8280 W WARM SPRINGS RD	None	LAS VEGAS	NV	89113	3612	00	None	36.057384	-115.2721395	Clark County
230806	Fee-for-Service	1245280460	1245280460	1	1	ELMES, CORNELIS M MD	1/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86984	20	Orthopedic Surgery	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
230990	Fee-for-Service	1588901532	1588901532	1	44	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	2195 SEPULVEDA BLVD	None	TORRANCE	CA	90501	4616	19	06037	33.8200833	-118.3195115	Los Angeles County
231024	Fee-for-Service	1962780148	1962780148	1	1	ESHTIAGHPOUR, DANIEL D MD	4/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	122301	10	Gastroenterology (M.D. only)	0	In state provider	None	200 MED PLAZA	365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
231067	Fee-for-Service	1093466047	1093466047	1	1	EMBRACE YOUR HEALING BEHAVIO	5/9/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	RAL HEALTH	15720 VENTURA BLVD	609	ENCINO	CA	91436	4733	19	06037	34.15524484	-118.4756687	Los Angeles County
231252	Fee-for-Service	1467984096	1467984096	1	1	EA, ROTH B DPM	10/4/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	635 ANDERSON RD STE 19	None	DAVIS	CA	95616	3505	57	06113	38.54876426	-121.7587542	Yolo County
231279	Fee-for-Service	1588901532	1588901532	1	44	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2195 SEPULVEDA BLVD	None	TORRANCE	CA	90501	4616	19	06037	33.8200833	-118.3195115	Los Angeles County
231283	Fee-for-Service	1679646731	1679646731	1	1	ELAM, ERIK A MD	1/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	71375	30	Radiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
231300	Fee-for-Service	1225423114	1225423114	1	1	EGUIA, EMANUEL MD	9/3/2024	2086X0206X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
231338	Fee-for-Service	1811081284	1811081284	1	1	ESCARZAGA, MONICA	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	340 E PALM LN	STE A175	PHOENIX	AZ	85004	4603	00	None	33.469812	-112.0681485	Maricopa County
231426	Fee-for-Service	1720549926	1720549926	1	1	ENG, DAVID J MD	6/28/2022	207R00000X	NA	Other	026	PHYSICIANS	177718	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
231568	Fee-for-Service	1588901532	1588901532	1	44	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2195 SEPULVEDA BLVD	None	TORRANCE	CA	90501	4616	19	06037	33.8200833	-118.3195115	Los Angeles County
231589	Fee-for-Service	1750098737	1750098737	1	1	EMOTIONAL & BEHAVIORAL HEALT	3/16/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	H PSYCHOLOGY SWISTUN PHD	7922 PALM ST	None	LEMON GROVE	CA	91945	2956	37	06073	32.73475153	-117.028116	San Diego County
231665	Fee-for-Service	1609314327	1609314327	1	1	ENSURE HOME HEALTH CARE INC	1/19/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	20944 SHERMAN WAY	STE 106	CANOGA PARK	CA	91303	1798	19	06037	34.20095151	-118.5900435	Los Angeles County
231682	Fee-for-Service	1083007942	1083007942	1	1	ELLER, SARAH K CRNA	6/12/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	1	Border provider	None	5330 SOUTH HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
231698	Fee-for-Service	1053409912	1053409912	1	1	ERIC COOPER MD	4/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1959 NE PACIFIC ST	None	SEATTLE	WA	98195	9110	00	None	47.65080692	-122.3081828	King County
231820	Fee-for-Service	1801473509	1801473509	1	1	EWING, TAKEISHA J NP	2/29/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
231854	Fee-for-Service	1588901532	1588901532	1	44	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2195 SEPULVEDA BLVD	None	TORRANCE	CA	90501	4616	19	06037	33.8200833	-118.3195115	Los Angeles County
231864	Fee-for-Service	1588901532	1588901532	1	30	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	831 S STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	4613	30	06059	33.83059011	-117.889382	Orange County
231866	Fee-for-Service	1124434261	1124434261	1	1	EASY SPEECH PATHOLOGY, INC.	2/25/2019	101Y00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
231868	Fee-for-Service	1861441230	1861441230	1	1	ELLEN ABELN M.D.	12/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4801 W 81ST ST	STE 108	MINNEAPOLIS	MN	55437	1111	00	None	44.85623947	-93.34035	Hennepin County
231880	Fee-for-Service	1548474778	1548474778	1	1	ETTEKAL, BABAK MD	5/25/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	91050	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
231921	Fee-for-Service	1639748098	1639748098	1	1	EVARDO, LIZA CNP	12/16/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4829 CLAIREMONT DR	None	SAN DIEGO	CA	92117	2706	37	06073	32.83175462	-117.2052088	San Diego County
231941	Fee-for-Service	1871607291	1871607291	1	1	ENG, ROGER S MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	75471	30	Radiology	0	In state provider	None	845 JACKSON ST	None	SAN FRANCISCO	CA	94133	4851	38	06075	37.79571919	-122.4089166	San Francisco County
231942	Fee-for-Service	1457384257	1457384257	1	1	ENDO, TIFFANY P LE DO	10/28/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7282	08	Family Practice	0	In state provider	None	920 N GAREY AVE	None	POMONA	CA	91767	4618	19	06037	34.06666631	-117.7515392	Los Angeles County
232092	Fee-for-Service	1538286109	1538286109	1	1	EGAN, DINERY LMFT	7/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
232149	Fee-for-Service	1124434261	1124434261	1	1	EASY SPEECH PATHOLOGY, INC.	11/10/2021	101Y00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
232155	Fee-for-Service	1588901532	1588901532	1	30	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	831 S STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	4613	30	06059	33.83059011	-117.889382	Orange County
232419	Fee-for-Service	1871699074	1871699074	1	1	EAST BAY NEPHROLOGY MED	1/1/1990	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GRP	2905 TELEGRAPH AVE	None	BERKELEY	CA	94705	2063	01	06001	37.85736641	-122.2594952	Alameda County
232436	Fee-for-Service	1124434261	1124434261	1	1	EASY SPEECH PATHOLOGY, INC.	9/7/2018	101Y00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
232438	Fee-for-Service	1588901532	1588901532	1	30	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	831 S STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	4613	30	06059	33.83059011	-117.889382	Orange County
232489	Fee-for-Service	1053349415	1053349415	1	1	ELLIOTT, MARK W. MD	1/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6 13TH AVE E	None	POLSON	MT	59860	5315	00	None	47.682243	-114.1626375	Lake County
232491	Fee-for-Service	1235217076	1235217076	1	1	ERTEZA, SAYED A MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	53828	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
232566	Fee-for-Service	1295741635	1295741635	1	1	ESSIEN, FRANCIS A MD	7/24/2008	208600000X	NA	General Surgery	026	PHYSICIANS	55612	02	General Surgery	0	In state provider	None	36320 INLAND VALLEY DR	SUITE 201	WILDOMAR	CA	92595	7512	33	06065	33.592158	-117.2367705	Riverside County
232572	Fee-for-Service	1972519122	1972519122	1	1	ELLENHORN, NAOMI L MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	51690	01	General Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
232584	Fee-for-Service	1972272169	1972272169	1	1	EMERGENCY PHYSICIANS URGENT	10/4/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	28110 CLINTON KEITH	None	MURRIETA	CA	92563	4535	33	06065	33.59797646	-117.1685565	Riverside County
232696	Fee-for-Service	1992704472	1992704472	1	1	ELMELUND, LORI A MFT	5/25/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27143	-	NOT APPLICABLE	0	In state provider	None	1919 N BEACHWOOD DR	None	LOS ANGELES	CA	90068	4006	19	06037	34.105806	-118.3213065	Los Angeles County
232708	Fee-for-Service	1871699074	1871699074	1	1	EAST BAY NEPHROLOGY MED	1/1/1990	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	GRP	2905 TELEGRAPH AVE	None	BERKELEY	CA	94705	2063	01	06001	37.85736641	-122.2594952	Alameda County
232723	Fee-for-Service	1124434261	1124434261	1	1	EASY SPEECH PATHOLOGY, INC.	9/7/2018	101Y00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
232724	Fee-for-Service	1588901532	1588901532	1	30	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	831 S STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	4613	30	06059	33.83059011	-117.889382	Orange County
232782	Fee-for-Service	1326238098	1326238098	1	1	EBERT, VALERIE C. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMBELL AVE	None	TUCSON	AZ	85724	0002	00	None	32.240493	-110.9460825	Pima County
232790	Fee-for-Service	1821406711	1821406711	1	1	EVERGREEN RX PHARMACY INC	1/22/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	41750 WINCHESTER ROAD	SUITE N	TEMECULA	CA	92590	4898	33	06065	33.51771256	-117.1684213	Riverside County
232852	Fee-for-Service	1295741635	1295741635	1	1	ESSIEN, FRANCIS A MD	7/24/2008	208600000X	NA	General Surgery	026	PHYSICIANS	55612	01	General Practice	0	In state provider	None	36320 INLAND VALLEY DR	SUITE 201	WILDOMAR	CA	92595	7512	33	06065	33.592158	-117.2367705	Riverside County
232857	Fee-for-Service	1972519122	1972519122	1	1	ELLENHORN, NAOMI L MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	51690	18	Ophthalmology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
232932	Fee-for-Service	1316168479	1316168479	1	1	ELIA, JAMES N DO	6/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9678	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CTR DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
232977	Fee-for-Service	1467753418	1467753418	1	1	EMERGENCY MEDICINE PHYSICIAN	10/29/2010	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9300 VALLEY CHILRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
233012	Fee-for-Service	1124434261	1124434261	1	1	EASY SPEECH PATHOLOGY, INC.	9/7/2018	101Y00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
233017	Fee-for-Service	1588901532	1588901532	1	30	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	831 S STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	4613	30	06059	33.83059011	-117.889382	Orange County
233040	Fee-for-Service	1871594614	1871594614	1	1	ENSIGN SONOMA LLC	11/16/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SONOMA HEALTHCARE CENTER	1250 BROADWAY	None	SONOMA	CA	95476	7500	49	06097	38.27841777	-122.4598827	Sonoma County
233078	Fee-for-Service	1306536743	1306536743	1	1	EMPATIA COUNSELING SERVICES,	2/27/2024	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	A LICENSED CLINICAL SOC	4401 ATLANTIC AVE	200	LONG BEACH	CA	90807	2264	19	06037	33.836976	-118.185096	Los Angeles County
233095	Fee-for-Service	1942419791	1942419791	1	1	ELIHU, ARVAND MD	11/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	90296	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
233106	Fee-for-Service	1932135977	1932135977	1	1	EWELL, BARRY DO	11/18/2020	207L00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
233162	Fee-for-Service	1710967633	1710967633	1	1	EDDY K. YOUNG, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2500 NE NEFF RD	None	BEND	OR	97701	6015	00	None	44.067735	-121.268187	Deschutes County
233188	Fee-for-Service	1083651707	1083651707	1	1	ERICKSON, MARK MD	10/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1305 W 18TH ST	None	SIOUX FALLS	SD	57105	0401	00	None	43.535484	-96.7428585	Minnehaha County
233194	Fee-for-Service	1326207655	1326207655	1	1	ELITE HOME CARE INC	8/8/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3807 WEST SIERRA HIGHWAY	SUITE 207	ACTON	CA	93510	1256	19	06037	34.49288707	-118.1991687	Los Angeles County
233239	Fee-for-Service	1003465709	1003465709	1	1	ESCOBAR, OSCAR S PHD	7/19/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
233300	Fee-for-Service	1124434261	1124434261	1	1	EASY SPEECH PATHOLOGY, INC.	9/25/2019	101Y00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
233338	Fee-for-Service	1194826388	1194826388	1	1	ELGOURT, LUDMILA MD	8/23/1982	207R00000X	NA	Other	026	PHYSICIANS	33452	01	General Practice	0	In state provider	None	15243 VANOWEN ST	STE 508	VAN NUYS	CA	91405	3668	19	06037	34.19394848	-118.4654115	Los Angeles County
233381	Fee-for-Service	1679600332	1679600332	1	1	EPIPHANY CARE HOMES, INC	12/16/2005	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2090 BOLIVAR CT	None	SIMI VALLEY	CA	93063	2761	56	06111	34.27396116	-118.7224411	Ventura County
233414	Fee-for-Service	1245538453	1245538453	1	1	EDELWEISS HOLDINGS LLC	6/7/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	396 DORSEY DR	None	GRASS VALLEY	CA	95945	5368	29	06057	39.22714445	-121.035285	Nevada County
233421	Fee-for-Service	1205857315	1205857315	1	2	ECP HOMES, INC	8/18/1999	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6962 SAN PACO CIR	None	BUENA PARK	CA	90620	2964	30	06059	33.84124066	-118.0121796	Orange County
233456	Fee-for-Service	1376626903	1376626903	1	1	ENLOE MEDICAL CENTER	9/17/1984	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HOME HEALTH AGENCY	1390 E LASSEN AVE	None	CHICO	CA	95973	7823	04	06007	39.77300289	-121.8389237	Butte County
233478	Fee-for-Service	1720031685	1720031685	1	1	ERESO, VIRGIL C MD	1/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	30308	41	Internal Medicine	0	In state provider	None	1917 MEMORIAL DR	APT 1	CERES	CA	95307	1861	50	06099	37.600164	-120.961096	Stanislaus County
233580	Fee-for-Service	1982478459	1982478459	1	1	ELITE TRAVEL LLC	2/14/2024	342000000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ION	481 ROOSEVELT AVE	None	POMONA	CA	91767	3139	19	06037	34.07273276	-117.7424974	Los Angeles County
233628	Fee-for-Service	1194826388	1194826388	1	1	ELGOURT, LUDMILA MD	8/23/1982	207R00000X	NA	Other	026	PHYSICIANS	33452	08	Family Practice	0	In state provider	None	15243 VANOWEN ST	STE 508	VAN NUYS	CA	91405	3668	19	06037	34.19394848	-118.4654115	Los Angeles County
233633	Fee-for-Service	1174600894	1174600894	1	1	EL-HALAWANI, MONA M LMFT	8/9/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
233663	Fee-for-Service	1063686889	1063686889	1	1	ELLYSON, DEAN S DC	2/1/2006	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	605 E ST	None	MARYSVILLE	CA	95901	5502	58	06115	39.14152304	-121.5906329	Yuba County
233786	Fee-for-Service	1497397632	1497397632	1	1	EMERGENCY PHYSICIANS URGENT	10/3/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	36290 HIDDEN SPRINGS RD	STE D & E	WILDOMAR	CA	92595	5801	33	06065	33.59360263	-117.2457093	Riverside County
233811	Fee-for-Service	1639676331	1639676331	1	1	ENNEN, JAMES P MD	9/18/2023	207L00000X	NA	Other	026	PHYSICIANS	184385	None	None	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
233884	Fee-for-Service	1649884834	1649884834	1	1	ENSURE HOSPICE INC	10/19/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1609 E PALMDALE BLVD	UNIT B	PALMDALE	CA	93550	4881	19	06037	34.57967548	-118.1008305	Los Angeles County
234015	Fee-for-Service	1326044140	1326044140	1	1	EASTERN PLUMAS HOSP-	7/1/1989	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PORTOLA CAMPUS	500 1ST AVE	None	PORTOLA	CA	96122	9406	32	06063	39.80595392	-120.4626723	Plumas County
234023	Fee-for-Service	1508083783	1508083783	1	2	EVERGREEN UNION SD	7/1/2024	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	19500 LEARNING WAY	None	COTTONWOOD	CA	96022	9602	52	06103	40.35830356	-122.3308198	Tehama County
234055	Fee-for-Service	1356385835	1356385835	1	1	EDWARDS, RAYMOND S. MD	3/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2801 N GANTENBEIN AVE	None	PORTLAND	OR	97227	1623	00	None	45.54387841	-122.6696022	Multnomah County
234074	Fee-for-Service	1497397632	1497397632	1	1	EMERGENCY PHYSICIANS URGENT	1/19/2021	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	36290 HIDDEN SPRINGS RD	STE D & E	WILDOMAR	CA	92595	5801	33	06065	33.59360263	-117.2457093	Riverside County
234124	Fee-for-Service	1104912062	1104912062	1	1	ECONOMOU, VASILIKI MD	1/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	44879	13	Neurology (M.D. only)	0	In state provider	None	27206 CALAROGA AVE	STE 104	HAYWARD	CA	94545	4300	01	06001	37.632357	-122.0868765	Alameda County
234171	Fee-for-Service	1649884834	1649884834	1	1	ENSURE HOSPICE INC	10/19/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1609 E PALMDALE BLVD	UNIT B	PALMDALE	CA	93550	4881	19	06037	34.57967548	-118.1008305	Los Angeles County
234195	Fee-for-Service	1407838584	1407838584	1	1	EMPEY, LONNIE R DO	10/31/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
234278	Fee-for-Service	1699079954	1699079954	1	1	EISEN-KEARNS, MOLLY A LCSW	7/21/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7400 MORRO RD UNIT B	None	ATASCADERO	CA	93422	4467	40	06079	35.47791933	-120.6672598	San Luis Obispo County
234332	Fee-for-Service	1073227351	1073227351	1	1	ESTRADA, MICHELLE	10/31/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
234344	Fee-for-Service	1316024920	1316024920	1	1	ENG, SOO J MD	5/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	47922	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
234350	Fee-for-Service	1184832313	1184832313	1	1	EDELMAN, ROBERT A MD	6/16/2009	207W00000X	NA	Ophthalmology	026	PHYSICIANS	46823	18	Ophthalmology	0	In state provider	P	20046 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5304	01	06001	37.69862821	-122.0873733	Alameda County
234364	Fee-for-Service	1629099080	1629099080	1	1	EBY, MICHAEL W MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70664	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	565 N MOUNT VERNON AVE	None	SAN BERNARDINO	CA	92411	2661	36	06071	34.109406	-117.313813	San Bernardino County
234402	Fee-for-Service	1881054997	1881054997	1	5	EMANATE HEALTH MEDICAL GROUP	1/14/2021	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	147 W. COLLEGE STREET	None	COVINA	CA	91723	2008	19	06037	34.0875033	-117.8914472	Los Angeles County
234527	Fee-for-Service	1316039241	1316039241	1	1	EL DORADO COMMUNITY SERVICE	8/29/1995	261QP2300X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	4023 MARINE AVE.	None	LAWNDALE	CA	90260	1840	19	06037	33.89468047	-118.344636	Los Angeles County
234662	Fee-for-Service	1285472449	1285472449	1	1	EBRAHIM, SARAH OD	9/30/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7291 BOULDER AVENUE SUIT	None	HIGHLAND	CA	92346	3389	36	06071	34.12169346	-117.1953693	San Bernardino County
234710	Fee-for-Service	1750491114	1750491114	1	1	ENRIQUEZ, BRIANNA K MD	1/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CHILDREN'S UNIV MED GRP	4500 SAND POINT WAY NE,	#100	SEATTLE	WA	98105	0000	00	None	47.66165594	-122.2864502	King County
234737	Fee-for-Service	1134116643	1134116643	1	1	EDISON, JOHN M MD	1/1/1979	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	27589	04	Otology, Laryngology, Rhinology	0	In state provider	None	3081 LOMA VISTA RD	None	VENTURA	CA	93003	2916	56	06111	34.27581347	-119.2550504	Ventura County
234751	Fee-for-Service	1588901532	1588901532	1	21	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8000 SUNSET BLVD	C110	LOS ANGELES	CA	90046	2439	19	06037	34.09796251	-118.365138	Los Angeles County
234814	Fee-for-Service	1134749864	1134749864	1	1	ELIZONDO, KARLA LMFT	5/8/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
234815	Fee-for-Service	1316039241	1316039241	1	1	EL DORADO COMMUNITY SERVICE	11/6/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	4023 MARINE AVE.	None	LAWNDALE	CA	90260	1840	19	06037	33.89468047	-118.344636	Los Angeles County
234941	Fee-for-Service	1356834071	1356834071	1	1	EFFORTLESS NURSING SOLUTIONS	3/9/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	2252 BEVERLY BLVD	STE 200	LOS ANGELES	CA	90057	2225	19	06037	34.06771646	-118.2728448	Los Angeles County
234990	Fee-for-Service	1396701868	1396701868	1	1	ESCOBEDO, DAVID MD	3/12/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	183869	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
235000	Fee-for-Service	1831653021	1831653021	1	1	EMPOWERED LIVING PSYCHOLOGIC	1/2/2022	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	AL SERVICES, INC.	9113 FOOTHILL BLVD	STE 130	RANCHO CUCAMONGA	CA	91730	6565	36	06071	34.10651347	-117.606528	San Bernardino County
235038	Fee-for-Service	1588901532	1588901532	1	21	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	8000 SUNSET BLVD	C110	LOS ANGELES	CA	90046	2439	19	06037	34.09796251	-118.365138	Los Angeles County
235057	Fee-for-Service	1144560749	1144560749	1	1	ELIZABETH BODINE	11/10/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3400 W TRUMAN BLVD	None	JEFFERSON CTY	MO	65109	5712	00	None	38.59093454	-92.24604998	Cole County
235081	Fee-for-Service	1447545330	1447545330	1	1	EVAN M GROSJEAN MD	12/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
235114	Fee-for-Service	1164739595	1164739595	1	1	EMMETT, ANDREA G M LMFT	10/2/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9330 BASELINE ROAD	STE 102	RANCHO CUCAMONGA	CA	91701	5827	36	06071	34.12157046	-117.6011595	San Bernardino County
235188	Fee-for-Service	1447778873	1447778873	1	1	ELPIS HOME HEALTH	7/18/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4250 PENNSYLVANIA AVE	STE 207	LA CRESCENTA	CA	91214	3369	19	06037	34.224183	-118.2486845	Los Angeles County
235262	Fee-for-Service	1518215086	1518215086	1	2	ENCINO FAMILY PHARMACY INC	2/8/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16060 VENTURA BLVD	UNIT #109	ENCINO	CA	91436	2761	19	06037	34.15625567	-118.483138	Los Angeles County
235290	Fee-for-Service	1710333976	1710333976	1	1	ELITE FIRST HEALTH	11/29/2017	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	3121 YOSEMITE BLVD.	SUITE D-2	MODESTO	CA	95354	4166	50	06099	37.63819029	-120.9367251	Stanislaus County
235291	Fee-for-Service	1831653021	1831653021	1	1	EMPOWERED LIVING PSYCHOLOGIC	1/2/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	AL SERVICES, INC.	9113 FOOTHILL BLVD	STE 130	RANCHO CUCAMONGA	CA	91730	6565	36	06071	34.10651347	-117.606528	San Bernardino County
235295	Fee-for-Service	1750389862	1750389862	1	2	ENSIGN, LARS D MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75593	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3860 SADDLE RD	None	SOUTH LAKE TAHOE	CA	96150	8673	09	06017	38.934261	-119.9399445	El Dorado County
235312	Fee-for-Service	1497787899	1497787899	1	1	ESCALADA, MARIA C MD	2/28/1993	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53152	01	General Practice	0	In state provider	None	2647 E 14TH ST	STE 210	OAKLAND	CA	94601	1540	01	06001	37.78099267	-122.2320006	Alameda County
235326	Fee-for-Service	1588901532	1588901532	1	21	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	8000 SUNSET BLVD	C110	LOS ANGELES	CA	90046	2439	19	06037	34.09796251	-118.365138	Los Angeles County
235394	Fee-for-Service	1740365907	1740365907	1	1	EMPORIUM MEDICAL EQ INC	10/7/2003	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	150 IMPERIAL HWY	None	FULLERTON	CA	92835	1019	30	06059	33.91729251	-117.9306495	Orange County
235431	Fee-for-Service	1013981554	1013981554	1	12	EISENHOWER MEDICAL CENTER	11/12/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	39000 BOB HOPE DR	W-201 WRIGHT BLDG 201	RANCHO MIRAGE	CA	92270	4126	33	06065	33.763572	-116.4056895	Riverside County
235432	Fee-for-Service	1952381659	1952381659	1	1	EASTMAN, THOMAS W DO	10/15/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	4364	41	Internal Medicine	0	In state provider	None	521 E ELDER ST	STE 104	FALLBROOK	CA	92028	3082	37	06073	33.38015149	-117.246267	San Diego County
235446	Fee-for-Service	1184166738	1184166738	2	1	EASYCARE PHARMACY LLC	2/8/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7320 WOODLAKE AVE	100	WEST HILLS	CA	91307	1493	19	06037	34.20245266	-118.6321273	Los Angeles County
235486	Fee-for-Service	1215062310	1215062310	1	1	EDWARDS, WHITNEY MD	10/31/1995	174400000X	NA	Other	026	PHYSICIANS	83598	40	Pediatrics	0	In state provider	None	10737 CAMINO RUIZ	STE 200	SAN DIEGO	CA	92126	2371	37	06073	32.91416051	-117.1437943	San Diego County
235489	Fee-for-Service	1871057786	1871057786	1	1	EYECARE SPECIALISTS MEDICAL	4/19/2021	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	ONTEBELLO	229 E BEVERLY BLVD	None	MONTEBELLO	CA	90640	3776	19	06037	34.01510765	-118.0962843	Los Angeles County
235545	Fee-for-Service	1104958883	1104958883	1	1	ESTRADA, LOURDES P LMFT	1/17/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11455 PARAMOUNT BLVD	SUITE F	DOWNEY	CA	90241	4550	19	06037	33.94022241	-118.1398143	Los Angeles County
235578	Fee-for-Service	1710333976	1710333976	1	1	ELITE FIRST HEALTH	11/29/2017	261QP2300X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3121 YOSEMITE BLVD.	SUITE D-2	MODESTO	CA	95354	4166	50	06099	37.63819029	-120.9367251	Stanislaus County
235613	Fee-for-Service	1588901532	1588901532	1	21	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	8000 SUNSET BLVD	C110	LOS ANGELES	CA	90046	2439	19	06037	34.09796251	-118.365138	Los Angeles County
235720	Fee-for-Service	1952381659	1952381659	1	1	EASTMAN, THOMAS W DO	10/15/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	4364	10	Gastroenterology (M.D. only)	0	In state provider	None	521 E ELDER ST	STE 104	FALLBROOK	CA	92028	3082	37	06073	33.38015149	-117.246267	San Diego County
235736	Fee-for-Service	1184321036	1184321036	1	1	EASTWOOD CARE, INC	1/1/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER	410 EASTWOOD AVE	None	MANTECA	CA	95336	6167	39	06077	37.81776073	-121.2228843	San Joaquin County
235797	Fee-for-Service	1982629440	1982629440	1	1	EMANATE HEALTH MEDICAL	5/17/1996	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	210 W SAN BERNARDINO	None	COVINA	CA	91723	1515	19	06037	34.088004	-117.893475	Los Angeles County
235853	Fee-for-Service	1952353575	1952353575	1	1	EATON, MARK HENRY MD	8/31/1991	207R00000X	NA	Other	026	PHYSICIANS	73724	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	500 UNIVERSITY AVE	STE 100	SACRAMENTO	CA	95825	6527	34	06067	38.568402	-121.418019	Sacramento County
235854	Fee-for-Service	1407493679	1407493679	1	1	ENRIQUEZ, KATHRYN A PT	7/10/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
235900	Fee-for-Service	1588901532	1588901532	1	21	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	8000 SUNSET BLVD	C110	LOS ANGELES	CA	90046	2439	19	06037	34.09796251	-118.365138	Los Angeles County
235943	Fee-for-Service	1164579918	1164579918	1	1	EVERITT, CHERYL M OD	10/14/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	BROCKTON OPTOMETRY	6377 RIVERSIDE AVE	STE 170	RIVERSIDE	CA	92506	3155	33	06065	33.9516	-117.387977	Riverside County
235959	Fee-for-Service	1134359102	1134359102	1	1	ERRECART, KEITH C MD	11/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114047	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
236049	Fee-for-Service	1437366473	1437366473	1	1	ELGAVISH, ROTEM L MD	1/21/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	170974	None	None	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
236055	Fee-for-Service	1477714087	1477714087	1	1	EKRAM, TASHFEEN MD	7/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124599	30	Radiology	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
236084	Fee-for-Service	1982629440	1982629440	1	1	EMANATE HEALTH MEDICAL	5/17/1996	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	210 W SAN BERNARDINO	None	COVINA	CA	91723	1515	19	06037	34.088004	-117.893475	Los Angeles County
236151	Fee-for-Service	1245640333	1245640333	1	1	EMAMI ESFAHANI, NADER	9/27/2022	207L00000X	NA	Other	026	PHYSICIANS	166914	None	None	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
236339	Fee-for-Service	1760824825	1760824825	1	1	ELSABBAGH, HOWAIDA LMFT	4/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	888 S HILL ROAD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
236591	Fee-for-Service	1619996105	1619996105	1	1	ERICKSON, SONIA DPM	2/4/2025	213ES0131X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1 SHRADER ST	SUITE 580	SAN FRANCISCO	CA	94117	1016	38	06075	37.77467326	-122.4529451	San Francisco County
236617	Fee-for-Service	1679659478	1679659478	1	1	ELLENBOGEN RICHARD G. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	325 9TH AVE	None	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
236622	Fee-for-Service	1316402597	1316402597	1	1	ELYSIUM HOME HEALTH CARE	11/3/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	13746 VICTORY BLVD	SUITE 214	VAN NUYS	CA	91401	6716	19	06037	34.18664551	-118.432764	Los Angeles County
236667	Fee-for-Service	1033312640	1033312640	1	1	EIN-GAL, SHLOMIT Y MD	9/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101628	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
236781	Fee-for-Service	1649590282	1649590282	1	1	EDWARDS, LAUREN M MD	7/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116912	41	Internal Medicine	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
236788	Fee-for-Service	1669577557	1669577557	1	1	EGLI, CATHERINE A MD	4/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	43183	67	Endocrinology	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
236790	Fee-for-Service	1760924849	1760924849	1	1	EVANS, JULIA PSYD	1/11/2018	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	23 CORPORATE PLAZA DR	150	NEWPORT BEACH	CA	92660	7911	30	06059	33.6090297	-117.8748261	Orange County
236902	Fee-for-Service	1437181930	1437181930	1	1	EYECARE SPECIALIST MEDICAL	10/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	ATLANTIS EYECARE	2571 W LA PALMA AVE	None	ANAHEIM	CA	92801	2622	30	06059	33.84687747	-117.975258	Orange County
237059	Fee-for-Service	1699079954	1699079954	1	2	EISEN-KEARNS, MOLLY A LCSW	1/13/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4565 MANANITA AVE	None	ATASCADERO	CA	93422	3068	40	06079	35.5063489	-120.6732297	San Luis Obispo County
237060	Fee-for-Service	1558596312	1558596312	1	1	ENGSTROM, NICHOLAS J MD	8/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	33	Thoracic Surgery	1	Border provider	None	520 MEDICAL CENTER DR	STE 201	MEDFORD	OR	97504	1910	00	None	42.318801	-122.831728	Jackson County
237078	Fee-for-Service	1669577557	1669577557	1	1	EGLI, CATHERINE A MD	4/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	43183	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
237098	Fee-for-Service	1104255215	1104255215	1	2	ETHOS HOLDING CORP	2/22/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	29 E 6TH STREET	None	NEWPORT	KY	41071	1803	00	None	39.09136642	-84.49392216	Campbell County
237158	Fee-for-Service	1558805226	1558805226	1	1	ELITE PHARMACY INC	12/3/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7111 BEVERLY BLVD	None	LOS ANGELES	CA	90036	2538	19	06037	34.0762263	-118.3446315	Los Angeles County
237185	Fee-for-Service	1588901532	1588901532	1	15	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2613 PACIFIC COAST HWY	None	TORRANCE	CA	90505	7037	19	06037	33.79066323	-118.3311878	Los Angeles County
237191	Fee-for-Service	1548288723	1548288723	1	1	EISENBUD, ELLIOTT MD INC	1/31/1986	207R00000X	NA	Other	026	PHYSICIANS	23760	41	Internal Medicine	0	In state provider	None	6600 MERCY CT	STE 110	FAIR OAKS	CA	95628	3150	34	06067	38.666565	-121.309857	Sacramento County
237288	Fee-for-Service	1669540522	1669540522	1	1	EVANS, LARRY C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2770 CORTEZ AVE	None	IDAHO FALLS	ID	83404	7590	00	None	43.47282307	-111.9887831	Bonneville County
237292	Fee-for-Service	1447096300	1447096300	1	1	ESTRIDGE, DENISE G OT	10/17/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
237306	Fee-for-Service	1922331008	1922331008	1	1	ESCOBEDO, ARIEL LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
237322	Fee-for-Service	1528449709	1528449709	1	1	ESCALANTE, WINNILA MAY Q NP	10/6/2020	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 MEDICAL PLAZA	565	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
237473	Fee-for-Service	1588901532	1588901532	1	15	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2613 PACIFIC COAST HWY	None	TORRANCE	CA	90505	7037	19	06037	33.79066323	-118.3311878	Los Angeles County
237475	Fee-for-Service	1588901532	1588901532	1	7	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	701 N WENDY DR	None	NEWBURY PARK	CA	91320	3066	56	06111	34.18816531	-118.9414165	Ventura County
237510	Fee-for-Service	1518442110	1518442110	1	1	ERICH, BRYCE A PSYD	1/14/2020	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
237569	Fee-for-Service	1336162726	1336162726	1	1	EMERGENCY MED SVS GRP	8/30/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
237585	Fee-for-Service	1982656187	1982656187	1	1	EISENDRATH, STUART J MD	3/19/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	30357	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
237598	Fee-for-Service	1417726852	1417726852	1	1	EXPRESS WALK-IN CLINIC	6/27/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	18182 US HIGHWAY 18	STE 106	APPLE VALLEY	CA	92307	2200	36	06071	34.54087945	-117.267147	San Bernardino County
237634	Fee-for-Service	1487637666	1487637666	1	1	ESAU, ARLIE E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 LINCOLN WAY	None	COEUR D ALENE	ID	83814	2611	00	None	47.69465937	-116.7917936	Kootenai County
237647	Fee-for-Service	1811081508	1811081508	1	1	EVANS-RAMSEY, TRACY M MD	3/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	71989	40	Pediatrics	0	In state provider	None	5700 TELEGRAPH AVE	SUITE 100	OAKLAND	CA	94609	1710	01	06001	37.84323585	-122.2614659	Alameda County
237737	Fee-for-Service	1780859041	1780859041	1	1	ECHOLS, MYRNA V PHD	8/28/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11344 COLOMA ROAD	SUITE 605	GOLD RIVER	CA	95670	4461	34	06067	38.62017	-121.2598125	Sacramento County
237746	Fee-for-Service	1164838520	1164838520	1	1	ESPINOZA, LINDA T LCSW	4/20/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
237752	Fee-for-Service	1760608707	1760608707	1	1	ENCOMPASS COMMUNITY SERVICES	3/14/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	585 AUTO CENTER DR	STE B	WATSONVILLE	CA	95076	3764	44	06087	36.91699314	-121.7673915	Santa Cruz County
237759	Fee-for-Service	1588901532	1588901532	1	15	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2613 PACIFIC COAST HWY	None	TORRANCE	CA	90505	7037	19	06037	33.79066323	-118.3311878	Los Angeles County
237764	Fee-for-Service	1588901532	1588901532	1	7	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	701 N WENDY DR	None	NEWBURY PARK	CA	91320	3066	56	06111	34.18816531	-118.9414165	Ventura County
237888	Fee-for-Service	1417726852	1417726852	1	1	EXPRESS WALK-IN CLINIC	6/27/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18182 US HIGHWAY 18	STE 106	APPLE VALLEY	CA	92307	2200	36	06071	34.54087945	-117.267147	San Bernardino County
237894	Fee-for-Service	1225463029	1225463029	1	2	ESTANTE, MARIA R LMFT	6/21/2024	106H00000X	NA	Mental Health Outpatient Services	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
237964	Fee-for-Service	1013981554	1013981554	1	35	EISENHOWER MEDICAL CENTER	10/27/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	39700 BOB HOPE DRIVE	SUITE 216	RANCHO MIRAGE	CA	92270	3221	33	06065	33.760683	-116.4080645	Riverside County
238047	Fee-for-Service	1588901532	1588901532	1	15	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2613 PACIFIC COAST HWY	None	TORRANCE	CA	90505	7037	19	06037	33.79066323	-118.3311878	Los Angeles County
238052	Fee-for-Service	1588901532	1588901532	1	7	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	701 N WENDY DR	None	NEWBURY PARK	CA	91320	3066	56	06111	34.18816531	-118.9414165	Ventura County
238148	Fee-for-Service	1770725491	1770725491	1	1	ENGLISH, ISAAC B MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120921	41	Internal Medicine	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
238174	Fee-for-Service	1417726852	1417726852	1	1	EXPRESS WALK-IN CLINIC	6/27/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	18182 US HIGHWAY 18	STE 106	APPLE VALLEY	CA	92307	2200	36	06071	34.54087945	-117.267147	San Bernardino County
238185	Fee-for-Service	1255996658	1255996658	1	2	EYONG, AGNES K NP	10/18/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
238200	Fee-for-Service	1073990149	1073990149	1	1	ERICKSON, JENNA R MD	3/28/2024	207PP0204X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
238271	Fee-for-Service	1700906849	1700906849	1	1	ESCAMILLA, SONIA L LCSW	2/26/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
238274	Fee-for-Service	1013981554	1013981554	1	2	EISENHOWER MEDICAL CENTER	7/1/1983	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	BUSINESS OFFICE	39000 BOB HOPE RD	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
238287	Fee-for-Service	1164885604	1164885604	1	2	ENLOE MEDICAL CENTER	9/22/2020	207PE0005X	NA	Other	022	PHYSICIANS GROUP	-	89	Surgery-Traumatic	0	In state provider	RIC CENTER	1026 MANGROVE AVE	STE 10	CHICO	CA	95926	3556	04	06007	39.73971182	-121.8368837	Butte County
238336	Fee-for-Service	1588901532	1588901532	1	15	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2613 PACIFIC COAST HWY	None	TORRANCE	CA	90505	7037	19	06037	33.79066323	-118.3311878	Los Angeles County
238339	Fee-for-Service	1588901532	1588901532	1	7	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	701 N WENDY DR	None	NEWBURY PARK	CA	91320	3066	56	06111	34.18816531	-118.9414165	Ventura County
238343	Fee-for-Service	1750307278	1750307278	1	2	EAST VALLEY HEMATOLOGY	10/1/1998	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	ONCOLOGY MEDICAL GROUP	4955 VAN NUYS BLVD	STE 715	SHERMAN OAKS	CA	91403	1842	19	06037	34.160805	-118.4487295	Los Angeles County
238354	Fee-for-Service	1659482107	1659482107	1	1	EIPE, MARIA DO	2/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8626	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
238398	Fee-for-Service	1265500912	1265500912	1	1	ESLAMI, CASSANDRA S LMFT	7/1/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	48904	-	NOT APPLICABLE	0	In state provider	None	1563 MISSION ST	None	SAN FRANCISCO	CA	94103	2543	38	06075	37.77327874	-122.4183559	San Francisco County
238442	Fee-for-Service	1336564574	1336564574	1	1	EDGAR, BRUCE W MD	3/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	44888	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6002	19	06037	34.28200485	-118.4030797	Los Angeles County
238480	Fee-for-Service	1588901532	1588901532	1	13	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	14550 SOLEDAD CYN RD	100	CANYON COUNTRY	CA	91387	2200	19	06037	34.43539863	-118.39023	Los Angeles County
238496	Fee-for-Service	1851458434	1851458434	1	1	EL CAMINO HOSP	1/1/1995	273R00000X	NA	Other	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2590 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36745824	-122.0779385	Santa Clara County
238571	Fee-for-Service	1164885604	1164885604	1	2	ENLOE MEDICAL CENTER	9/22/2020	207PE0005X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	RIC CENTER	1026 MANGROVE AVE	STE 10	CHICO	CA	95926	3556	04	06007	39.73971182	-121.8368837	Butte County
238627	Fee-for-Service	1588901532	1588901532	1	7	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	701 N WENDY DR	None	NEWBURY PARK	CA	91320	3066	56	06111	34.18816531	-118.9414165	Ventura County
238633	Fee-for-Service	1750307278	1750307278	1	2	EAST VALLEY HEMATOLOGY	10/1/1998	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	ONCOLOGY MEDICAL GROUP	4955 VAN NUYS BLVD	STE 715	SHERMAN OAKS	CA	91403	1842	19	06037	34.160805	-118.4487295	Los Angeles County
238767	Fee-for-Service	1588901532	1588901532	1	13	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	14550 SOLEDAD CYN RD	100	CANYON COUNTRY	CA	91387	2200	19	06037	34.43539863	-118.39023	Los Angeles County
238824	Fee-for-Service	1801244181	1801244181	1	1	ELLISON, THERESA L LMFT	1/18/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1357 W SHAW AVE	SUITE 103	FRESNO	CA	93711	3619	10	06019	36.80824094	-119.8162512	Fresno County
238915	Fee-for-Service	1841507514	1841507514	1	1	EDANO, DEBBIE E MD	11/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6900 N DURANGO DR	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
238930	Fee-for-Service	1851657787	1851657787	1	1	ELLA ASHABI ACUPUNCTURE INC	7/1/2016	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	22772 CENTRE DR	STE 100	LAKE FOREST	CA	92630	6303	30	06059	33.63155928	-117.7169152	Orange County
238971	Fee-for-Service	1982084901	1982084901	1	1	E JOSEPH NADJI MD A MEDICAL	8/9/2024	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	1301 20TH ST	SUITE 260	SANTA MONICA	CA	90404	2052	19	06037	34.02976782	-118.4812493	Los Angeles County
239056	Fee-for-Service	1588901532	1588901532	1	13	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	14550 SOLEDAD CYN RD	100	CANYON COUNTRY	CA	91387	2200	19	06037	34.43539863	-118.39023	Los Angeles County
239067	Fee-for-Service	1588901532	1588901532	1	35	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	269 S SAN PEDRO ST	None	LOS ANGELES	CA	90012	3808	19	06037	34.04784355	-118.2423412	Los Angeles County
239074	Fee-for-Service	1285672881	1285672881	1	1	ENGIBARIAN, MARIANNA	2/8/2015	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
239181	Fee-for-Service	1245476597	1245476597	1	1	EVANS, MATTHEW SHANE CPO	12/13/2012	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1705 COFFEE RD	#1	MODESTO	CA	95355	2809	50	06099	37.669266	-120.975728	Stanislaus County
239222	Fee-for-Service	1558970871	1558970871	1	1	EXCELLENT PALLIATIVE AND	7/11/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	HOSPICE CARE, INC	10600 SEPULVEDA BLVD	SUITE 106	MISSION HILLS	CA	91345	9100	19	06037	34.263036	-118.467243	Los Angeles County
239223	Fee-for-Service	1326462631	1326462631	1	1	EL CAPITAN WOUND & DIABETIC	9/14/2015	207R00000X	NA	Other	026	PHYSICIANS	64927	None	None	0	In state provider	None	4747 N 1ST ST	STE 132	FRESNO	CA	93726	0517	10	06019	36.803385	-119.7724465	Fresno County
239271	Fee-for-Service	1750677522	1750677522	1	1	ELAHIMEHR, REZA MD	3/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119841	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
239294	Fee-for-Service	1629242854	1629242854	1	3	EDMONDS, MATHEW S MD	1/25/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	118791	None	None	0	In state provider	None	4010 WATSON PLAZA D	140	LAKEWOOD	CA	90712	4047	19	06037	33.83123565	-118.1550195	Los Angeles County
239307	Fee-for-Service	1154313419	1154313419	1	1	ENZENAUER, ROBERT W MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	18	Ophthalmology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
239332	Fee-for-Service	1275578429	1275578429	1	1	EL-SADEN, SUZIE M MD	4/30/1991	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	62058	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
239340	Fee-for-Service	1588901532	1588901532	1	13	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	14550 SOLEDAD CYN RD	100	CANYON COUNTRY	CA	91387	2200	19	06037	34.43539863	-118.39023	Los Angeles County
239354	Fee-for-Service	1588901532	1588901532	1	35	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	269 S SAN PEDRO ST	None	LOS ANGELES	CA	90012	3808	19	06037	34.04784355	-118.2423412	Los Angeles County
239407	Fee-for-Service	1962212902	1962212902	1	1	EMBRACE REHABILITATION INC	1/13/2025	373H00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	468 W 5TH ST	SUITE 212	SAN BERNARDINO	CA	92401	1316	36	06071	34.1083653	-117.2933767	San Bernardino County
239463	Fee-for-Service	1922003706	1922003706	1	1	EDWARDS, RUSSELL P MD	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	57008	66	Emergency Medicine (Urgent Care)	0	In state provider	APC	3969 4TH AVE	STE 301	SAN DIEGO	CA	92103	3165	37	06073	32.74948151	-117.1615826	San Diego County
239483	Fee-for-Service	1780019612	1780019612	1	1	EQUANIMITY HOSPICE &	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE, INC	22365 BARTON RD	SUITE 100	GRAND TERRACE	CA	92313	5015	36	06071	34.03387854	-117.316818	San Bernardino County
239510	Fee-for-Service	1558970871	1558970871	1	1	EXCELLENT PALLIATIVE AND	7/11/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	HOSPICE CARE, INC	10600 SEPULVEDA BLVD	SUITE 106	MISSION HILLS	CA	91345	9100	19	06037	34.263036	-118.467243	Los Angeles County
239559	Fee-for-Service	1538228291	1538228291	1	1	EKANAYAKE, DEEPAL M MD	2/28/1991	207R00000X	NA	Other	026	PHYSICIANS	49246	41	Internal Medicine	0	In state provider	None	44469 10TH ST W	None	LANCASTER	CA	93534	3324	19	06037	34.691454	-118.148068	Los Angeles County
239592	Fee-for-Service	1154313419	1154313419	1	1	ENZENAUER, ROBERT W MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
239611	Fee-for-Service	1962908756	1962908756	1	1	EXPRESS HOME CARE	9/13/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	15643 SHERMAN WAY	STE 270	VAN NUYS	CA	91406	4135	19	06037	34.20128049	-118.474155	Los Angeles County
239631	Fee-for-Service	1588901532	1588901532	1	13	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	14550 SOLEDAD CYN RD	100	CANYON COUNTRY	CA	91387	2200	19	06037	34.43539863	-118.39023	Los Angeles County
239641	Fee-for-Service	1588901532	1588901532	1	35	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	269 S SAN PEDRO ST	None	LOS ANGELES	CA	90012	3808	19	06037	34.04784355	-118.2423412	Los Angeles County
239642	Fee-for-Service	1063244234	1063244234	1	1	ELIZABETH SCOTT MD INC	9/10/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
239668	Fee-for-Service	1750142634	1750142634	1	1	E3 CIVIC HIGH	7/1/2024	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	395 11TH AVE	6TH FLOOR	SAN DIEGO	CA	92101	0000	37	06073	32.70931759	-117.1545609	San Diego County
239672	Fee-for-Service	1447332945	1447332945	1	1	ETHAN T HOERSCHGEN	2/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1911 S NATIONAL AVE	STE 301	SPRINGFIELD	MO	65804	2213	00	None	37.17992552	-93.27671151	Greene County
239694	Fee-for-Service	1730212937	1730212937	1	1	EL DORADO COUNTY CCS	2/17/2000	No Taxonomy Provided	NA	None	046	REHABILITATION CLINIC	-	-	NOT APPLICABLE	0	In state provider	SOUTH LAKE TAHOE MTU	1100 LYONS AVE	None	SOUTH LAKE TAHOE	CA	96150	8252	09	06017	38.93778925	-119.9742102	El Dorado County
239714	Fee-for-Service	1720124274	1720124274	1	1	EHK MEDICAL CORP	1/12/2016	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3663 W 6TH ST	STE 202	LOS ANGELES	CA	90020	3048	19	06037	34.06360557	-118.30199	Los Angeles County
239751	Fee-for-Service	1922003706	1922003706	1	1	EDWARDS, RUSSELL P MD	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	57008	18	Ophthalmology	0	In state provider	APC	3969 4TH AVE	STE 301	SAN DIEGO	CA	92103	3165	37	06073	32.74948151	-117.1615826	San Diego County
239785	Fee-for-Service	1780019612	1780019612	1	1	EQUANIMITY HOSPICE &	2/26/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE, INC	22365 BARTON RD	SUITE 100	GRAND TERRACE	CA	92313	5015	36	06071	34.03387854	-117.316818	San Bernardino County
239814	Fee-for-Service	1902954795	1902954795	1	1	EDGERTON, BRADFORD W MD	5/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	33416	24	Plastic Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
239815	Fee-for-Service	1366503427	1366503427	1	1	EVANS, SEAN J MD	6/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	71217	13	Neurology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
239872	Fee-for-Service	1982085981	1982085981	1	1	EXCELLENT CARE PROVIDER INC	7/28/2015	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	723 MADDUX DR	None	DALY CITY	CA	94015	3500	41	06081	37.69404098	-122.4825567	San Mateo County
239929	Fee-for-Service	1588901532	1588901532	1	35	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	269 S SAN PEDRO ST	None	LOS ANGELES	CA	90012	3808	19	06037	34.04784355	-118.2423412	Los Angeles County
239956	Fee-for-Service	1902062136	1902062136	1	4	EL PORTAL RADIATION ONCOLOGY	3/15/2016	193400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	360 E ALMOND AVE	STE 103	MADERA	CA	93637	5690	20	06039	36.94549856	-120.0527351	Madera County
239985	Fee-for-Service	1720536097	1720536097	1	1	ESMAILZADEGAN, ARASH MD INC	9/27/2016	193400000X	NA	Other	026	PHYSICIANS	136449	05	Anesthesiology	0	In state provider	None	12601 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92843	1908	30	06059	33.77450951	-117.913014	Orange County
240004	Fee-for-Service	1083616106	1083616106	1	1	ESPARRAGO, JOSE M MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64025	41	Internal Medicine	0	In state provider	None	14901 RINALDI ST	STE 200	MISSION HILLS	CA	91345	1254	19	06037	34.27903452	-118.457433	Los Angeles County
240064	Fee-for-Service	1194852988	1194852988	1	1	EPIPHANY CARE HOMES, INC	8/1/2003	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SANDPIPER HOME ICF/DD-H	1621 SOPHIA DR	None	OXNARD	CA	93030	3288	56	06111	34.217253	-119.1969075	Ventura County
240138	Fee-for-Service	1285746198	1285746198	1	1	EBERT-SANTOS, CHRISTINE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	340 PEAK ONE DRIVE	None	FRISCO	CO	80443	0000	00	None	39.57003029	-106.0781094	Summit County
240199	Fee-for-Service	1871609966	1871609966	1	1	EICKHOFF, LEO E MD	9/4/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	88920	10	Gastroenterology (M.D. only)	0	In state provider	None	1825 SONOMA ST	None	REDDING	CA	96001	2519	45	06089	40.5756004	-122.3928987	Shasta County
240216	Fee-for-Service	1588901532	1588901532	1	35	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	269 S SAN PEDRO ST	None	LOS ANGELES	CA	90012	3808	19	06037	34.04784355	-118.2423412	Los Angeles County
240241	Fee-for-Service	1902062136	1902062136	1	4	EL PORTAL RADIATION ONCOLOGY	3/15/2016	193400000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	360 E ALMOND AVE	STE 103	MADERA	CA	93637	5690	20	06039	36.94549856	-120.0527351	Madera County
240316	Fee-for-Service	1033191317	1033191317	1	2	ERA HOME HEALTH SERVICES	10/19/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	270 W BADILLO ST	None	COVINA	CA	91723	1906	19	06037	34.08623903	-117.8942651	Los Angeles County
240318	Fee-for-Service	1083786867	1083786867	2	1	ENTAG INC	1/21/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1685 E MAIN ST	STE 101	EL CAJON	CA	92021	5225	37	06073	32.81132509	-116.9192044	San Diego County
240339	Fee-for-Service	1518982495	1518982495	1	1	ESCUETA, ANTONIO V MD	6/11/1998	2084N0400X	NA	Neurology	026	PHYSICIANS	29488	13	Neurology (M.D. only)	0	In state provider	None	710 WESTWOOD PLZ	STE C24	LOS ANGELES	CA	90095	8353	19	06037	34.06680182	-118.4450804	Los Angeles County
240391	Fee-for-Service	1942045653	1942045653	1	1	EBONIE REED LMFT A LICENSED	7/19/2024	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	TER	5055 CANYON CREST DR	None	RIVERSIDE	CA	92507	6015	33	06065	33.95862536	-117.3310726	Riverside County
240492	Fee-for-Service	1588901532	1588901532	1	54	EXER MEDICAL CORPORATION	1/9/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	23341 MULHOLLAND DR	None	WOODLAND HILLS	CA	91364	2734	19	06037	34.15781385	-118.6354611	Los Angeles County
240579	Fee-for-Service	1508961897	1508961897	2	1	ENNS, GREGORY M MD	2/15/2019	207SG0202X	NA	Other	026	PHYSICIANS	52095	01	General Practice	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
240669	Fee-for-Service	1508944315	1508944315	1	1	ENSTROM, RANDALL J MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	46482	30	Radiology	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
240721	Fee-for-Service	1134320716	1134320716	1	1	ESPINOZA, MARIA A MD INC	8/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	65846	08	Family Practice	0	In state provider	None	2151 W 6TH ST	None	LOS ANGELES	CA	90057	3121	19	06037	34.05994359	-118.2756756	Los Angeles County
240729	Fee-for-Service	1093133951	1093133951	1	1	EASTERLIN, MOLLY C MD	3/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140415	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
240775	Fee-for-Service	1588901532	1588901532	1	54	EXER MEDICAL CORPORATION	1/9/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	23341 MULHOLLAND DR	None	WOODLAND HILLS	CA	91364	2734	19	06037	34.15781385	-118.6354611	Los Angeles County
240899	Fee-for-Service	1427411198	1427411198	1	1	EVERETT, SCOTT MD	12/11/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	159033	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
240998	Fee-for-Service	1760085880	1760085880	1	1	EVEXIA HEALTH, INC.	4/8/2021	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9902 BRIMHALL RD	SUITE 100	BAKERSFIELD	CA	93312	2801	15	06029	35.36882344	-119.1124447	Kern County
241012	Fee-for-Service	1134320716	1134320716	1	1	ESPINOZA, MARIA A MD INC	8/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	65846	34	Urology and Urological Surgery	0	In state provider	None	2151 W 6TH ST	None	LOS ANGELES	CA	90057	3121	19	06037	34.05994359	-118.2756756	Los Angeles County
241049	Fee-for-Service	1508220096	1508220096	1	1	EFFRON, MORGAN R	12/11/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	169319	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
241058	Fee-for-Service	1225144553	1225144553	1	1	EBREO, ADAM C DO	8/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14598	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
241065	Fee-for-Service	1588901532	1588901532	1	54	EXER MEDICAL CORPORATION	3/25/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	23341 MULHOLLAND DR	None	WOODLAND HILLS	CA	91364	2734	19	06037	34.15781385	-118.6354611	Los Angeles County
241092	Fee-for-Service	1609319946	1609319946	1	1	ELLEHCAL OBGYN INC	2/1/2017	174400000X	NA	Other	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	577 EAST ELDER ST	SUITE F	FALLBROOK	CA	92028	3079	37	06073	33.3801147	-117.2456536	San Diego County
241099	Fee-for-Service	1730249384	1730249384	1	1	ELIAS, CAROL PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2001 N GAREY AVE	STE 107	POMONA	CA	91767	2773	19	06037	34.082721	-117.7530165	Los Angeles County
241149	Fee-for-Service	1073321337	1073321337	1	1	EADARA, INC.	1/6/2025	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7130 MAGNOLIA AVE STE	C & F	RIVERSIDE	CA	92504	3864	33	06065	33.94520323	-117.4026649	Riverside County
241202	Fee-for-Service	1801998836	1801998836	2	1	ENZ, JOSE PEDRO MD	6/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51091	40	Pediatrics	0	In state provider	None	6333 TELEGRAPH AVE	STE 203	OAKLAND	CA	94609	1359	01	06001	37.84914135	-122.260702	Alameda County
241263	Fee-for-Service	1629416862	1629416862	1	1	EDWARD MALCOLM	5/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5200 DTC PKWY	STE 400	GREENWOOD VLG	CO	80111	2719	00	None	39.621636	-104.8992545	Arapahoe County
241315	Fee-for-Service	1053538538	1053538538	1	1	EMERY, KERRY S CRNA	6/13/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
241325	Fee-for-Service	1972007847	1972007847	1	1	EHLERS, PAUL	8/21/2024	207P00000X	NA	Other	026	PHYSICIANS	166512	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
241350	Fee-for-Service	1588901532	1588901532	1	54	EXER MEDICAL CORPORATION	1/9/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	23341 MULHOLLAND DR	None	WOODLAND HILLS	CA	91364	2734	19	06037	34.15781385	-118.6354611	Los Angeles County
241371	Fee-for-Service	1689103814	1689103814	1	1	ELLISON, LAVINA	5/18/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
241431	Fee-for-Service	1588901532	1588901532	1	29	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9726 VENICE BLVD	None	CULVER CITY	CA	90232	2717	19	06037	34.02402034	-118.3974264	Los Angeles County
241437	Fee-for-Service	1699796722	1699796722	1	1	ELEVADO, MARIA M D C MD	12/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	90906	40	Pediatrics	0	In state provider	None	204 E BEACH ST	None	WATSONVILLE	CA	95076	4809	44	06087	36.91224802	-121.7541363	Santa Cruz County
241471	Fee-for-Service	1114935285	1114935285	1	1	ECK, MARY JO J MFT	1/9/2015	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	50 E ALPINE DRIVE	None	MERCED	CA	95340	2402	24	06047	37.31181497	-120.4687099	Merced County
241543	Fee-for-Service	1861621435	1861621435	1	1	ERFAN, NAHAN OD	12/23/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
241657	Fee-for-Service	1588901532	1588901532	1	63	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	245 TERRACINA BLVD	102	REDLANDS	CA	92373	4865	36	06071	34.03858912	-117.2066515	San Bernardino County
241670	Fee-for-Service	1922294552	1922294552	1	1	EWAN, CAROLINE M LMFT	3/3/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
241721	Fee-for-Service	1588901532	1588901532	1	29	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	9726 VENICE BLVD	None	CULVER CITY	CA	90232	2717	19	06037	34.02402034	-118.3974264	Los Angeles County
241814	Fee-for-Service	1114082062	1114082062	1	1	ENES, INC	4/11/2023	224900000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	50 BEN FRANKLIN CT	None	SAN MATEO	CA	94401	4041	41	06081	37.56294731	-122.3244624	San Mateo County
241847	Fee-for-Service	1134625908	1134625908	1	1	EDMUNDSON, JUDITH A LPCC	3/31/2021	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
241868	Fee-for-Service	1184780181	1184780181	1	1	EBBETTS PASS FIRE DIST	9/23/2002	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1037 BLAGEN RD	None	ARNOLD	CA	95223	0066	05	06009	38.25734617	-120.3476703	Calaveras County
241872	Fee-for-Service	1407873102	1407873102	1	1	EGEKEZE, CAROLINE O MD	8/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86266	40	Pediatrics	0	In state provider	None	7301 STATE ST	None	HUNTINGTON PARK	CA	90255	5823	19	06037	33.97149395	-118.2097278	Los Angeles County
241894	Fee-for-Service	1669461281	1669461281	1	1	EXEMPLA LUTHERAN HOSP	6/9/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	8300 W 38TH AVE	None	WHEAT RIDGE	CO	80033	6005	00	None	39.76932763	-105.0903492	Jefferson County
241910	Fee-for-Service	1780203802	1780203802	1	1	ELIJAH HOUSE FOUNDATION	6/24/2024	163WA0400X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	2060 PARK AVE	None	OROVILLE	CA	95966	5350	04	06007	39.50921909	-121.5520114	Butte County
241916	Fee-for-Service	1922214857	1922214857	1	1	EMBRY, THOMAS T	4/8/1997	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	WE CARE TRANSIT	27433 CAPRI AVE	None	HAYWARD	CA	94545	4001	01	06001	37.62618644	-122.1047595	Alameda County
241946	Fee-for-Service	1588901532	1588901532	1	63	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	245 TERRACINA BLVD	102	REDLANDS	CA	92373	4865	36	06071	34.03858912	-117.2066515	San Bernardino County
242008	Fee-for-Service	1588901532	1588901532	1	10	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	19346 NORDHOFF ST	None	NORTHRIDGE	CA	91324	2415	19	06037	34.233309	-118.554714	Los Angeles County
242159	Fee-for-Service	1841678646	1841678646	1	1	ENHANCED HOME HEALTH CARE	9/19/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	17620 SHERMAN WAY	SUITE 212	VAN NUYS	CA	91406	3527	19	06037	34.20105176	-118.5171046	Los Angeles County
242183	Fee-for-Service	1669461281	1669461281	1	1	EXEMPLA LUTHERAN HOSP	6/9/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	8300 W 38TH AVE	None	WHEAT RIDGE	CO	80033	6005	00	None	39.76932763	-105.0903492	Jefferson County
242228	Fee-for-Service	1255810636	1255810636	1	1	ESHERA, NOHA MD	8/3/2023	390200000X	NA	Other	026	PHYSICIANS	182017	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
242232	Fee-for-Service	1588901532	1588901532	1	63	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	245 TERRACINA BLVD	102	REDLANDS	CA	92373	4865	36	06071	34.03858912	-117.2066515	San Bernardino County
242294	Fee-for-Service	1588901532	1588901532	1	29	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	9726 VENICE BLVD	None	CULVER CITY	CA	90232	2717	19	06037	34.02402034	-118.3974264	Los Angeles County
242303	Fee-for-Service	1972905503	1972905503	1	2	ENLOE MEDICAL CENTER	1/23/2020	208100000X	NA	Physical Medicine and Rehabilitation	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	REHABILITATION	340 W EAST AVE	None	CHICO	CA	95926	7238	04	06007	39.75353271	-121.8668176	Butte County
242331	Fee-for-Service	1962588764	1962588764	1	1	EBY, R PETER	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	HARBORVIEW MEDICAL CENTE	325 9TH AVE	None	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
242376	Fee-for-Service	1235502832	1235502832	1	1	EMELITA MORALES PRICE	12/4/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2771 CAMBRIDGE AVE	None	HEMET	CA	92545	5315	33	06065	33.73154179	-117.0015937	Riverside County
242472	Fee-for-Service	1861508368	1861508368	1	1	ESPINOSA, DEBRA L CRNA	9/22/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
242497	Fee-for-Service	1861157844	1861157844	1	1	EASY CHOICE HOME HEALTH CARE	4/12/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	6912 OWENSMOUTH AVE	SUITE 104	CANOGA PARK	CA	91303	3109	19	06037	34.19599425	-118.6015033	Los Angeles County
242519	Fee-for-Service	1588901532	1588901532	1	63	EXER MEDICAL CORPORATION	4/2/2025	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	245 TERRACINA BLVD	102	REDLANDS	CA	92373	4865	36	06071	34.03858912	-117.2066515	San Bernardino County
242582	Fee-for-Service	1588901532	1588901532	1	29	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	9726 VENICE BLVD	None	CULVER CITY	CA	90232	2717	19	06037	34.02402034	-118.3974264	Los Angeles County
242593	Fee-for-Service	1225218373	1225218373	1	1	ELKIN, ADAM D MD	7/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100984	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
242619	Fee-for-Service	1265088637	1265088637	1	1	ECLIPSE HOSPICE CARE, INC	5/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	127 S BRAND BLVD	STE 305	GLENDALE	CA	91204	1388	19	06037	34.145289	-118.255096	Los Angeles County
242846	Fee-for-Service	1477969269	1477969269	1	1	EDEN KIM	2/26/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	451 CLARKSON AVE	None	BROOKLYN	NY	11203	2054	00	None	40.656258	-73.9446165	Kings County
242871	Fee-for-Service	1588901532	1588901532	1	29	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9726 VENICE BLVD	None	CULVER CITY	CA	90232	2717	19	06037	34.02402034	-118.3974264	Los Angeles County
242911	Fee-for-Service	1265088637	1265088637	1	1	ECLIPSE HOSPICE CARE, INC	5/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	127 S BRAND BLVD	STE 305	GLENDALE	CA	91204	1388	19	06037	34.145289	-118.255096	Los Angeles County
242948	Fee-for-Service	1780107797	1780107797	1	8	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	1320 EL CAPITAN DRIVE	STE 320	DANVILLE	CA	94526	6258	07	06013	37.78476866	-121.9658691	Contra Costa County
243070	Fee-for-Service	1316114051	1316114051	1	1	ECKER, DAVID J MD	8/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
243222	Fee-for-Service	1891032652	1891032652	1	1	EMMADA PSYCHOLOGY CENTER, IN	2/17/2020	103G00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	C.	8939 S SEPULVEDA BLVD	SUITE #200	LOS ANGELES	CA	90045	3631	19	06037	33.95485856	-118.3962461	Los Angeles County
243235	Fee-for-Service	1780107797	1780107797	1	8	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1320 EL CAPITAN DRIVE	STE 320	DANVILLE	CA	94526	6258	07	06013	37.78476866	-121.9658691	Contra Costa County
243451	Fee-for-Service	1154397933	1154397933	1	1	ELIZABETH ANN OTTNEY DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1242 E MCKELLIPS RD	103	MESA	AZ	85203	0000	00	None	33.45183	-111.8035575	Maricopa County
243515	Fee-for-Service	1891032652	1891032652	1	1	EMMADA PSYCHOLOGY CENTER, IN	2/17/2020	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	C.	8939 S SEPULVEDA BLVD	SUITE #200	LOS ANGELES	CA	90045	3631	19	06037	33.95485856	-118.3962461	Los Angeles County
243525	Fee-for-Service	1780107797	1780107797	1	8	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	1320 EL CAPITAN DRIVE	STE 320	DANVILLE	CA	94526	6258	07	06013	37.78476866	-121.9658691	Contra Costa County
243648	Fee-for-Service	1376104315	1376104315	1	1	EWALD, IVY MD	6/7/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
243669	Fee-for-Service	1437247400	1437247400	1	1	ESCAMILLO, ARTHUR J MD	8/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55409	None	None	0	In state provider	None	315 E ROUTE 66	STE 101	GLENDORA	CA	91740	6244	19	06037	34.1288429	-117.8607244	Los Angeles County
243697	Fee-for-Service	1639227606	1639227606	1	1	EDWARDS, GARY MD	1/1/1982	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	45147	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
243710	Fee-for-Service	1609124692	1609124692	1	1	ERICK MADRIGAL, MD, MBA, INC	2/21/2023	193400000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	222 WEST HENDERSON AVE	None	PORTERVILLE	CA	93257	1731	54	06107	36.0804034	-119.0217006	Tulare County
243745	Fee-for-Service	1588901532	1588901532	1	47	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	35 W LOS ANGELES AVE	None	MOORPARK	CA	93021	1820	56	06111	34.27900253	-118.8824532	Ventura County
243779	Fee-for-Service	1528750015	1528750015	1	1	E MAC CARE SERVICES INC	6/20/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	11503 THOMAS PLACE	None	NORWALK	CA	90650	7907	19	06037	33.92664079	-118.0879549	Los Angeles County
243793	Fee-for-Service	1255450318	1255450318	1	1	ENT & FACIAL PLASTICS OF OC	9/12/2012	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	9575	None	None	0	In state provider	INC	9940 TALBERT AVE	STE 202	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166347	-117.955494	Orange County
243997	Fee-for-Service	1609124692	1609124692	1	1	ERICK MADRIGAL, MD, MBA, INC	12/10/2020	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	222 WEST HENDERSON AVE	None	PORTERVILLE	CA	93257	1731	54	06107	36.0804034	-119.0217006	Tulare County
244032	Fee-for-Service	1588901532	1588901532	1	47	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	35 W LOS ANGELES AVE	None	MOORPARK	CA	93021	1820	56	06111	34.27900253	-118.8824532	Ventura County
244081	Fee-for-Service	1245606078	1245606078	1	1	EXELLABS LLC	12/20/2016	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	1	Border provider	None	3365 E FLAMINGO RD	SUITE 3	LAS VEGAS	NV	89121	7440	00	None	36.11511747	-115.1016351	Clark County
244088	Fee-for-Service	1013981554	1013981554	1	30	EISENHOWER MEDICAL CENTER	9/1/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	39000 BOB HOPE DR	SUITE 304	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
244151	Fee-for-Service	1316044522	1316044522	1	1	EISNER PEDIATRIC &	12/10/2002	261Q00000X	NA	Other	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	FAMILY MEDICAL CENTER	1530 S OLIVE ST	None	LOS ANGELES	CA	90015	3023	19	06037	34.03542552	-118.2652073	Los Angeles County
244194	Fee-for-Service	1457368136	1457368136	1	1	ENNIS, LINDA C CNM	12/6/2005	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
244245	Fee-for-Service	1891847927	1891847927	1	1	EISERMANN, BRIAN J	4/1/1998	332S00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1074 EAST AVE	K-2	CHICO	CA	95926	9596	04	06007	39.76099443	-121.8353929	Butte County
244247	Fee-for-Service	1689150716	1689150716	1	1	EJIGU, DESALEGN NP	1/19/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	678 3RD ST	None	WOODLAND	CA	95695	4034	57	06113	38.67218698	-121.7707131	Yolo County
244287	Fee-for-Service	1609124692	1609124692	1	1	ERICK MADRIGAL, MD, MBA, INC	2/21/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	222 WEST HENDERSON AVE	None	PORTERVILLE	CA	93257	1731	54	06107	36.0804034	-119.0217006	Tulare County
244319	Fee-for-Service	1588901532	1588901532	1	47	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	35 W LOS ANGELES AVE	None	MOORPARK	CA	93021	1820	56	06111	34.27900253	-118.8824532	Ventura County
244444	Fee-for-Service	1346271012	1346271012	1	1	ESENSTEN, MARK L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	32016	None	None	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
244542	Fee-for-Service	1033426366	1033426366	1	1	EVANS, WENDY LCSW	10/28/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3711 LONG BEACH BLVD	601	LONG BEACH	CA	90807	3315	19	06037	33.824583	-118.1893785	Los Angeles County
244571	Fee-for-Service	1871337873	1871337873	1	1	EMERGENCY PHYSICIANS URGENT	3/26/2025	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	10401 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	6950	19	06037	34.05769596	-118.4243293	Los Angeles County
244575	Fee-for-Service	1629492426	1629492426	1	1	ESCOBEDO, ERIKA V MD	1/7/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	125462	40	Pediatrics	0	In state provider	None	6555 COYLE AVENUE	SUITE 290	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
244608	Fee-for-Service	1588901532	1588901532	1	47	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	35 W LOS ANGELES AVE	None	MOORPARK	CA	93021	1820	56	06111	34.27900253	-118.8824532	Ventura County
244638	Fee-for-Service	1720065188	1720065188	1	1	ERIC COHEN MD	8/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2000 S THOMPSON ST	None	FLAGSTAFF	AZ	86001	8759	00	None	35.184573	-111.674529	Coconino County
244666	Fee-for-Service	1568929404	1568929404	1	1	ENNIS, VERONICA OT	1/4/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	77622 COUNTRY CLUB DR	STE G	PALM DESERT	CA	92211	0447	33	06065	33.75833438	-116.3101957	Riverside County
244739	Fee-for-Service	1881873784	1881873784	1	1	ECHT, MARGARET L MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	83194	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2329 OAK PARK LN	None	SANTA BARBARA	CA	93105	4280	42	06083	34.4291325	-119.7252464	Santa Barbara County
244753	Fee-for-Service	1801415989	1801415989	1	1	EL-HALEES, SARAH A MD	12/1/2023	207R00000X	NA	Other	026	PHYSICIANS	188202	None	None	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
244781	Fee-for-Service	1841558566	1841558566	1	1	ESPINOSA, MARIA LMFT	7/6/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
244782	Fee-for-Service	1043658602	1043658602	1	1	EDEN HOME HEALTH INC	7/27/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6300 CANOGA AVE	SUITE 1310	WOODLAND HILLS	CA	91367	2555	19	06037	34.185249	-118.5973705	Los Angeles County
244804	Fee-for-Service	1366177867	1366177867	1	1	ESCONDIDO POST ACUTE LLC	8/16/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1980 FELICITA ROAD	None	ESCONDIDO	CA	92025	5922	37	06073	33.09776955	-117.0830087	San Diego County
244855	Fee-for-Service	1871337873	1871337873	1	1	EMERGENCY PHYSICIANS URGENT	1/9/2025	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	10401 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	6950	19	06037	34.05769596	-118.4243293	Los Angeles County
244889	Fee-for-Service	1821195660	1821195660	1	2	EXPRESS PHARMACY INC	12/16/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	752 E ARROW HWY	None	POMONA	CA	91767	2247	19	06037	34.08992503	-117.737801	Los Angeles County
244896	Fee-for-Service	1588901532	1588901532	1	47	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	35 W LOS ANGELES AVE	None	MOORPARK	CA	93021	1820	56	06111	34.27900253	-118.8824532	Ventura County
244906	Fee-for-Service	1780107797	1780107797	1	21	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1330 TARA HILLS DRIVE	STE E	PINOLE	CA	94564	2531	07	06013	37.99580466	-122.3048363	Contra Costa County
244937	Fee-for-Service	1295870095	1295870095	1	1	EDELSTEIN, ARTHUR J INC	2/28/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	3737 MLK JR BLVD	STE 340	LYNWOOD	CA	90262	3531	19	06037	33.92872742	-118.2006921	Los Angeles County
244994	Fee-for-Service	1487762159	1487762159	1	1	EYECARE SPECIALISTS MEDICAL	10/3/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	23521 PASEO DE VALENCIA	None	LAGUNA HILLS	CA	92653	3126	30	06059	33.61113028	-117.7126684	Orange County
244998	Fee-for-Service	1831291350	1831291350	1	1	EAST BAY PEDIATRICS INC	2/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77244	40	Pediatrics	0	In state provider	EAST BAY PED PRIM CARE	2324 SANTA RITA RD	STE 12	PLEASANTON	CA	94566	4150	01	06001	37.68217511	-121.8757097	Alameda County
245084	Fee-for-Service	1891158259	1891158259	1	1	EVANS, TERESA A MD	5/23/2022	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	152112	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
245110	Fee-for-Service	1851461123	1851461123	1	2	ENHANCE BY LINDA REIB INC.	1/29/2021	222Z00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	4811 CHIPPENDALE DR	SUITE 208	SACRAMENTO	CA	95841	2555	34	06067	38.663046	-121.352472	Sacramento County
245155	Fee-for-Service	1780344820	1780344820	1	1	EMINENCE HEALTH MANAGEMENT I	7/3/2023	261QP2300X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	NC	557 N CENTRAL AVE	None	UPLAND	CA	91786	4241	36	06071	34.10029088	-117.6896845	San Bernardino County
245194	Fee-for-Service	1780107797	1780107797	1	21	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	1330 TARA HILLS DRIVE	STE E	PINOLE	CA	94564	2531	07	06013	37.99580466	-122.3048363	Contra Costa County
245255	Fee-for-Service	1134286222	1134286222	1	1	ELENA DUMITRESCU	11/7/1995	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1240 RADCLIFF LN	None	HAYWARD	CA	94545	2644	01	06001	37.64247938	-122.0966242	Alameda County
245261	Fee-for-Service	1912063637	1912063637	1	1	ELENA'S HOME CARE	6/10/1998	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	ELENA'S ICF/DD-H #3	1162 MERRITT LN	None	HAYWARD	CA	94545	2642	01	06001	37.64375973	-122.097181	Alameda County
245283	Fee-for-Service	1487762159	1487762159	1	1	EYECARE SPECIALISTS MEDICAL	10/3/2018	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	23521 PASEO DE VALENCIA	None	LAGUNA HILLS	CA	92653	3126	30	06059	33.61113028	-117.7126684	Orange County
245285	Fee-for-Service	1982782629	1982782629	1	1	ESPINO, JULIAN R MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64532	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
245305	Fee-for-Service	1427346840	1427346840	1	1	ERICKSON, ANDREW C LMFT	1/20/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
245399	Fee-for-Service	1851461123	1851461123	1	2	ENHANCE BY LINDA REIB INC.	1/29/2021	222Z00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	4811 CHIPPENDALE DR	SUITE 208	SACRAMENTO	CA	95841	2555	34	06067	38.663046	-121.352472	Sacramento County
245414	Fee-for-Service	1235377847	1235377847	1	1	EUCLID INTERVENTIONAL PAIN	10/13/2011	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MANAGEMENT INC	350 S EUCLID AVE	#C	UPLAND	CA	91786	6665	36	06071	34.089822	-117.650922	San Bernardino County
245425	Fee-for-Service	1225090681	1225090681	1	1	EMINENCE HOME HEALTH CARE	4/7/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	2443 ATLANTIC AVE	None	LONG BEACH	CA	90806	3221	19	06037	33.801597	-118.1850585	Los Angeles County
245432	Fee-for-Service	1144584392	1144584392	1	1	ESPINO, ERWIN ROMMEL M MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145793	01	General Practice	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
245447	Fee-for-Service	1184990988	1184990988	1	1	EDWARDS-OJEBA, FAYOLA A MD	8/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129145	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
245483	Fee-for-Service	1780107797	1780107797	1	21	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	1330 TARA HILLS DRIVE	STE E	PINOLE	CA	94564	2531	07	06013	37.99580466	-122.3048363	Contra Costa County
245576	Fee-for-Service	1760433601	1760433601	1	1	ELOISA S WALKER, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	520 S EAGLE RD	None	MERIDIAN	ID	83642	6351	00	None	43.600527	-116.3518425	Ada County
245658	Fee-for-Service	1568485324	1568485324	1	1	ERNST, STEVEN B MD	1/1/1990	207P00000X	NA	Other	026	PHYSICIANS	63787	66	Emergency Medicine (Urgent Care)	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
245720	Fee-for-Service	1811295819	1811295819	1	1	EBERLIN, SETH A MD	2/11/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	115740	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
245769	Fee-for-Service	1588901532	1588901532	1	42	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	4121 SANTA MONICA BLVD	103	LOS ANGELES	CA	90029	3883	19	06037	34.09195911	-118.282318	Los Angeles County
245772	Fee-for-Service	1902682313	1902682313	1	1	ESCOBAR, MONIKA COSETTE OT	10/26/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1630 W REDLANDS BLVD.	SUITE L	REDLANDS	CA	92373	8032	36	06071	34.06293049	-117.2104992	San Bernardino County
245812	Fee-for-Service	1699884841	1699884841	1	1	ENGEL, CYNTHIA A LCSW	9/27/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	725 COLLEGE AVE	None	SANTA ROSA	CA	95404	4106	49	06097	38.445867	-122.713731	Sonoma County
245840	Fee-for-Service	1588901532	1588901532	1	49	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	424 W BROADWAY	None	GLENDALE	CA	91204	1209	19	06037	34.14680919	-118.262105	Los Angeles County
245879	Fee-for-Service	1093780900	1093780900	1	1	ECOFF, STEVEN A DO	12/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	5497	05	Anesthesiology	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
245923	Fee-for-Service	1275627986	1275627986	1	1	EDWARD MEDICAL GROUP INC	3/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	12828 HARBOR BLVD	STE 200	GARDEN GROVE	CA	92840	5834	30	06059	33.7767046	-117.9154296	Orange County
246033	Fee-for-Service	1265573984	1265573984	1	1	EVERMOST HEALTH MGMT	9/22/1999	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	SUNNY DAY ADULT DAY HLTH	10530 LOWER AZUSA RD	None	EL MONTE	CA	91731	1209	19	06037	34.0922127	-118.0380758	Los Angeles County
246056	Fee-for-Service	1588901532	1588901532	1	42	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	4121 SANTA MONICA BLVD	103	LOS ANGELES	CA	90029	3883	19	06037	34.09195911	-118.282318	Los Angeles County
246105	Fee-for-Service	1194300459	1194300459	1	1	EGUNGWU, JOY NP	6/8/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
246125	Fee-for-Service	1588901532	1588901532	1	49	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	424 W BROADWAY	None	GLENDALE	CA	91204	1209	19	06037	34.14680919	-118.262105	Los Angeles County
246180	Fee-for-Service	1124335625	1124335625	1	1	EREZ, ISHAI MD	8/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115310	05	Anesthesiology	0	In state provider	None	700 LAWRENCE PKWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
246214	Fee-for-Service	1790162402	1790162402	1	1	EOM, KEE H MD	6/8/2020	207R00000X	NA	Other	026	PHYSICIANS	155077	41	Internal Medicine	0	In state provider	None	28078 BAXTER RD	SUITE 320	MURRIETA	CA	92563	1404	33	06065	33.615	-117.1670265	Riverside County
246219	Fee-for-Service	1255786455	1255786455	1	1	ENRIQUEZ, NICOLAS MD	11/10/2021	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
246414	Fee-for-Service	1588901532	1588901532	1	49	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	424 W BROADWAY	None	GLENDALE	CA	91204	1209	19	06037	34.14680919	-118.262105	Los Angeles County
246485	Fee-for-Service	1528551082	1528551082	1	1	ENALEN, TRACY S LMFT	11/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	24977 WASHINGTON AVENUE	SUITES K & L	MURRIETA	CA	92562	6149	33	06065	33.55150034	-117.2118708	Riverside County
246489	Fee-for-Service	1649941519	1649941519	1	1	ELLIT HOME HEALTH CARE	6/17/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	18546 SHERMAN WAY	STE 202	RESEDA	CA	91335	8668	19	06037	34.20103253	-118.5377535	Los Angeles County
246496	Fee-for-Service	1619936556	1619936556	1	1	EFTEKHARI, ROSHANAK MD	12/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76119	41	Internal Medicine	0	In state provider	None	3628 E IMPERIAL HWY	STE 408	LYNWOOD	CA	90262	2646	19	06037	33.93070837	-118.2044557	Los Angeles County
246541	Fee-for-Service	1861925471	1861925471	1	1	EGESDAL, CHARLES S MD	1/10/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	157470	None	None	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
246573	Fee-for-Service	1568103331	1568103331	1	1	EXPERT HEALTH & BEAUTY, INC.	6/13/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12922 HARBOR BLVD	None	GARDEN GROVE	CA	92840	5809	30	06059	33.77554119	-117.9178077	Orange County
246589	Fee-for-Service	1285892109	1285892109	1	1	EPPELE, CLAUDIA MD	11/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110633	08	Family Practice	0	In state provider	None	5750 DOWNEY AVE	STE 100	LAKEWOOD	CA	90712	1411	19	06037	33.859611	-118.1511435	Los Angeles County
246672	Fee-for-Service	1780643346	1780643346	2	1	ESTERS, DANIELLE M MD	3/30/2022	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	60954	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
246676	Fee-for-Service	1275554685	1275554685	1	1	ERICKSON, KEVIN J PT	7/5/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
246677	Fee-for-Service	1780721993	1780721993	1	1	EBY, EMIE L NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	322 E THOUSAND OAKS BLVD	100	THOUSAND OAKS	CA	91360	5804	56	06111	34.17896875	-118.8712017	Ventura County
246702	Fee-for-Service	1588901532	1588901532	1	49	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	424 W BROADWAY	None	GLENDALE	CA	91204	1209	19	06037	34.14680919	-118.262105	Los Angeles County
246740	Fee-for-Service	1215541131	1215541131	1	1	EXENDINE, DESIRAE R NP	10/27/2021	363LN0005X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
246759	Fee-for-Service	1821079310	1821079310	1	1	ERICKSON, JOHN J MD INC	9/15/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55499	08	Family Practice	0	In state provider	None	275 W HERNDON AVE	None	CLOVIS	CA	93612	0204	10	06019	36.83766747	-119.715174	Fresno County
246767	Fee-for-Service	1912679143	1912679143	1	1	ERWIN, SHAYNE M NP	9/26/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
246820	Fee-for-Service	1033262381	1033262381	1	1	EEL RIVER VALLEY	5/1/1998	193400000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	SURGICAL GROUP	3301 RENNER DR	None	FORTUNA	CA	95540	3119	12	06023	40.58243651	-124.135992	Humboldt County
246823	Fee-for-Service	1992803514	1992803514	1	1	ERNY, BARBARA MD	8/31/1991	207W00000X	NA	Ophthalmology	026	PHYSICIANS	66569	18	Ophthalmology	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
246839	Fee-for-Service	1336883438	1336883438	1	1	EDWARDS, AMANDA NP	11/1/2023	207Q00000X	NA	Adult Primary Care	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
246885	Fee-for-Service	1295000388	1295000388	1	1	ESCOBEDO HARTON, SHEENA LMF	12/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
246891	Fee-for-Service	1427348044	1427348044	1	1	ELMARIAH, HANY MD	1/16/2025	207RH0003X	NA	Oncology	026	PHYSICIANS	None	68	Hematology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
246894	Fee-for-Service	1093804452	1093804452	1	1	ERNT, TRACY A LMFT	11/15/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	39266	-	NOT APPLICABLE	0	In state provider	None	3115 RED HILL AVE	None	COSTA MESA	CA	92626	4517	30	06059	33.6763772	-117.8776418	Orange County
246910	Fee-for-Service	1932173713	1932173713	1	1	EDWARDS, TINA F MD	7/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	93271	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
246991	Fee-for-Service	1588901532	1588901532	1	38	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4623 EAGLE ROCK BLVD	None	LOS ANGELES	CA	90041	3049	19	06037	34.12808902	-118.2176465	Los Angeles County
246992	Fee-for-Service	1588901532	1588901532	1	49	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	424 W BROADWAY	None	GLENDALE	CA	91204	1209	19	06037	34.14680919	-118.262105	Los Angeles County
246994	Fee-for-Service	1609986975	1609986975	1	1	EITAN, NATHAN MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	36074	67	Endocrinology	0	In state provider	None	9200 COLIMA RD	STE 200	WHITTIER	CA	90605	1814	19	06037	33.95015827	-118.0054753	Los Angeles County
247031	Fee-for-Service	1821551227	1821551227	1	1	ESTRADA, GLORIA S LMFT	9/17/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
247072	Fee-for-Service	1902062136	1902062136	1	2	EL PORTAL RADIATION ONCOLOGY	7/15/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	3303 M STREET	None	MERCED	CA	95348	2714	24	06047	37.32305822	-120.4784106	Merced County
247112	Fee-for-Service	1811931603	1811931603	1	1	ENENMOH, ANTHONY C MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80369	41	Internal Medicine	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	0000	15	06029	35.37327448	-119.0278665	Kern County
247142	Fee-for-Service	1831404185	1831404185	1	1	ESPINOSA, SUANNY LCSW	10/20/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
247217	Fee-for-Service	1104255215	1104255215	1	1	ETHOS HOLDING CORP	10/3/2017	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	29 EAST 6TH STREET	None	NEWPORT	KY	41071	1803	00	None	39.09136642	-84.49392216	Campbell County
247280	Fee-for-Service	1588901532	1588901532	1	38	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4623 EAGLE ROCK BLVD	None	LOS ANGELES	CA	90041	3049	19	06037	34.12808902	-118.2176465	Los Angeles County
247284	Fee-for-Service	1598138562	1598138562	1	1	EQUALTOX LLC	4/10/2018	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	1562 PARKWAY LOOP	SUITE B	TUSTIN	CA	92780	7246	30	06059	33.71947812	-117.8272756	Orange County
247366	Fee-for-Service	1891766937	1891766937	1	1	ESPOSITO, SALVATORE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2900 S LOOP 256	None	PALESTINE	TX	75801	6958	00	None	31.73397157	-95.62744897	Anderson County
247401	Fee-for-Service	1811931603	1811931603	1	1	ENENMOH, ANTHONY C MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80369	45	Nephrology (Renal-Kidney)	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	0000	15	06029	35.37327448	-119.0278665	Kern County
247449	Fee-for-Service	1497823405	1497823405	1	1	ELACION, JOSE MARI L	10/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50675	08	Family Practice	0	In state provider	None	7862 FIRESTONE BLVD	None	DOWNEY	CA	90241	4221	19	06037	33.94382457	-118.1402202	Los Angeles County
247487	Fee-for-Service	1992810634	1992810634	1	1	ENGELHARDT, GABRIELLE MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75461	41	Internal Medicine	0	In state provider	None	520 N PROSPECT AVE	SUITE 103	REDONDO BEACH	CA	90277	3033	19	06037	33.8529819	-118.3802954	Los Angeles County
247518	Fee-for-Service	1801028204	1801028204	1	1	ENKE, SERENA PHD	7/25/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	521 W CITRUS AVE	None	REDLANDS	CA	92373	4625	36	06071	34.0560682	-117.1887598	San Bernardino County
247565	Fee-for-Service	1093883803	1093883803	1	1	ECKSTEIN, CHARLES P LMFT	9/10/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3333 SKY PARK DR	STE 220	TORRANCE	CA	90505	5023	19	06037	33.81036565	-118.3466218	Los Angeles County
247566	Fee-for-Service	1588901532	1588901532	1	38	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	4623 EAGLE ROCK BLVD	None	LOS ANGELES	CA	90041	3049	19	06037	34.12808902	-118.2176465	Los Angeles County
247575	Fee-for-Service	1174063788	1174063788	1	1	EMBASSY SURGERY CENTER, LLC	11/7/2022	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	42135 10TH ST W	SUITE 325	LANCASTER	CA	93534	7095	19	06037	34.648533	-118.1477975	Los Angeles County
247696	Fee-for-Service	1730573015	1730573015	1	1	ENG, VICTORIA	12/1/2017	390200000X	NA	Other	026	PHYSICIANS	145818	40	Pediatrics	0	In state provider	None	4733 SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
247702	Fee-for-Service	1609848191	1609848191	1	1	EYSSELEIN, VIKTOR E MD	6/30/1992	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	48752	41	Internal Medicine	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
247707	Fee-for-Service	1942973920	1942973920	1	1	ERIK JAMESON CHIROPRACTIC IN	9/20/2024	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1175 N MAIN ST	SUITE C	LAKEPORT	CA	95453	3858	17	06033	39.04966046	-122.9151377	Lake County
247744	Fee-for-Service	1932141520	1932141520	1	1	ELHAJ, ALAA MD	2/4/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	144314	None	None	0	In state provider	None	2001 DWIGHT WAY	None	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
247810	Fee-for-Service	1144458555	1144458555	1	1	ENG, JONATHAN K MD	2/23/2018	207L00000X	NA	Other	026	PHYSICIANS	121799	05	Anesthesiology	0	In state provider	None	309 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	19	06037	34.01597577	-118.1003516	Los Angeles County
247852	Fee-for-Service	1588901532	1588901532	1	38	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	4623 EAGLE ROCK BLVD	None	LOS ANGELES	CA	90041	3049	19	06037	34.12808902	-118.2176465	Los Angeles County
247870	Fee-for-Service	1730788001	1730788001	1	1	EM HOME HEALTH INC	4/26/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	21900 BURBANK BLVD	STE 116	WOODLAND HILLS	CA	91367	7939	19	06037	34.1719246	-118.6044964	Los Angeles County
247909	Fee-for-Service	1265708275	1265708275	1	1	EBARA, LEONA Y MD	6/15/2023	207R00000X	NA	Other	026	PHYSICIANS	184630	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
247922	Fee-for-Service	1235844580	1235844580	1	1	EVANGELISTA, CHRISTIAN NOEL	1/20/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	I NP	1161 E COVINA BLVD	None	COVINA	CA	91724	1523	19	06037	34.09946746	-117.8671905	Los Angeles County
247961	Fee-for-Service	1881054997	1881054997	1	7	EMANATE HEALTH MEDICAL GROUP	2/2/2022	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1305 W ARROW HWY	SUITE 104	SAN DIMAS	CA	91773	2337	19	06037	34.10677063	-117.8334375	Los Angeles County
247989	Fee-for-Service	1609848191	1609848191	1	1	EYSSELEIN, VIKTOR E MD	6/30/1992	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	48752	10	Gastroenterology (M.D. only)	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
247996	Fee-for-Service	1568555324	1568555324	1	1	ELIASHOF, BRUCE A MD	1/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54722	36	Psychiatry	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
248082	Fee-for-Service	1003866120	1003866120	1	7	EMERGENCY ASSOCIATES COR	9/15/2011	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
248112	Fee-for-Service	1215910641	1215910641	2	1	EKELUND, NANCY C OD	2/5/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1080 E CYPRESS AVE	SUITE D	REDDING	CA	96002	1161	45	06089	40.57108047	-122.3504865	Shasta County
248139	Fee-for-Service	1588901532	1588901532	1	38	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	4623 EAGLE ROCK BLVD	None	LOS ANGELES	CA	90041	3049	19	06037	34.12808902	-118.2176465	Los Angeles County
248150	Fee-for-Service	1881054997	1881054997	1	3	EMANATE HEALTH MEDICAL GROUP	7/12/2018	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1135 S SUNSET AVENUE	SUITE 401	WEST COVINA	CA	91790	3921	19	06037	34.06215064	-117.9453997	Los Angeles County
248251	Fee-for-Service	1881054997	1881054997	1	7	EMANATE HEALTH MEDICAL GROUP	2/2/2022	208000000X	NA	Pediatric Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1305 W ARROW HWY	SUITE 104	SAN DIMAS	CA	91773	2337	19	06037	34.10677063	-117.8334375	Los Angeles County
248257	Fee-for-Service	1821050725	1821050725	1	1	EITZMAN, SARAH R MD	12/11/2002	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	74265	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
248389	Fee-for-Service	1790865764	1790865764	1	1	ELKOUSTAF, RACHID A MD	4/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108229	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
248487	Fee-for-Service	1942499793	1942499793	2	1	ENDOCRINOLOGY MEDICAL GROUP	2/25/2019	207RE0101X	NA	Endocrinology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	OF ORANGE COUNTY INC	725 W LA VETA AVE	STE 220	ORANGE	CA	92868	4446	30	06059	33.78063949	-117.8603285	Orange County
248490	Fee-for-Service	1164940284	1164940284	1	1	ESPINOZA, DESIREE NP	3/3/2025	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
248543	Fee-for-Service	1821050725	1821050725	1	1	EITZMAN, SARAH R MD	12/11/2002	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	74265	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
248603	Fee-for-Service	1629656327	1629656327	1	1	EDHI, MUHAMMAD MUZZAMMIL MD	10/2/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	15248 ELEVENTH ST	None	VICTORVILLE	CA	92395	3704	36	06071	34.52825401	-117.2925587	San Bernardino County
248651	Fee-for-Service	1295037992	1295037992	1	1	ETERNITY HOME HEALTH INC	8/15/2014	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	15859 EDNA PLACE	SUITE 111	IRWINDALE	CA	91706	2153	19	06037	34.0926333	-117.9347788	Los Angeles County
248706	Fee-for-Service	1336681881	1336681881	2	1	EVERYTHING MEDICAL EQUIPMENT	5/14/2018	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	INC	2376 ATHENS AVE	None	REDDING	CA	96001	2817	45	06089	40.57550026	-122.3761811	Shasta County
248718	Fee-for-Service	1356363642	1356363642	1	1	ENRIQUE, LOUIS A	8/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	50869	41	Internal Medicine	0	In state provider	None	3432 HILLCREST AVE	STE 105	ANTIOCH	CA	94531	6310	07	06013	37.98756749	-121.7809963	Contra Costa County
248774	Fee-for-Service	1942499793	1942499793	2	1	ENDOCRINOLOGY MEDICAL GROUP	2/25/2019	207RE0101X	NA	Endocrinology	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	OF ORANGE COUNTY INC	725 W LA VETA AVE	STE 220	ORANGE	CA	92868	4446	30	06059	33.78063949	-117.8603285	Orange County
248787	Fee-for-Service	1275627986	1275627986	1	2	EDWARD MEDICAL GROUP INC	3/31/1991	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	6301 BEACH BLVD	STE 101	BUENA PARK	CA	90621	4030	30	06059	33.86880928	-117.9983013	Orange County
248874	Fee-for-Service	1376198044	1376198044	1	1	EPIONE HOSPICE CARE INC	3/13/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	17620 SHERMAN WAY	#216	VAN NUYS	CA	91406	3527	19	06037	34.20105176	-118.5171046	Los Angeles County
248875	Fee-for-Service	1649324443	1649324443	1	3	EAST VALLEY COMMUNITY HEALTH	8/13/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1400 EAST MISSION BLVD	BLDG A STE 2	POMONA	CA	91766	2229	19	06037	34.05562006	-117.7279926	Los Angeles County
248886	Fee-for-Service	1952402802	1952402802	1	2	EDWARDS, LARRY J MD	6/21/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	151225	08	Family Practice	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
248902	Fee-for-Service	1851486989	1851486989	1	1	EUREKA COMM HEALTH CTR	6/1/2003	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	BURRE DENTAL CENTER	959 MYRTLE AVE	None	EUREKA	CA	95501	1219	12	06023	40.80062789	-124.1497475	Humboldt County
248966	Fee-for-Service	1346241189	1346241189	2	1	ELISCO, ALVIN B MD	4/14/2009	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	2912	00	None	35.208594	-111.645099	Coconino County
249052	Fee-for-Service	1003015124	1003015124	1	1	EVERT, JESSICA A MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100346	08	Family Practice	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
249070	Fee-for-Service	1659365948	1659365948	1	1	EXCELLENT IN-HOME CARE	4/15/1997	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	22041 CLARENDON	SUITE 100	WOODLAND HILLS	CA	91367	7628	19	06037	34.16969086	-118.6073492	Los Angeles County
249082	Fee-for-Service	1841477973	1841477973	1	1	ELADH, LP	8/4/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	EAST LA DOCTORS HOSP	4060 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2526	19	06037	34.02390148	-118.184319	Los Angeles County
249104	Fee-for-Service	1093733073	1093733073	1	1	EVANS, JOHN W MD	11/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	23864	-	NOT APPLICABLE	0	In state provider	None	540 C MIDDLE RINCON ROAD	None	SANTA ROSA	CA	95409	3107	49	06097	38.471364	-122.6695725	Sonoma County
249123	Fee-for-Service	1558418590	1558418590	1	1	EGAN, JOHN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1919 E THOMAS	None	PHOENIX	AZ	85016	0000	00	None	33.478749	-112.0426515	Maricopa County
249126	Fee-for-Service	1003992504	1003992504	1	1	EISENBERG, MARCI B LCSW	5/1/2001	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	29447 WILKES RD	None	VALLEY CENTER	CA	92082	5647	37	06073	33.24600406	-117.0872531	San Diego County
249150	Fee-for-Service	1649324443	1649324443	1	3	EAST VALLEY COMMUNITY HEALTH	8/13/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1400 EAST MISSION BLVD	BLDG A STE 2	POMONA	CA	91766	2229	19	06037	34.05562006	-117.7279926	Los Angeles County
249157	Fee-for-Service	1972829455	1972829455	1	1	ENGLISH, TESHA M MD	1/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130903	05	Anesthesiology	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
249162	Fee-for-Service	1376198044	1376198044	1	1	EPIONE HOSPICE CARE INC	3/13/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	17620 SHERMAN WAY	#216	VAN NUYS	CA	91406	3527	19	06037	34.20105176	-118.5171046	Los Angeles County
249190	Fee-for-Service	1851486989	1851486989	1	1	EUREKA COMM HEALTH CTR	6/1/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	BURRE DENTAL CENTER	959 MYRTLE AVE	None	EUREKA	CA	95501	1219	12	06023	40.80062789	-124.1497475	Humboldt County
249278	Fee-for-Service	1790982858	1790982858	1	1	ETAYEB, MARY T	10/5/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
249310	Fee-for-Service	1285703850	1285703850	1	1	EROY, ARIANE E PHD	3/24/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1801 BUSH ST	132	SAN FRANCISCO	CA	94109	5239	38	06075	37.78777536	-122.427321	San Francisco County
249362	Fee-for-Service	1811140155	1811140155	1	1	ENGH, DOUGLAS M MD FACS INC	10/28/2009	207W00000X	NA	Ophthalmology	026	PHYSICIANS	50142	18	Ophthalmology	0	In state provider	None	25775 MCBEAN PKWY	STE 208	VALENCIA	CA	91355	3703	19	06037	34.40042013	-118.5511416	Los Angeles County
249377	Fee-for-Service	1033139076	1033139076	1	1	ELLISON, DAVID E MD	8/24/2004	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	46178	66	Emergency Medicine (Urgent Care)	0	In state provider	None	40 N SAN MATEO DR	None	SAN MATEO	CA	94401	2824	41	06081	37.56752371	-122.3273214	San Mateo County
249440	Fee-for-Service	1649324443	1649324443	1	3	EAST VALLEY COMMUNITY HEALTH	8/16/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1400 EAST MISSION BLVD	BLDG A STE 2	POMONA	CA	91766	2229	19	06037	34.05562006	-117.7279926	Los Angeles County
249476	Fee-for-Service	1326200882	1326200882	1	1	ENRIQUEZ, JANICE L PHD	5/21/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
249578	Fee-for-Service	1689810483	1689810483	1	1	EISLEY, MATTHEW J MD	3/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125561	01	General Practice	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
249609	Fee-for-Service	1558311837	1558311837	1	1	ERIC BRESSLER	2/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4801 W 81ST ST	STE 108	MINNEAPOLIS	MN	55437	1111	00	None	44.85623947	-93.34035	Hennepin County
249651	Fee-for-Service	1235256884	1235256884	1	1	EAST TEXAS MEDICAL CTR	6/1/2003	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1000 S BECKHAM AVE	None	TYLER	TX	75701	1908	00	None	32.33843395	-95.29189674	Smith County
249685	Fee-for-Service	1013248152	1013248152	1	1	EYE POD OPTOMETRY, INC.	10/9/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8016 2ND ST	None	DOWNEY	CA	90241	3622	19	06037	33.94327337	-118.13679	Los Angeles County
249803	Fee-for-Service	1528703253	1528703253	1	1	EXPRESS RIDE LLC	5/10/2024	344600000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	11505 VIA VISTA	None	NEVADA CITY	CA	95959	9639	29	06057	39.24339053	-121.0536869	Nevada County
249938	Fee-for-Service	1235256884	1235256884	1	1	EAST TEXAS MEDICAL CTR	6/1/2003	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1000 S BECKHAM AVE	None	TYLER	TX	75701	1908	00	None	32.33843395	-95.29189674	Smith County
249953	Fee-for-Service	1780107797	1780107797	1	11	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	400 TAYLOR BLVD	STE 302B	PLEASANT HILL	CA	94523	2160	07	06013	37.96132631	-122.0740275	Contra Costa County
250020	Fee-for-Service	1609124692	1609124692	1	2	ERICK MADRIGAL, MD, MBA, INC	1/17/2022	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	H & WELLNESS CLINIC	1410 MOONEY BLVD	None	VISALIA	CA	93277	4440	54	06107	36.318231	-119.313621	Tulare County
250130	Fee-for-Service	1629127519	1629127519	1	1	ELLEN SHUHAM, OD	11/30/1989	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	18661 DEVONSHIRE ST	None	NORTHRIDGE	CA	91324	1310	19	06037	34.25729235	-118.539358	Los Angeles County
250139	Fee-for-Service	1720822711	1720822711	1	1	ESQUIVEL PATINO, JANET Y DOU	9/5/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
250241	Fee-for-Service	1780107797	1780107797	1	11	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	400 TAYLOR BLVD	STE 302B	PLEASANT HILL	CA	94523	2160	07	06013	37.96132631	-122.0740275	Contra Costa County
250295	Fee-for-Service	1295069375	1295069375	1	1	EBRAHEEM, MOHAMMAD MD	11/8/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	174844	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
250310	Fee-for-Service	1609124692	1609124692	1	2	ERICK MADRIGAL, MD, MBA, INC	8/29/2023	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	H & WELLNESS CLINIC	1410 MOONEY BLVD	None	VISALIA	CA	93277	4440	54	06107	36.318231	-119.313621	Tulare County
250316	Fee-for-Service	1114184074	1114184074	1	1	ESMAILI, ALI MD	1/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111261	None	None	0	In state provider	None	35800 BOB HOPE DRIVE	STE 150 B	RANCHO MIRAGE	CA	92270	1739	33	06065	33.790527	-116.4058645	Riverside County
250464	Fee-for-Service	1134140346	1134140346	1	1	EYE SITE SACRAMENTO	3/19/2018	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	4925 J ST	None	SACRAMENTO	CA	95819	3828	34	06067	38.566971	-121.4426385	Sacramento County
250468	Fee-for-Service	1275997512	1275997512	1	1	EBY, LAUREN E DO	10/1/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15807	08	Family Practice	0	In state provider	None	550 S GREEN VALLEY RD	None	WATSONVILLE	CA	95076	3053	44	06087	36.92586689	-121.7796602	Santa Cruz County
250530	Fee-for-Service	1780107797	1780107797	1	11	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 TAYLOR BLVD	STE 302B	PLEASANT HILL	CA	94523	2160	07	06013	37.96132631	-122.0740275	Contra Costa County
250586	Fee-for-Service	1902062136	1902062136	1	3	EL PORTAL RADIATION ONCOLOGY	3/15/2016	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CENTER	311 WEST I STREET	None	LOS BANOS	CA	93635	3479	24	06047	37.06343055	-120.8570545	Merced County
250598	Fee-for-Service	1609124692	1609124692	1	2	ERICK MADRIGAL, MD, MBA, INC	2/21/2023	207Q00000X	NA	Adult Primary Care	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	H & WELLNESS CLINIC	1410 MOONEY BLVD	None	VISALIA	CA	93277	4440	54	06107	36.318231	-119.313621	Tulare County
250684	Fee-for-Service	1154911071	1154911071	1	1	ELMZADEH, AVA LMFT	4/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	37 TESSERA AVE	None	LAKE FOREST	CA	92610	1921	30	06059	33.68970569	-117.6523366	Orange County
250734	Fee-for-Service	1588901532	1588901532	1	61	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	420 W ROWLAND STREET	101	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
250755	Fee-for-Service	1134140346	1134140346	1	1	EYE SITE SACRAMENTO	5/17/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	MEDICAL GROUP INC	4925 J ST	None	SACRAMENTO	CA	95819	3828	34	06067	38.566971	-121.4426385	Sacramento County
250763	Fee-for-Service	1437117231	1437117231	1	1	ELITE EYECARE MEDICAL GROUP	12/17/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	AMC	425 W CENTRAL AVE	SUITE 102	LOMPOC	CA	93436	2806	42	06083	34.66085568	-120.4617943	Santa Barbara County
250838	Fee-for-Service	1063439909	1063439909	2	1	ELAM, ANNETHE S NP	12/18/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	92825	2115	34	06067	38.602089	-121.3925895	Sacramento County
250900	Fee-for-Service	1013981554	1013981554	1	36	EISENHOWER MEDICAL CENTER	12/10/2020	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	72-780 COUNTRY CLUB DR	SUITE B-205	RANCHO MIRAGE	CA	92270	4126	33	06065	33.68689976	-116.4073828	Riverside County
250930	Fee-for-Service	1982050159	1982050159	1	1	ELAHI, SHAN M MD	8/5/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	172956	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
250954	Fee-for-Service	1306838131	1306838131	1	1	ENOCH, DUARD W III MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85825	None	None	0	In state provider	None	1111 E OCEAN AVE	STE 2	LOMPOC	CA	93436	2500	42	06083	34.63889719	-120.4447732	Santa Barbara County
251008	Fee-for-Service	1033799945	1033799945	1	1	ELGAWLY, CHANTAL S	11/5/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
251020	Fee-for-Service	1588901532	1588901532	1	61	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	420 W ROWLAND STREET	101	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
251051	Fee-for-Service	1437117231	1437117231	1	1	ELITE EYECARE MEDICAL GROUP	4/22/2004	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	AMC	425 W CENTRAL AVE	SUITE 102	LOMPOC	CA	93436	2806	42	06083	34.66085568	-120.4617943	Santa Barbara County
251063	Fee-for-Service	1154551240	1154551240	1	1	ENABORE, DARRYL M	5/19/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
251098	Fee-for-Service	1033127014	1033127014	1	1	EXETER DISTRICT AMB	1/1/1986	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LORI TROWBRIDGE	302 E PALM ST	None	EXETER	CA	93221	1807	54	06107	36.29806087	-119.1400245	Tulare County
251108	Fee-for-Service	1831518414	1831518414	1	1	ESQUIVEL, JESSICA LMFT	2/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
251164	Fee-for-Service	1285667063	1285667063	1	1	ELITE DIAGNOSTIC AND MEDICAL	11/1/2005	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP, A MEDICAL CORPOR	600 N GARFIELD AVE.,	STE 210	MONTEREY PARK	CA	91754	1170	19	06037	34.06820797	-118.1228835	Los Angeles County
251167	Fee-for-Service	1891258737	1891258737	1	1	ELLIS-CALEO, TIMOTHY J MD	5/18/2022	390200000X	NA	Other	026	PHYSICIANS	176813	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
251266	Fee-for-Service	1609200187	1609200187	1	1	ELGART, SARAH M NP	12/14/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
251309	Fee-for-Service	1588901532	1588901532	1	61	EXER MEDICAL CORPORATION	4/2/2025	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	420 W ROWLAND STREET	101	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
251352	Fee-for-Service	1346300670	1346300670	1	1	EVERGREEN PHYSICAL THERAPY	9/16/2013	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	SPECIALISTS INC	200 E DEL MAR BLVD	STE 302	PASADENA	CA	91115	2552	19	06037	34.14047497	-118.1464685	Los Angeles County
251404	Fee-for-Service	1528750015	1528750015	1	2	E MAC CARE SERVICES INC	6/20/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	11507 THOMAS PLACE	None	NORWALK	CA	90650	7907	19	06037	33.92665152	-118.0879155	Los Angeles County
251454	Fee-for-Service	1992733513	1992733513	1	1	EMANATE HEALTH FOOTHILL	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESSBYTERIAN HOSPITAL	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
251572	Fee-for-Service	1205105293	1205105293	1	1	EVERLASTING HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	21054 SHERMAN WAY	SUITE 305	CANOGA PARK	CA	91303	4517	19	06037	34.20094949	-118.592541	Los Angeles County
251582	Fee-for-Service	1265880173	1265880173	1	1	EDEN, KAYLEIGH LCSW	8/27/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
251597	Fee-for-Service	1588901532	1588901532	1	61	EXER MEDICAL CORPORATION	10/24/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	420 W ROWLAND STREET	101	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
251641	Fee-for-Service	1689752453	1689752453	1	1	EPPERSON, DOUGLAS F MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65620	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
251665	Fee-for-Service	1356599898	1356599898	1	1	ELIZABETH MCCLENNEN MD	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	190 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.6124738	-116.1926844	Ada County
251672	Fee-for-Service	1669492591	1669492591	1	1	EDWARD R SERROS MD INC	3/31/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	7223 CHURCH STREET	A20	HIGHLAND	CA	92346	5869	36	06071	34.122888	-117.1737945	San Bernardino County
251689	Fee-for-Service	1205254950	1205254950	1	1	EXODUS RECOVERY INC	7/17/2013	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1902 MARENGO STREET	STE 109-110	LOS ANGELES	CA	90033	1378	19	06037	34.05770831	-118.2099519	Los Angeles County
251706	Fee-for-Service	1538237268	1538237268	1	1	EXTENDED HEALTH CARE	3/1/1995	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	1718 E ARTESIA BLVD	None	LONG BEACH	CA	90805	1649	19	06037	33.87455162	-118.171466	Los Angeles County
251733	Fee-for-Service	1952691685	1952691685	1	1	EGGER, NICHOLAS B LCSW	12/17/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	384 E OLIVE AVE	SUITE 2	TURLOCK	CA	95380	4051	50	06099	37.49658844	-120.8452043	Stanislaus County
251740	Fee-for-Service	1992733513	1992733513	1	1	EMANATE HEALTH FOOTHILL	12/1/1977	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESSBYTERIAN HOSPITAL	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
251759	Fee-for-Service	1619329968	1619329968	1	1	EBRAHIMI DARYANI, NARGES MD	9/18/2020	207R00000X	NA	Other	026	PHYSICIANS	163264	41	Internal Medicine	0	In state provider	None	4502 EAST AVE S	None	PALMDALE	CA	93552	4480	19	06037	34.55800153	-118.0488825	Los Angeles County
251839	Fee-for-Service	1376753459	1376753459	1	1	ENEJ GASEVIC	10/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5225 23RD AVE S	None	FARGO	ND	58104	7927	00	None	46.845468	-96.8753655	Cass County
251860	Fee-for-Service	1205105293	1205105293	1	1	EVERLASTING HOSPICE INC	3/18/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	21054 SHERMAN WAY	SUITE 305	CANOGA PARK	CA	91303	4517	19	06037	34.20094949	-118.592541	Los Angeles County
251933	Fee-for-Service	1326189671	1326189671	1	1	EMDUR, LARRY I DO PHD	1/1/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	5555 RESERVOIR DR	STE 201	SAN DIEGO	CA	92120	5191	37	06073	32.77628471	-117.0563688	San Diego County
251958	Fee-for-Service	1669492591	1669492591	1	1	EDWARD R SERROS MD INC	3/31/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	7223 CHURCH STREET	A20	HIGHLAND	CA	92346	5869	36	06071	34.122888	-117.1737945	San Bernardino County
251968	Fee-for-Service	1609379445	1609379445	1	1	ESPARZA, BRENNA D NP	5/14/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
251978	Fee-for-Service	1629613260	1629613260	2	1	EMPIRE INFUSION PHARMACY INC	9/17/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2025 CHICAGO AVE	STE A3	RIVERSIDE	CA	92507	2315	33	06065	33.99277238	-117.3485534	Riverside County
252052	Fee-for-Service	1851047344	1851047344	1	1	EGAL & SONS LLC	8/21/2022	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	DICAL TRANSPORTATION	39899 BALENTINE DR	SUITE 200	NEWARK	CA	94560	5361	01	06001	37.52205657	-121.993549	Alameda County
252054	Fee-for-Service	1093845943	1093845943	1	1	ELLISON, JOHN M MD	2/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	79299	None	None	0	In state provider	None	23625 HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
252060	Fee-for-Service	1457840498	1457840498	1	1	ESTES, TAMMY M LMFT	2/26/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	118582	-	NOT APPLICABLE	0	In state provider	None	1735 ENTERPISE DR	STE 105A	FAIRFIELD	CA	94533	6822	48	06095	38.24294683	-122.060841	Solano County
252309	Fee-for-Service	1649911371	1649911371	1	2	E LIN, DO, INC.	5/21/2024	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1850 S AZUSA AVE	201	HACIENDA HEIGHTS	CA	91745	3832	19	06037	33.98895597	-117.9322797	Los Angeles County
252325	Fee-for-Service	1992474779	1992474779	1	1	EMPOWERED MIND-BODY THERAPY	8/23/2024	104100000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	FOR INDIVIDUALS AND FA	3711 LONG BEACH BLVD	601	LONG BEACH	CA	90807	3315	19	06037	33.824583	-118.1893785	Los Angeles County
252356	Fee-for-Service	1780107797	1780107797	1	6	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	355 LENNON LANE	STE 205	WALNUT CREEK	CA	94598	2475	07	06013	37.92784983	-122.0301444	Contra Costa County
252366	Fee-for-Service	1588901532	1588901532	1	43	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	475 FOOTHILL BLVD	K	LA CANADA FLINTRI	CA	91011	3555	19	06037	34.20020709	-118.1880617	Los Angeles County
252390	Fee-for-Service	1578809794	1578809794	1	1	ELIAS, GEORGE A JR DO	1/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	15770	02	General Surgery	0	In state provider	None	1211 W LA PALMA AVENUE	STE 705	ANAHEIM	CA	92801	2814	30	06059	33.84718298	-117.933758	Orange County
252440	Fee-for-Service	1578613386	1578613386	1	1	ELLYASON, BORIS D MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70408	25	Physical Medicine and Rehabilitation	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
252468	Fee-for-Service	1467891515	1467891515	1	1	ELIM SENIOR SERVICES LLC	5/2/2014	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	3653 WREN AVE	None	CONCORD	CA	94519	1767	07	06013	37.98073516	-122.0073933	Contra Costa County
252487	Fee-for-Service	1932769924	1932769924	1	1	ESTRELLA, CARLOS MD	8/31/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180671	None	None	0	In state provider	None	5825 KANAN RD	B	AGOURA HILLS	CA	91301	1651	19	06037	34.15592291	-118.7563824	Los Angeles County
252537	Fee-for-Service	1851322887	1851322887	1	1	ELMASHAT, ASHRAF M MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68922	36	Psychiatry	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
252565	Fee-for-Service	1275529992	1275529992	1	1	EMERY, HOWARD B MD	4/26/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	21140	41	Internal Medicine	0	In state provider	None	405 HILGARD AVE	None	LOS ANGELES	CA	90095	9000	19	06037	34.07067	-118.4432445	Los Angeles County
252570	Fee-for-Service	1275101511	1275101511	1	1	ETHEREAL CONNECTEDNESS INC	8/9/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	431 30TH ST	210E	OAKLAND	CA	94609	3307	01	06001	37.81910206	-122.2653479	Alameda County
252611	Fee-for-Service	1477150886	1477150886	1	1	EDWARDS, ROBIN PT	1/13/2024	2081S0010X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
252614	Fee-for-Service	1992474779	1992474779	1	1	EMPOWERED MIND-BODY THERAPY	8/23/2024	104100000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	FOR INDIVIDUALS AND FA	3711 LONG BEACH BLVD	601	LONG BEACH	CA	90807	3315	19	06037	33.824583	-118.1893785	Los Angeles County
252645	Fee-for-Service	1780107797	1780107797	1	6	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	355 LENNON LANE	STE 205	WALNUT CREEK	CA	94598	2475	07	06013	37.92784983	-122.0301444	Contra Costa County
252655	Fee-for-Service	1588901532	1588901532	1	43	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	475 FOOTHILL BLVD	K	LA CANADA FLINTRI	CA	91011	3555	19	06037	34.20020709	-118.1880617	Los Angeles County
252679	Fee-for-Service	1306457072	1306457072	1	1	EDWARDSON, MEGHAN	9/23/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1650 OREGON ST	STE 216	REDDING	CA	96001	1757	45	06089	40.58198408	-122.3937903	Shasta County
252714	Fee-for-Service	1043604515	1043604515	1	1	ENG, MAIA MD	7/26/2019	390200000X	NA	Other	026	PHYSICIANS	145087	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
252738	Fee-for-Service	1558474270	1558474270	1	1	ELIASER, GERALD E MD	12/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	40198	08	Family Practice	0	In state provider	None	3A S LINDEN AVE	None	S SAN FRANCISCO	CA	94080	6407	41	06081	37.65202387	-122.4111492	San Mateo County
252775	Fee-for-Service	1487198719	1487198719	1	1	EMERICK, JOSHUA J CRNA	6/20/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
252932	Fee-for-Service	1780107797	1780107797	1	6	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	355 LENNON LANE	STE 205	WALNUT CREEK	CA	94598	2475	07	06013	37.92784983	-122.0301444	Contra Costa County
252941	Fee-for-Service	1588901532	1588901532	1	43	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	475 FOOTHILL BLVD	K	LA CANADA FLINTRI	CA	91011	3555	19	06037	34.20020709	-118.1880617	Los Angeles County
252951	Fee-for-Service	1588901532	1588901532	1	64	EXER MEDICAL CORPORATION	2/25/2025	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	839 N HIGHLAND SPRINGS A	101	BEAUMONT	CA	92223	5767	33	06065	33.93246349	-116.9469871	Riverside County
252971	Fee-for-Service	1518478452	1518478452	1	2	ECCO CONNECT	8/26/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	274 E. ROWLAND ST.	STE G	COVINA	CA	91723	3185	19	06037	34.07886931	-117.8860658	Los Angeles County
252980	Fee-for-Service	1447708094	1447708094	1	1	EADY, AMY CNP	11/30/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2455 SAN RAMON VALLEY BL	None	SAN RAMON	CA	94583	1601	07	06013	37.77494737	-121.9771019	Contra Costa County
253194	Fee-for-Service	1912949538	1912949538	1	1	ENLOE MEDICAL CENTER	9/7/1994	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1531 ESPLANADE	ROOM 1044	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
253230	Fee-for-Service	1588901532	1588901532	1	43	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	475 FOOTHILL BLVD	K	LA CANADA FLINTRI	CA	91011	3555	19	06037	34.20020709	-118.1880617	Los Angeles County
253239	Fee-for-Service	1588901532	1588901532	1	64	EXER MEDICAL CORPORATION	5/29/2025	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	839 N HIGHLAND SPRINGS A	101	BEAUMONT	CA	92223	5767	33	06065	33.93246349	-116.9469871	Riverside County
253344	Fee-for-Service	1588385454	1588385454	1	1	ENLOE MEDICAL CENTER	10/17/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CENTER	251 COHASSET RD	145	CHICO	CA	95926	0000	04	06007	39.75090044	-121.8522609	Butte County
253349	Fee-for-Service	1447220215	1447220215	1	1	EAST BAY DERMATOLOGY MEDICAL	8/13/2020	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	ETIC AND LASER SURGERY	2557 MOWRY AVE	STE 25	FREMONT	CA	94538	1614	01	06001	37.55561575	-121.9826617	Alameda County
253447	Fee-for-Service	1376621953	1376621953	1	1	EDWARDS, GREGORY D MD	7/10/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69684	66	Emergency Medicine (Urgent Care)	0	In state provider	None	140 LITTON DR	STE 100	GRASS VALLEY	CA	95945	5078	29	06057	39.23422354	-121.0525426	Nevada County
253450	Fee-for-Service	1699977793	1699977793	1	1	EYETECH DIGITAL SYSTEMS, INC	2/2/2022	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	.	2588-L EL CAMINO REAL	STE L	CARLSBAD	CA	92008	1213	37	06073	33.17815688	-117.3264997	San Diego County
253508	Fee-for-Service	1780107797	1780107797	1	22	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	20400 LAKE CHABOT RD	STE 102	CASTRO VALLEY	CA	94546	5314	01	06001	37.69628351	-122.0866765	Alameda County
253533	Fee-for-Service	1588901532	1588901532	1	64	EXER MEDICAL CORPORATION	2/25/2025	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	839 N HIGHLAND SPRINGS A	101	BEAUMONT	CA	92223	5767	33	06065	33.93246349	-116.9469871	Riverside County
253639	Fee-for-Service	1972832327	1972832327	1	1	EVANS, CASSANDRA	3/5/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
253664	Fee-for-Service	1104876283	1104876283	1	1	ERTNER, ROBERT A MD	6/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97004	05	Anesthesiology	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
253683	Fee-for-Service	1245811918	1245811918	1	1	ENAYATI, DONYA MD	1/8/2025	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
253735	Fee-for-Service	1376621953	1376621953	1	1	EDWARDS, GREGORY D MD	7/10/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69684	08	Family Practice	0	In state provider	None	140 LITTON DR	STE 100	GRASS VALLEY	CA	95945	5078	29	06057	39.23422354	-121.0525426	Nevada County
253752	Fee-for-Service	1013981554	1013981554	1	34	EISENHOWER MEDICAL CENTER	7/6/2017	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	39000 BOB HOPE DRIVE	SUITE 310	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
253779	Fee-for-Service	1326086489	1326086489	1	1	ELKAYAM, URI MD	2/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	33649	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1355 SAN PABLO ST	None	LOS ANGELES	CA	90033	1035	19	06037	34.06080447	-118.203734	Los Angeles County
253797	Fee-for-Service	1356429120	1356429120	1	1	EDELSON, LOUIS M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34300	41	Internal Medicine	0	In state provider	None	2233 POST ST	STE 102	SAN FRANCISCO	CA	94115	3444	38	06075	37.78442133	-122.4386368	San Francisco County
253809	Fee-for-Service	1003553017	1003553017	1	1	EANG, THORN	6/3/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	829 ALLACANTE DRIVE	None	CERES	CA	95307	7308	50	06099	37.59101536	-120.9825747	Stanislaus County
253812	Fee-for-Service	1275928129	1275928129	1	1	ELHOFY, ASHRAF MD	11/21/2019	207R00000X	NA	Other	026	PHYSICIANS	154984	41	Internal Medicine	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
253820	Fee-for-Service	1588901532	1588901532	1	64	EXER MEDICAL CORPORATION	2/25/2025	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	839 N HIGHLAND SPRINGS A	101	BEAUMONT	CA	92223	5767	33	06065	33.93246349	-116.9469871	Riverside County
254007	Fee-for-Service	1376597930	1376597930	1	1	EMERYVILLE ADVANCED IMAG	5/22/2007	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	6121 HOLLIS ST	STE 1	EMERYVILLE	CA	94608	2077	01	06001	37.84254056	-122.2901636	Alameda County
254059	Fee-for-Service	1205337292	1205337292	1	1	ENGEBRETSEN, STEVEN DO	8/19/2024	207YP0228X	NA	ENT/Otolaryngology	026	PHYSICIANS	21193	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
254097	Fee-for-Service	1003553017	1003553017	1	1	EANG, THORN	6/3/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	829 ALLACANTE DRIVE	None	CERES	CA	95307	7308	50	06099	37.59101536	-120.9825747	Stanislaus County
254122	Fee-for-Service	1245407956	1245407956	1	1	EDPAO, MICHELLE T	1/6/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
254203	Fee-for-Service	1033355235	1033355235	1	1	ETEMADIAN, ASHKAN MD	11/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105385	41	Internal Medicine	0	In state provider	None	16250 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.66136831	-117.7739731	Orange County
254412	Fee-for-Service	1902092042	1902092042	1	1	ESKANDARI, SAEED MD	9/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79114	41	Internal Medicine	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
254413	Fee-for-Service	1639110414	1639110414	1	1	ESSIEN USIGBE, GRACE E LMFT	2/18/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8710 MONROE CT	SUITE 150	RANCHO CUCAMONGA	CA	91730	4883	36	06071	34.09544496	-117.5747968	San Bernardino County
254437	Fee-for-Service	1972953156	1972953156	1	1	EVANS ELDERLY RESIDENTIAL	2/23/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	13947 CASTILLE ST	None	VICTORVILLE	CA	92392	5508	36	06071	34.49055645	-117.3587278	San Bernardino County
254505	Fee-for-Service	1316518681	1316518681	1	1	ELIZA SUKHEE AHN MD INC	8/6/2021	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	15243 VANOWEN ST	SUITE 311	VAN NUYS	CA	91405	3653	19	06037	34.19394848	-118.4654115	Los Angeles County
254650	Fee-for-Service	1780107797	1780107797	1	19	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	15035 EAST 14TH ST	STE B	SAN LEANDRO	CA	94578	1901	01	06001	37.70496067	-122.1281915	Alameda County
254665	Fee-for-Service	1750307278	1750307278	1	3	EAST VALLEY HEMATOLOGY	8/17/2010	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	181 S BUENA VISTA ST	4TH FLOOR	BURBANK	CA	91505	4504	19	06037	34.15958049	-118.328816	Los Angeles County
254717	Fee-for-Service	1083890701	1083890701	1	1	EAST-WEST EYE INSTITUTE A ME	3/31/1995	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	1045 W REDONDO BEACH BLV	STE 400	GARDENA	CA	90247	4180	19	06037	33.89247044	-118.2931941	Los Angeles County
254780	Fee-for-Service	1235252206	1235252206	1	1	EFTEKHARI, FOROUGH	12/19/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3200 E GUASTI RD	#100	ONTARIO	CA	91761	8660	36	06071	34.06518	-117.5822055	San Bernardino County
254784	Fee-for-Service	1801826813	1801826813	1	1	EYE CARE WEST OPTOMETRY INC	6/14/2006	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	17100 NORWALK BLVD	STE 107	CERRITOS	CA	90703	2750	19	06037	33.87557796	-118.0725386	Los Angeles County
254836	Fee-for-Service	1861561540	1861561540	1	1	ELLIS, PETER S MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	60702	01	General Practice	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
254939	Fee-for-Service	1780107797	1780107797	1	19	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	15035 EAST 14TH ST	STE B	SAN LEANDRO	CA	94578	1901	01	06001	37.70496067	-122.1281915	Alameda County
254953	Fee-for-Service	1750307278	1750307278	1	3	EAST VALLEY HEMATOLOGY	8/17/2010	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	181 S BUENA VISTA ST	4TH FLOOR	BURBANK	CA	91505	4504	19	06037	34.15958049	-118.328816	Los Angeles County
254971	Fee-for-Service	1437181930	1437181930	1	2	EYECARE SPECIALIST MEDICAL	10/3/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	947 S ANAHEIM BLVD	STE 120	ANAHEIM	CA	92805	8502	30	06059	33.82164135	-117.909385	Orange County
255005	Fee-for-Service	1083890701	1083890701	1	1	EAST-WEST EYE INSTITUTE A ME	8/10/2022	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MEDICAL CORPORATION	1045 W REDONDO BEACH BLV	STE 400	GARDENA	CA	90247	4180	19	06037	33.89247044	-118.2931941	Los Angeles County
255013	Fee-for-Service	1528671633	1528671633	1	1	ELIAA LLC	12/11/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	FACILITY	1229 KELLEY AVENUE	None	CORONA	CA	92882	4207	33	06065	33.86940621	-117.5749257	Riverside County
255126	Fee-for-Service	1861561540	1861561540	1	1	ELLIS, PETER S MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	60702	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
255156	Fee-for-Service	1992582449	1992582449	1	1	ENDLESS CARE SOLUTIONS	12/4/2023	251S00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	530 27TH ST	515	LOS ANGELES	CA	90007	3203	19	06037	34.02702454	-118.275906	Los Angeles County
255193	Fee-for-Service	1639602998	1639602998	1	1	ELLIS, STEPHANIE E MD	12/28/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169751	None	None	0	In state provider	None	1600 OWENS ST	None	SAN FRANCISCO	CA	94158	2261	38	06075	37.76850146	-122.3949365	San Francisco County
255228	Fee-for-Service	1780107797	1780107797	1	19	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	15035 EAST 14TH ST	STE B	SAN LEANDRO	CA	94578	1901	01	06001	37.70496067	-122.1281915	Alameda County
255260	Fee-for-Service	1437181930	1437181930	1	2	EYECARE SPECIALIST MEDICAL	10/3/2018	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	947 S ANAHEIM BLVD	STE 120	ANAHEIM	CA	92805	8502	30	06059	33.82164135	-117.909385	Orange County
255286	Fee-for-Service	1871778993	1871778993	1	1	ESTEVA, SORAYA G MD	4/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	93716	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	219 N SANBORN RD	None	SALINAS	CA	93905	2218	27	06053	36.67720965	-121.6266381	Monterey County
255329	Fee-for-Service	1245417997	1245417997	1	1	ESCOBEDO, LILIA B LMFT	10/2/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	47923 OASIS ST	None	INDIO	CA	92201	9203	33	06065	33.70080223	-116.2209518	Riverside County
255436	Fee-for-Service	1144476474	1144476474	1	1	ESCARENO, ERIK J LCSW	12/7/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9431 HAVEN AVE	STE 100	RANCHO CUCAMONGA	CA	91730	5879	36	06071	34.082244	-117.5756135	San Bernardino County
255440	Fee-for-Service	1275724833	1275724833	1	1	EGAN, DIMITRI LMFT	3/22/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1411 MARSH ST.	103	SAN LUIS OBISPO	CA	93401	2908	40	06079	35.28418203	-120.6540933	San Luis Obispo County
255525	Fee-for-Service	1699792598	1699792598	1	1	EAR NOSE AND THROAT MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	OF SAN MATEO INC	40 N SAN MATEO DR	None	SAN MATEO	CA	94401	2824	41	06081	37.56752371	-122.3273214	San Mateo County
255530	Fee-for-Service	1851002109	1851002109	1	1	EXCELLENT TRANSPORTER LLC	6/19/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	365 BROADWAY	103	EL CAJON	CA	92021	5400	37	06073	32.80758354	-116.9589285	San Diego County
255546	Fee-for-Service	1083743066	1083743066	2	2	EAST BAY VISION CENTER OPTOM	12/31/2019	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ETRY	34420 FREMONT BLVD	SUITE E	FREMONT	CA	94555	3323	01	06001	37.57486959	-122.040298	Alameda County
255571	Fee-for-Service	1972904084	1972904084	1	1	ETN MEDICAL INFUSION INC	2/27/2017	193400000X	NA	Other	026	PHYSICIANS	62911	None	None	0	In state provider	None	11100 WARNER AVE	STE 158	FOUNTAIN VALLEY	CA	92708	7513	30	06059	33.716291	-117.9355051	Orange County
255608	Fee-for-Service	1710667118	1710667118	1	1	EXPRESS URGENTCARE INC	4/24/2024	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	750 N DIAMOND BAR BLVD	SUITE 102-103	DIAMOND BAR	CA	91765	1023	19	06037	34.03332339	-117.8078346	Los Angeles County
255647	Fee-for-Service	1215967773	1215967773	1	1	EMMONS, EDWARD R MD	5/20/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	22993	20	Orthopedic Surgery	0	In state provider	REDWOOD MEM HOSP	RENNER DRIVE	None	FORTUNA	CA	95540	0000	12	06023	40.58257979	-124.1335714	Humboldt County
255695	Fee-for-Service	1447726849	1447726849	1	1	EDVIN DILANCHIYAN MD INC	4/9/2019	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1509 WILSON TER	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
255824	Fee-for-Service	1720797095	1720797095	1	1	ERICKSON, KAITLYN G CRNA	1/27/2024	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
255886	Fee-for-Service	1770760670	1770760670	1	1	EASTSIDE NEIGHBORHOOD	4/22/2008	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CLINIC	915 N MILPAS ST	None	SANTA BARBARA	CA	93103	2331	42	06083	34.43040726	-119.6909855	Santa Barbara County
255960	Fee-for-Service	1801975107	1801975107	1	1	EAST TEXAS MEDICAL CENTER CA	6/20/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CARTHAGE	409 COTTAGE RD	None	CARTHAGE	TX	75633	1466	00	None	32.16716464	-94.34629008	Panola County
255997	Fee-for-Service	1942087119	1942087119	1	1	EVOLVE PSYCHIATRY AND WELLNE	7/16/2024	193400000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	SS A NURSING CORPORATI	1461 E COOLEY DR	STE 250	COLTON	CA	92324	3921	36	06071	34.05562007	-117.3036377	San Bernardino County
256172	Fee-for-Service	1952332256	1952332256	1	1	ECOLOGICALLY SOUND MED S	2/6/1998	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	HUHN, DONALD E	1865 N MACARTHUR DR	None	TRACY	CA	95376	2820	39	06077	37.74945851	-121.4125003	San Joaquin County
256187	Fee-for-Service	1629216353	1629216353	1	1	ENGELAGE, ELYSIA M MD	5/16/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112633	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#420	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
256190	Fee-for-Service	1689646994	1689646994	1	1	EGRIE, GLENN D MD	3/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	67588	89	Surgery-Traumatic	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
256340	Fee-for-Service	1023763331	1023763331	1	1	E&E HOME HEALTH INC	8/27/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2369 COLORADO BLVD	STE 201	LOS ANGELES	CA	90041	1185	19	06037	34.13985099	-118.2180331	Los Angeles County
256369	Fee-for-Service	1356812978	1356812978	1	1	EUGENIO, DONNA L RCP	1/11/2019	207QS1201X	NA	Adult Primary Care	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
256443	Fee-for-Service	1336241199	1336241199	1	1	EMERALD EYE CENTER	4/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	8859	18	Ophthalmology	0	In state provider	None	16260 VENTURA BLVD	STE 711	ENCINO	CA	91436	2232	19	06037	34.15687678	-118.4876342	Los Angeles County
256487	Fee-for-Service	1629266507	1629266507	1	1	EXCEPTIONAL PARENTS UNLIMITE	3/20/2025	252Y00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	D, INC.	4440 N 1ST ST	None	FRESNO	CA	93726	2304	10	06019	36.79900426	-119.7722187	Fresno County
256539	Fee-for-Service	1093712374	1093712374	1	13	EL CAMINO HOSP	6/25/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2495 HOSPITAL DRIVE	1ST FLOOR STE 1F61	MOUNTAIN VIEW	CA	94040	4119	43	06085	37.369341	-122.0817635	Santa Clara County
256566	Fee-for-Service	1962489237	1962489237	2	1	ESOTERIX, INC	10/15/2009	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	4301 LOST HILLS RD	None	CALABASAS	CA	91301	5358	19	06037	34.13764309	-118.7077786	Los Angeles County
256679	Fee-for-Service	1710950977	1710950977	1	1	ESWARAN, KALI S MD	4/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	40842	41	Internal Medicine	0	In state provider	None	2001 ZINFANDEL DRIVE	SUITE B3	RANCHO CORDOVA	CA	95670	4265	34	06067	38.611782	-121.271499	Sacramento County
256773	Fee-for-Service	1336402635	1336402635	1	1	EKROSS, STEPHANIE LCSW	10/6/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8247 E STOCKTON BLVD	None	SACRAMENTO	CA	95828	8200	34	06067	38.459187	-121.4080245	Sacramento County
256836	Fee-for-Service	1174942312	1174942312	1	1	ELDRIST DIALYSIS LLC	5/2/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	721 W HUNTINGTON DR	None	ARCADIA	CA	91007	6734	19	06037	34.13180661	-118.0555974	Los Angeles County
256885	Fee-for-Service	1295149540	1295149540	1	1	ESPARZA, MICHAEL A MD	5/12/2020	2086S0127X	NA	General Surgery	026	PHYSICIANS	138859	85	Surgery-Pediatric	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
256946	Fee-for-Service	1750307278	1750307278	1	1	EAST VALLEY HEMATOLOGY	3/8/1991	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	AND ONCOLOGY MED GRP,INC	2601 W ALAMEDA AVE	STE 210	BURBANK	CA	91505	4810	19	06037	34.15783817	-118.3293969	Los Angeles County
257082	Fee-for-Service	1598802282	1598802282	1	1	EMPEY, GREGORY M OD	6/5/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3605 HOSPITAL ROAD	None	ATWATER	CA	95301	5179	24	06047	37.36678073	-120.576731	Merced County
257155	Fee-for-Service	1427176809	1427176809	1	1	ETU, ROBIN PT	10/30/2018	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
257186	Fee-for-Service	1679143416	1679143416	1	1	ELEANOR LEUNG M.D. A PROFESS	7/3/2021	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	IONAL CORPORATION	50 ALESSANDRO PL	STE 230	PASADENA	CA	91105	4003	19	06037	34.13101049	-118.151532	Los Angeles County
257200	Fee-for-Service	1174923544	1174923544	1	1	EXCELCARE INC	4/20/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12526 WESTMINSTER AVE	None	SANTA ANA	CA	92706	2166	30	06059	33.7597437	-117.906968	Orange County
257217	Fee-for-Service	1407845035	1407845035	1	1	EXEMPLA GOOD SAMARITAN	12/27/2004	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER	200 EXEMPLA CIR	None	LAFAYETTE	CO	80026	3370	00	None	39.97232464	-105.086171	Boulder County
257234	Fee-for-Service	1750307278	1750307278	1	1	EAST VALLEY HEMATOLOGY	3/8/1991	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	AND ONCOLOGY MED GRP,INC	2601 W ALAMEDA AVE	STE 210	BURBANK	CA	91505	4810	19	06037	34.15783817	-118.3293969	Los Angeles County
257237	Fee-for-Service	1467064436	1467064436	1	1	ESTERON, JOMELYN NP	11/16/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
257280	Fee-for-Service	1750028775	1750028775	1	1	ENGBER, NATALIE LCSW	10/31/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1742 OREGON STREET	None	REDDING	CA	96001	1717	45	06089	40.5808265	-122.3932989	Shasta County
257310	Fee-for-Service	1144371667	1144371667	1	1	EDWARDS, COLSTYN R LMFT	7/19/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3179 BECHELLI LN	206	REDDING	CA	96002	2041	45	06089	40.560831	-122.3625705	Shasta County
257325	Fee-for-Service	1255505723	1255505723	1	1	EL-YUSSIF, EDDIE DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12150 30 MILE RD	STE 105	WASHINGTON	MI	48095	2035	00	None	42.77245501	-83.01369143	Macomb County
257354	Fee-for-Service	1750371852	1750371852	2	1	EISINGER, PHILIP DO	7/26/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	21315	30	Radiology	0	In state provider	None	1301 N ROSE DR	None	PLACENTIA	CA	92870	3802	30	06059	33.8868003	-117.8420447	Orange County
257503	Fee-for-Service	1407845035	1407845035	1	1	EXEMPLA GOOD SAMARITAN	12/27/2004	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER	200 EXEMPLA CIR	None	LAFAYETTE	CO	80026	3370	00	None	39.97232464	-105.086171	Boulder County
257576	Fee-for-Service	1750488169	1750488169	1	1	EYECARE SPECIALISTS MEDICAL	10/3/2018	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	GROUP INC	7677 CENTER AVE	STE 301	HUNTINGTON BEACH	CA	92647	3049	30	06059	33.736257	-117.995535	Orange County
257644	Fee-for-Service	1467534826	1467534826	1	2	EXPRESS SCRIPTS SPECIALTY DI	12/3/2019	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	STRIBUTION SERVICES, INC	4600 HANLEY	SUITE B	SAINT LOUIS	MO	63134	2715	00	None	38.72408957	-90.31690554	St. Louis County
257770	Fee-for-Service	1528245800	1528245800	1	1	ELDRIDGE, DENTENE E DPM	2/15/2016	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1460 N CAMINO ALTO	STE 206	VALLEJO	CA	94589	2567	48	06095	38.13262019	-122.2386804	Solano County
257862	Fee-for-Service	1750488169	1750488169	1	1	EYECARE SPECIALISTS MEDICAL	10/3/2018	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	7677 CENTER AVE	STE 301	HUNTINGTON BEACH	CA	92647	3049	30	06059	33.736257	-117.995535	Orange County
257886	Fee-for-Service	1235210501	1235210501	1	1	EARLE, JAMES G	11/3/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5061 SHASTA DAM BLVD	None	SHASTA LAKE	CA	96019	9405	45	06089	40.68027851	-122.3557875	Shasta County
257905	Fee-for-Service	1447646070	1447646070	1	1	ESMAILI, ARMOND M MD	7/30/2019	208M00000X	NA	Other	026	PHYSICIANS	148866	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
257960	Fee-for-Service	1740285667	1740285667	1	1	EPSTEIN, WILLIAM S MD	12/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	39568	18	Ophthalmology	0	In state provider	None	510 4TH ST	None	YREKA	CA	96097	3008	47	06093	41.72822046	-122.6387089	Siskiyou County
258154	Fee-for-Service	1750488169	1750488169	1	1	EYECARE SPECIALISTS MEDICAL	10/3/2018	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	GROUP INC	7677 CENTER AVE	STE 301	HUNTINGTON BEACH	CA	92647	3049	30	06059	33.736257	-117.995535	Orange County
258337	Fee-for-Service	1588784508	1588784508	1	2	EYZAGUIRRE, ROBERT D MD	10/28/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	47748	01	General Practice	0	In state provider	None	9349 OAK ST	None	BELLFLOWER	CA	90706	4407	19	06037	33.88479711	-118.1344399	Los Angeles County
258569	Fee-for-Service	1114302742	1114302742	1	1	ELIXIR HOME HEALTH CARE &	8/24/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HOSPICE INC	1420 W KETTLEMAN LANE	SUITE S2	LODI	CA	95242	4557	39	06077	38.11534153	-121.289823	San Joaquin County
258593	Fee-for-Service	1225476252	1225476252	1	1	EADS, ANDREW M MD	5/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125560	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2623 E SLAUSON AVENUE	None	HUNTINGTON PARK	CA	90255	2926	19	06037	33.98921547	-118.2242565	Los Angeles County
258623	Fee-for-Service	1508946641	1508946641	1	1	EMIL, SHERIF G MD	11/16/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75548	02	General Surgery	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
258641	Fee-for-Service	1740474733	1740474733	1	1	ENRIQUEZ, ABILENE A MD	12/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104931	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
258666	Fee-for-Service	1811383813	1811383813	1	1	ESSENTIAL HOSPICE CARE	1/5/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7200 VINELAND AVE	SUITE 211	SUN VALLEY	CA	91352	5002	19	06037	34.2016328	-118.3703012	Los Angeles County
258701	Fee-for-Service	1619428828	1619428828	1	1	ELLEDGE, LINDSAY LCSW	8/16/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
258781	Fee-for-Service	1427498278	1427498278	1	1	EKATAH, OSEZEMEGHONGHON O MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143304	41	Internal Medicine	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
258800	Fee-for-Service	1437425550	1437425550	1	1	ELHASSAN, MOHAMMED G MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125562	41	Internal Medicine	0	In state provider	None	2828 FRESNO STREET	SUITE 203	FRESNO	CA	93721	1327	10	06019	36.7418099	-119.7838487	Fresno County
258804	Fee-for-Service	1922442466	1922442466	1	1	ESCOVEDO, CAMERON J MD	7/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136029	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
258820	Fee-for-Service	1891019394	1891019394	1	1	EGGERS, ASHLEY D MD	11/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145411	05	Anesthesiology	0	In state provider	None	6235 N FRESNO STREET	SUITE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
258912	Fee-for-Service	1508946641	1508946641	1	1	EMIL, SHERIF G MD	11/16/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75548	85	Surgery-Pediatric	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
258951	Fee-for-Service	1811383813	1811383813	1	1	ESSENTIAL HOSPICE CARE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7200 VINELAND AVE	SUITE 211	SUN VALLEY	CA	91352	5002	19	06037	34.2016328	-118.3703012	Los Angeles County
258973	Fee-for-Service	1730152208	1730152208	1	1	ERDMAN, DANIEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	941 KAMEHAMEHA HWY	STE 208	PEARL CITY	HI	96782	2516	00	None	21.39429472	-157.97183	Honolulu County
259016	Fee-for-Service	1629109269	1629109269	1	1	EDWARDS, ALEXANDER S LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
259029	Fee-for-Service	1669061784	1669061784	1	2	ELEGANT TRANSPORTATION GROUP	8/19/2021	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1807 W KATELLA AVE	212	ANAHEIM	CA	92804	6690	30	06059	33.80322548	-117.946044	Orange County
259078	Fee-for-Service	1053728642	1053728642	1	1	ENG, VIVIAN LMFT	6/10/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
259153	Fee-for-Service	1396933545	1396933545	1	1	EVERGREEN PHARMACY INC	12/7/2010	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	EVERGREEN PHARMACY	2690 S WHITE RD.	SUITE 200-A	SAN JOSE	CA	95148	2076	43	06085	37.32946528	-121.7984732	Santa Clara County
259174	Fee-for-Service	1295784023	1295784023	1	1	EISEN, DANIEL BRIAN MD	7/5/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74875	07	Dermatology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
259263	Fee-for-Service	1699298984	1699298984	1	1	EMPIRE MEDICAL TRANSPORTATIO	4/2/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ON	1433 W. LINDEN STREET	SUITE M	RIVERSIDE	CA	92507	0002	33	06065	33.9793804	-117.3435287	Riverside County
259291	Fee-for-Service	1275656217	1275656217	1	2	ENCOMPASS COMMUNITY SERVICES	12/17/2013	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	380 ENCINAL STREET	SUITE 200	SANTA CRUZ	CA	95060	2178	44	06087	36.98747083	-122.0380148	Santa Cruz County
259354	Fee-for-Service	1780107797	1780107797	1	5	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	13851 EAST 14TH ST	SUITE 308	SAN LEANDRO	CA	94578	2630	01	06001	37.71458918	-122.1418781	Alameda County
259480	Fee-for-Service	1780107797	1780107797	1	12	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1480 64TH ST	STE 100, 125, 175	EMERYVILLE	CA	94608	2038	01	06001	37.84431239	-122.2926758	Alameda County
259493	Fee-for-Service	1831430784	1831430784	1	1	EIRICH, PATRICIA A LMFT	9/18/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17326 EDWARD ROAD	None	CERRITOS	CA	90703	2444	19	06037	33.87401441	-118.0344613	Los Angeles County
259530	Fee-for-Service	1093136269	1093136269	1	1	EDGINTON, MELISSA NP	8/29/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6121 N THESTA AVE	SUITE 204	FRESNO	CA	93710	5294	10	06019	36.82493955	-119.783139	Fresno County
259638	Fee-for-Service	1013981554	1013981554	1	17	EISENHOWER MEDICAL CENTER	12/18/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	151 SOUTH SUNRISE WAY	None	PALM SPRINGS	CA	92262	0118	33	06065	33.821694	-116.5282555	Riverside County
259662	Fee-for-Service	1093000689	1093000689	1	1	EKAMBARAM, VIJAYABHARATHI	11/30/2020	2084S0012X	NA	Neurology	026	PHYSICIANS	133502	None	None	0	In state provider	None	1805 N CALIFORNIA ST	201	STOCKTON	CA	95204	6032	39	06077	37.9711691	-121.2894221	San Joaquin County
259695	Fee-for-Service	1932755584	1932755584	1	1	EVEREST PEAK HOME HEALTHCARE	6/17/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12160 HAMLIN ST	None	NORTH HOLLYWOOD	CA	91606	1409	19	06037	34.18845983	-118.3984616	Los Angeles County
259724	Fee-for-Service	1043655053	1043655053	1	1	ELGIN, LARA K NP	8/8/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
259752	Fee-for-Service	1982730628	1982730628	1	1	EFREN J. FLORES	9/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	55 FRUIT ST	BUL-2	BOSTON	MA	02114	2621	00	None	42.363216	-71.0687745	Suffolk County
259760	Fee-for-Service	1679729313	1679729313	1	1	EDER, SHELLEY J MD	8/31/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105557	08	Family Practice	0	In state provider	None	1201 ALHAMBRA BLVD	STE 230	SACRAMENTO	CA	95816	5243	34	06067	38.570076	-121.4657145	Sacramento County
259779	Fee-for-Service	1497804918	1497804918	1	1	ERNEST MEDICAL CORPORATION	6/10/2009	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	31133	06	Cardiovascular Disease (M.D. only)	0	In state provider	INC	43807 10 ST W	STE E	LANCASTER	CA	93534	4802	19	06037	34.6788	-118.1479295	Los Angeles County
259805	Fee-for-Service	1104594175	1104594175	1	1	EMPATHY CARE, INC	9/29/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	8953 WOODMAN AVE	STE 108	ARLETA	CA	91331	6457	19	06037	34.23249056	-118.4383491	Los Angeles County
259852	Fee-for-Service	1780107797	1780107797	1	24	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2400 BALFOUR ROAD	SUITE 230	BRENTWOOD	CA	94513	4957	07	06013	37.92519383	-121.734461	Contra Costa County
259869	Fee-for-Service	1306397674	1306397674	1	1	ELLIS, REBECCA J CNM	5/3/2021	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1665 ESPLANADE	None	CHICO	CA	95926	3312	04	06007	39.74388808	-121.8503372	Butte County
259921	Fee-for-Service	1235186313	1235186313	1	1	ELLER, KENT C MD	4/29/2019	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	142177	-	NOT APPLICABLE	0	In state provider	None	298 BERNAL RD	STE B	SAN JOSE	CA	95119	1809	43	06085	37.215603	-121.7858355	Santa Clara County
259936	Fee-for-Service	1609891795	1609891795	1	1	ELLIS, JIMMY S DO	5/28/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	17989	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	18300 HWY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
259952	Fee-for-Service	1497170583	1497170583	1	1	ESQUIVEL, MILITZA DO	9/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15359	01	General Practice	0	In state provider	None	3285 CLAREMONT WY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
260045	Fee-for-Service	1740036094	1740036094	1	1	EVOLUER COUNSELING SERVICES,	7/5/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	601 UNIVERSITY AVE	STE 140	SACRAMENTO	CA	95825	6775	34	06067	38.568276	-121.4199405	Sacramento County
260070	Fee-for-Service	1497804918	1497804918	1	1	ERNEST MEDICAL CORPORATION	6/10/2009	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	31133	41	Internal Medicine	0	In state provider	INC	43807 10 ST W	STE E	LANCASTER	CA	93534	4802	19	06037	34.6788	-118.1479295	Los Angeles County
260139	Fee-for-Service	1780107797	1780107797	1	13	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	388 9TH STREET	STE 218	OAKLAND	CA	94607	4287	01	06001	37.80019425	-122.2715222	Alameda County
260211	Fee-for-Service	1497136238	1497136238	1	1	ESPINOSA, JAIRO MD	9/7/2022	208G00000X	NA	General Surgery	026	PHYSICIANS	176621	None	None	0	In state provider	None	506 W VALLEY BLVD	None	SAN GABRIEL	CA	91776	3731	19	06037	34.07936003	-118.1070139	Los Angeles County
260348	Fee-for-Service	1538490115	1538490115	1	1	EBBAGE, JEFFREY L MFT	12/28/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	91247	-	NOT APPLICABLE	0	In state provider	None	709 MISSION STREET	None	SANTA CRUZ	CA	95060	3614	44	06087	36.97380944	-122.0345408	Santa Cruz County
260364	Fee-for-Service	1386413706	1386413706	1	1	ESTELLA, MARLON CARLO NP	8/1/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25000 AVENUE STANFORD	167	VALENCIA	CA	91355	4553	19	06037	34.43847322	-118.5729968	Los Angeles County
260418	Fee-for-Service	1942512009	1942512009	1	1	EARHART, BETH A PHD	11/1/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
260429	Fee-for-Service	1780107797	1780107797	1	13	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	388 9TH STREET	STE 218	OAKLAND	CA	94607	4287	01	06001	37.80019425	-122.2715222	Alameda County
260467	Fee-for-Service	1083705362	1083705362	1	1	ENDELMAN, IRWIN MD	3/8/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	48058	15	Obstetrics (D.O. only)	0	In state provider	None	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
260486	Fee-for-Service	1003866120	1003866120	1	2	EMERGENCY ASSOCIATES COR	9/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3220	33	06065	33.763572	-116.4056895	Riverside County
260508	Fee-for-Service	1780107797	1780107797	1	7	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	5201 NORRIS CANYON RD	STE 310	SAN RAMON	CA	94583	5405	07	06013	37.77779028	-121.9600626	Contra Costa County
260572	Fee-for-Service	1376727768	1376727768	1	1	EUNICE HAHN M.D	8/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3333 BURNET AVE	ML 5021	CINCINNATI	OH	45229	3026	00	None	39.14105892	-84.50040782	Hamilton County
260582	Fee-for-Service	1538543731	1538543731	1	1	EXOSOME DIAGNOSTICS INC	11/5/2018	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	266 SECOND AVENUE	STE 200	WALTHAM	MA	02451	1166	00	None	42.388155	-71.26308	Middlesex County
260633	Fee-for-Service	1548204332	1548204332	1	1	ECKARD, DONALD A MD	4/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	64701	30	Radiology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
260718	Fee-for-Service	1780107797	1780107797	1	13	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	388 9TH STREET	STE 218	OAKLAND	CA	94607	4287	01	06001	37.80019425	-122.2715222	Alameda County
260778	Fee-for-Service	1003866120	1003866120	1	2	EMERGENCY ASSOCIATES COR	9/15/2011	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3220	33	06065	33.763572	-116.4056895	Riverside County
260794	Fee-for-Service	1013981554	1013981554	1	9	EISENHOWER MEDICAL CENTER	12/18/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	78120 WILDCAT DR	None	PALM DESERT	CA	92211	1140	33	06065	33.76498951	-116.302005	Riverside County
260795	Fee-for-Service	1780107797	1780107797	1	7	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	5201 NORRIS CANYON RD	STE 310	SAN RAMON	CA	94583	5405	07	06013	37.77779028	-121.9600626	Contra Costa County
260998	Fee-for-Service	1861623555	1861623555	1	1	EL-ISA, ZAINA MD	10/30/2021	207R00000X	NA	Other	026	PHYSICIANS	131838	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
261006	Fee-for-Service	1780107797	1780107797	1	24	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	2400 BALFOUR ROAD	SUITE 230	BRENTWOOD	CA	94513	4957	07	06013	37.92519383	-121.734461	Contra Costa County
261082	Fee-for-Service	1780107797	1780107797	1	7	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	5201 NORRIS CANYON RD	STE 310	SAN RAMON	CA	94583	5405	07	06013	37.77779028	-121.9600626	Contra Costa County
261090	Fee-for-Service	1922489053	1922489053	1	1	ESCALLIER, KRISZTINA E MD	10/18/2021	207L00000X	NA	Other	026	PHYSICIANS	162465	None	None	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
261268	Fee-for-Service	1780107797	1780107797	1	9	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	13851 EAST 14TH ST	STE 305	SAN LEANDRO	CA	94578	2630	01	06001	37.71458918	-122.1418781	Alameda County
261294	Fee-for-Service	1780107797	1780107797	1	24	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	2400 BALFOUR ROAD	SUITE 230	BRENTWOOD	CA	94513	4957	07	06013	37.92519383	-121.734461	Contra Costa County
261417	Fee-for-Service	1225021777	1225021777	1	1	ETNYRE, ETHAN R MD	10/31/1991	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	73939	01	General Practice	0	In state provider	MARIAN HANCOCK MED CLINI	116 S PALISADE DR	STE 1A	SANTA MARIA	CA	93454	8904	42	06083	34.9523869	-120.4120717	Santa Barbara County
261442	Fee-for-Service	1386188241	1386188241	1	1	ESSAKOW, JENNA MD	5/6/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	158537	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
261507	Fee-for-Service	1073527875	1073527875	1	1	EDELSTEIN, WILLIAM MD	5/31/1986	207R00000X	NA	Other	026	PHYSICIANS	39503	41	Internal Medicine	0	In state provider	None	300 N SAN ANTONIO RD	None	SANTA BARBARA	CA	93110	1316	42	06083	34.4458497	-119.779596	Santa Barbara County
261557	Fee-for-Service	1780107797	1780107797	1	9	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	13851 EAST 14TH ST	STE 305	SAN LEANDRO	CA	94578	2630	01	06001	37.71458918	-122.1418781	Alameda County
261610	Fee-for-Service	1669878989	1669878989	1	1	ENCINO HOSPICE CARE, INC	10/7/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	16250 VENTURA BLVD	STE 415	ENCINO	CA	91436	2204	19	06037	34.15682212	-118.4871886	Los Angeles County
261785	Fee-for-Service	1942401625	1942401625	1	1	EGODAGE, PUJITHA M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	43149	41	Internal Medicine	0	In state provider	None	1066 ATLANTIC AVE	STE E	LONG BEACH	CA	90813	3400	19	06037	33.78015	-118.1850225	Los Angeles County
261792	Fee-for-Service	1073527875	1073527875	1	1	EDELSTEIN, WILLIAM MD	5/31/1986	207R00000X	NA	Other	026	PHYSICIANS	39503	01	General Practice	0	In state provider	None	300 N SAN ANTONIO RD	None	SANTA BARBARA	CA	93110	1316	42	06083	34.4458497	-119.779596	Santa Barbara County
261823	Fee-for-Service	1164447090	1164447090	1	1	EMG MEDICAL SUPPLY, INC	8/8/2006	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	22750 HAWTHORNE BLVD	STE 200	TORRANCE	CA	90505	3667	19	06037	33.820596	-118.350971	Los Angeles County
261843	Fee-for-Service	1780107797	1780107797	1	9	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	13851 EAST 14TH ST	STE 305	SAN LEANDRO	CA	94578	2630	01	06001	37.71458918	-122.1418781	Alameda County
261870	Fee-for-Service	1528569175	1528569175	1	1	ETS EXPRESS TRANS SYS	6/19/2018	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	14032 ENDERLE CENTER DR	STE 204	TUSTIN	CA	92780	9518	30	06059	33.75892205	-117.8270462	Orange County
261874	Fee-for-Service	1013981554	1013981554	1	29	EISENHOWER MEDICAL CENTER	9/1/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	39000 BOB HOPE DR	SUITE 305	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
261898	Fee-for-Service	1669878989	1669878989	1	1	ENCINO HOSPICE CARE, INC	10/7/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	16250 VENTURA BLVD	STE 415	ENCINO	CA	91436	2204	19	06037	34.15682212	-118.4871886	Los Angeles County
261919	Fee-for-Service	1770560914	1770560914	1	1	EL CAMINO RENAL MEDICAL GROU	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	515 SOUTH DR	STE 12	MOUNTAIN VIEW	CA	94040	4209	43	06085	37.36725925	-122.0837256	Santa Clara County
261956	Fee-for-Service	1255496949	1255496949	1	1	EIBECK, DOUGLAS L	3/29/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
262024	Fee-for-Service	1669610267	1669610267	1	1	EPIPHANY CARE HOMES INC	11/26/2008	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	546 CENTRAL AVE	None	FILLMORE	CA	93015	1332	56	06111	34.40393284	-118.9143914	Ventura County
262029	Fee-for-Service	1063864544	1063864544	1	1	EMILYS HOME HEALTH CARE INC	8/3/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	16661 VENTURA BLVD	STE 400G	ENCINO	CA	91436	1914	19	06037	34.15820737	-118.496492	Los Angeles County
262035	Fee-for-Service	1588775159	1588775159	1	1	ENOS, JOHN R	11/29/2005	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3087	31	06061	38.76566391	-121.2457432	Placer County
262074	Fee-for-Service	1942401625	1942401625	1	1	EGODAGE, PUJITHA M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	43149	08	Family Practice	0	In state provider	None	1066 ATLANTIC AVE	STE E	LONG BEACH	CA	90813	3400	19	06037	33.78015	-118.1850225	Los Angeles County
262100	Fee-for-Service	1194936625	1194936625	1	1	EVANS, ROBERT B	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110782	None	None	0	In state provider	None	116 S PALISADE DR	# 306	SANTA MARIA	CA	93454	8904	42	06083	34.9523869	-120.4120717	Santa Barbara County
262172	Fee-for-Service	1972905503	1972905503	1	1	ENLOE MEDICAL CENTER	8/31/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	340 W EAST AVE	None	CHICO	CA	95926	7238	04	06007	39.75353271	-121.8668176	Butte County
262338	Fee-for-Service	1447378815	1447378815	1	1	ELLINGTON, JOHN S LCSW	1/13/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	APY	803 COFFEE RD.	10	MODESTO	CA	95355	4244	50	06099	37.65474897	-120.9756157	Stanislaus County
262366	Fee-for-Service	1013448281	1013448281	1	1	EVANS, NICOLE S MD	8/21/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	158765	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
262424	Fee-for-Service	1790990141	1790990141	1	1	EROGUL, JOHN Y MD	2/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	2874 N CARSON ST	SUITE 300	CARSON CITY	NV	89706	1683	00	None	39.185271	-119.7710595	Consolidated Municipality of Carson City
262445	Fee-for-Service	1437175528	1437175528	1	1	EL MONTE LATINO MED GRP	3/1/1999	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	EL MONTE CLINICA DESALUD	10012 GARVEY AVE	STE 5&6	EL MONTE	CA	91733	2083	19	06037	34.06270848	-118.050633	Los Angeles County
262486	Fee-for-Service	1780107797	1780107797	1	1	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4721 DALLAS RANCH RD	None	ANTIOCH	CA	94531	8811	07	06013	37.97016362	-121.7967323	Contra Costa County
262504	Fee-for-Service	1922016286	1922016286	1	1	EMGE, LAURA A MD	9/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87536	40	Pediatrics	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
262558	Fee-for-Service	1922494061	1922494061	1	1	EGUIA, MARY A MD	9/3/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
262664	Fee-for-Service	1871909663	1871909663	1	1	EWING, SARAH K A CO	3/8/2016	222Z00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	5525 DEWEY DRIVE	SUITE 102/104	FAIR OAKS	CA	95628	3130	34	06067	38.666592	-121.309182	Sacramento County
262723	Fee-for-Service	1013992726	1013992726	1	1	ENGEL, THOMAS P MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	64169	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
262733	Fee-for-Service	1437175528	1437175528	1	1	EL MONTE LATINO MED GRP	3/1/1999	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	EL MONTE CLINICA DESALUD	10012 GARVEY AVE	STE 5&6	EL MONTE	CA	91733	2083	19	06037	34.06270848	-118.050633	Los Angeles County
262759	Fee-for-Service	1437226289	1437226289	1	1	ETO, JEFFREY T DPM	6/8/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	18081 BEACH BLVD	None	HUNTINGTON BEACH	CA	92641	8304	30	06059	33.69987737	-117.9892394	Orange County
262798	Fee-for-Service	1952402802	1952402802	1	1	EDWARDS, LARRY J MD	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	305 SOUTH DR	STE 6	MOUNTAIN VIEW	CA	94040	4207	43	06085	37.36724311	-122.0815284	Santa Clara County
262856	Fee-for-Service	1669502225	1669502225	1	1	EATON CANYON PEDIATRIC	5/5/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP	2750 E WASHINGTON BLVD	STE 360	PASADENA	CA	91107	6203	19	06037	34.1680038	-118.0943955	Los Angeles County
262890	Fee-for-Service	1891870523	1891870523	1	1	EMERY, KATHRYN D MD	7/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
262893	Fee-for-Service	1720046022	1720046022	1	1	EQUAL HUSSEIN MD	3/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	301 BECKER AVE SW	None	WILLMAR	MN	56201	3302	00	None	45.1205233	-95.04619753	Kandiyohi County
263020	Fee-for-Service	1437175528	1437175528	1	1	EL MONTE LATINO MED GRP	3/1/1999	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	EL MONTE CLINICA DESALUD	10012 GARVEY AVE	STE 5&6	EL MONTE	CA	91733	2083	19	06037	34.06270848	-118.050633	Los Angeles County
263048	Fee-for-Service	1780145607	1780145607	1	1	ERUSIAFE, YVONNE MD	7/18/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	185732	None	None	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
263060	Fee-for-Service	1801971148	1801971148	1	1	EVENSEN, MARC-EIVIND MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65848	25	Physical Medicine and Rehabilitation	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
263068	Fee-for-Service	1659507861	1659507861	1	1	EVANS, KIMBERLY S MD	4/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	114084	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
263104	Fee-for-Service	1063955011	1063955011	1	1	EMERDELLO, KATHLEEN D CNM	7/5/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
263177	Fee-for-Service	1891870523	1891870523	1	1	EMERY, KATHRYN D MD	7/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
263289	Fee-for-Service	1609201706	1609201706	1	1	ESCONDIDO PHARMACY & DME INC	11/7/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	909 EAST VALLEY PARKWAY	None	ESCONDIDO	CA	92025	3428	37	06073	33.12861682	-117.0709275	San Diego County
263308	Fee-for-Service	1720461346	1720461346	1	1	EIDE, GLORIA ALEXIS V PSYD	7/21/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	777 DAVIS ST	None	SAN LEANDRO	CA	94577	6923	01	06001	37.72317409	-122.162925	Alameda County
263353	Fee-for-Service	1740471879	1740471879	1	1	EZZEDDINE, TAREK M MD	11/13/2018	207R00000X	NA	Other	026	PHYSICIANS	133690	41	Internal Medicine	0	In state provider	None	10841 WHITE OAK AVE	SUITE 103	RANCHO CUCAMONGA	CA	91730	3817	36	06071	34.10467596	-117.5661881	San Bernardino County
263363	Fee-for-Service	1386760395	1386760395	1	1	EDWARDS, DAVID S PT	11/2/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
263593	Fee-for-Service	1821014820	1821014820	1	1	EISENBERG, ROBERT B MD	2/15/1989	208800000X	NA	Other	026	PHYSICIANS	31900	34	Urology and Urological Surgery	0	In state provider	None	1444 FLORIDA AVE	STE 103	MODESTO	CA	95350	4400	50	06099	37.66487562	-120.9961927	Stanislaus County
263737	Fee-for-Service	1235256652	1235256652	1	1	EVANS, MARICSA LMFT	8/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
263802	Fee-for-Service	1073671228	1073671228	1	1	ELKINS, TAMARA L	9/6/1999	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	802 14TH ST	STE G	MODESTO	CA	95354	1029	50	06099	37.64172216	-120.9944627	Stanislaus County
263812	Fee-for-Service	1942263660	1942263660	1	1	ERICA LYNN SCHIPPER MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1305 W 18TH ST	None	SIOUX FALLS	SD	57105	0401	00	None	43.535484	-96.7428585	Minnehaha County
263891	Fee-for-Service	1588901532	1588901532	1	58	EXER MEDICAL CORPORATION	5/17/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	600 S LAKE AVE	105	PASADENA	CA	91106	3955	19	06037	34.135569	-118.1322515	Los Angeles County
263923	Fee-for-Service	1962663286	1962663286	1	1	ENGLEA LARRA, JAIME A DO	3/8/2011	207LP2900X	NA	Other	026	PHYSICIANS	9851	05	Anesthesiology	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
263939	Fee-for-Service	1841262102	1841262102	1	1	ELAD, YARON MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65098	41	Internal Medicine	0	In state provider	None	8635 W 3RD ST	None	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
264073	Fee-for-Service	1730361122	1730361122	1	1	EVEY, CRYSTAL M MD	6/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105241	41	Internal Medicine	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
264107	Fee-for-Service	1255367819	1255367819	1	1	ENTECH MEDICAL CORP	2/1/1986	332BP3500X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1910 D ST	None	LA VERNE	CA	91750	5410	19	06037	34.09704333	-117.7714513	Los Angeles County
264112	Fee-for-Service	1164885604	1164885604	1	1	ENLOE MEDICAL CENTER	8/31/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1026 MANGROVE AVE	SUITE 10	CHICO	CA	95926	3556	04	06007	39.73971182	-121.8368837	Butte County
264180	Fee-for-Service	1588901532	1588901532	1	58	EXER MEDICAL CORPORATION	5/17/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	600 S LAKE AVE	105	PASADENA	CA	91106	3955	19	06037	34.135569	-118.1322515	Los Angeles County
264206	Fee-for-Service	1649911371	1649911371	1	1	E LIN, DO, INC.	2/7/2024	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1617 S AZUSA AVE	None	HACIENDA HEIGHTS	CA	91745	3832	19	06037	33.99329659	-117.9316917	Los Angeles County
264230	Fee-for-Service	1841262102	1841262102	1	1	ELAD, YARON MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65098	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	8635 W 3RD ST	None	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
264234	Fee-for-Service	1487010567	1487010567	1	1	EDWARDS, NOREEN	1/18/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
264357	Fee-for-Service	1528167558	1528167558	1	1	ELIAS, DARLENE J MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	45176	01	General Practice	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
264364	Fee-for-Service	1144480492	1144480492	1	1	ERESO, ALEXANDER Q MD	4/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	91510	24	Plastic Surgery	0	In state provider	None	1628 B STREET	None	HAYWARD	CA	94541	3020	01	06001	37.6795481	-122.0717846	Alameda County
264468	Fee-for-Service	1588901532	1588901532	1	58	EXER MEDICAL CORPORATION	5/17/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	600 S LAKE AVE	105	PASADENA	CA	91106	3955	19	06037	34.135569	-118.1322515	Los Angeles County
264493	Fee-for-Service	1386744779	1386744779	1	1	ERASMUS, DESMOND MD	2/8/2015	207T00000X	NA	General Surgery	026	PHYSICIANS	34539	14	Neurological Surgery	0	In state provider	None	39039 PASEO PADRE PKWY	STE 207	FREMONT	CA	94538	1618	01	06001	37.55409261	-121.9821804	Alameda County
264504	Fee-for-Service	1093712374	1093712374	1	5	EL CAMINO HOSP	12/9/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	355 DARDANELLI LANE	None	LOS GATOS	CA	95032	0000	43	06085	37.262493	-121.967456	Santa Clara County
264518	Fee-for-Service	1780107797	1780107797	1	10	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	400 TAYLOR BLVD	STE 102	PLEASANT HILL	CA	94523	2147	07	06013	37.96132631	-122.0740275	Contra Costa County
264565	Fee-for-Service	1669031258	1669031258	1	1	ESTRADA, ALYSSA MD	7/25/2023	174400000X	NA	Other	026	PHYSICIANS	178159	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
264596	Fee-for-Service	1528418233	1528418233	1	1	ENGSTROM, ERIN T PHD	12/7/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2230 STOCKTON BLVD	STE 2800	SACRAMENTO	CA	95817	1353	34	06067	38.555631	-121.459203	Sacramento County
264689	Fee-for-Service	1205285145	1205285145	1	1	EYERLY, EMILY A LMFT	11/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
264758	Fee-for-Service	1821479221	1821479221	1	1	EUSTACHE, KIMBERLY L MD	7/21/2021	207P00000X	NA	Other	026	PHYSICIANS	171065	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
264765	Fee-for-Service	1619496981	1619496981	1	1	ENGLE, ASHLIE N PT	3/8/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3191 B MISSION INN AVE	None	RIVERSIDE	CA	92507	4138	33	06065	33.98015514	-117.3677324	Riverside County
264794	Fee-for-Service	1093712374	1093712374	1	15	EL CAMINO HOSP	6/25/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2495 HOSPITAL DRIVE	5TH FLOOR STE 550	MOUNTAIN VIEW	CA	94040	4157	43	06085	37.369341	-122.0817635	Santa Clara County
264885	Fee-for-Service	1467001230	1467001230	1	1	ELIJAH HOUSE FOUNDATION	6/24/2024	261QM0850X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	7904 STATE HIGHWAY 99E	None	LOS MOLINOS	CA	96055	9781	52	06103	40.02553002	-122.0998076	Tehama County
264901	Fee-for-Service	1669774980	1669774980	1	1	ERICKSON, ELIZABETH A LCSW	9/18/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 MAGNOLIA AVE	STE 1F	CORONA	CA	92879	3121	33	06065	33.85936872	-117.5534605	Riverside County
264995	Fee-for-Service	1548348196	1548348196	1	1	EMBLAD, PETER W MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75592	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
265005	Fee-for-Service	1982787016	1982787016	1	1	ENLOE MEDICAL CENTER	2/1/2024	273Y00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	340 W. EAST AVE	None	CHICO	CA	95926	7238	04	06007	39.75353271	-121.8668176	Butte County
265022	Fee-for-Service	1528333986	1528333986	1	1	EGUIZABAL, JOHNNY A MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128101	01	General Practice	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
265118	Fee-for-Service	1336707496	1336707496	1	1	ESPINOZA, ALDO D NP	8/17/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
265119	Fee-for-Service	1881159531	1881159531	1	1	EYEC VISION PROFESSIONAL OPT	2/4/2021	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1150 HARTER PKWY	None	YUBA CITY	CA	95993	2642	51	06101	39.14475744	-121.655431	Sutter County
265159	Fee-for-Service	1538294822	1538294822	1	1	ESWARAN, KALI S MD INC	6/14/2013	207R00000X	NA	Other	026	PHYSICIANS	40842	None	None	0	In state provider	None	1995 ZINFANDEL DR	STE 201	RANCHO CORDOVA	CA	95670	2862	34	06067	38.612124	-121.27131	Sacramento County
265198	Fee-for-Service	1114965761	1114965761	1	1	EUREKA FAMILY PRACTICE	10/23/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	INC MEDICAL GROUP	2675 HARRIS ST	None	EUREKA	CA	95503	4806	12	06023	40.78053022	-124.1369379	Humboldt County
265319	Fee-for-Service	1366468969	1366468969	1	1	ELMARAACHLI, WAEL MD	1/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106280	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
265348	Fee-for-Service	1538588207	1538588207	1	1	EZUDDIN, MOHAMMED MD	12/28/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	192219	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
265459	Fee-for-Service	1942818505	1942818505	1	1	ELANDT, EMILY R PT	8/16/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
265595	Fee-for-Service	1073519997	1073519997	1	1	ESTRADA, JAIME OD	2/4/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4511 GAGE AVE	None	BELL	CA	90201	1308	19	06037	33.97797496	-118.1864256	Los Angeles County
265605	Fee-for-Service	1366468969	1366468969	1	1	ELMARAACHLI, WAEL MD	1/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106280	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
265611	Fee-for-Service	1538554548	1538554548	1	1	ELHADARY, MAZIN A MD	8/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151384	01	General Practice	0	In state provider	None	17095 MAIN ST	None	HESPERIA	CA	92345	6004	36	06071	34.41984761	-117.2904344	San Bernardino County
265651	Fee-for-Service	1366641383	1366641383	1	1	EBBERT, TODD MD	11/7/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	191653	None	None	0	In state provider	None	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
265726	Fee-for-Service	1871513366	1871513366	1	1	EJIKE, JANETH C MD	10/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84491	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
265838	Fee-for-Service	1700332442	1700332442	1	1	EMILE SHARIFI MD A MEDICAL C	1/23/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	None	None	0	In state provider	ORPORATION	1680 E HERNDON AVE	101	FRESNO	CA	93720	3384	10	06019	36.83756052	-119.7571005	Fresno County
265915	Fee-for-Service	1568400513	1568400513	1	1	EDWARDS, IRV E MD	8/25/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	32513	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5925 SAN VICENTE BLVD	None	LOS ANGELES	CA	90019	6630	19	06037	34.05682871	-118.360716	Los Angeles County
265977	Fee-for-Service	1477600260	1477600260	1	1	ENKER, MARK H MD	4/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111260	None	None	0	In state provider	None	3883 AIRWAY DRIVE	SUITE 202	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
266057	Fee-for-Service	1497955371	1497955371	1	1	ESTURI, LAKSHMI P MD	6/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112574	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
266263	Fee-for-Service	1366458200	1366458200	1	1	ERB, MELANIE H MD	12/16/2004	174400000X	NA	Other	026	PHYSICIANS	76828	18	Ophthalmology	0	In state provider	None	2121 WILSHIRE BLVD	SUITE 301	SANTA MONICA	CA	90403	5743	19	06037	34.03262306	-118.4817131	Los Angeles County
266314	Fee-for-Service	1477589794	1477589794	1	1	EKWA-EKOKO, CATHERINE MD	11/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	300 W CLARENDON AVE	STE 375	PHOENIX	AZ	85013	3498	00	None	33.49179	-112.07844	Maricopa County
266354	Fee-for-Service	1245288083	1245288083	1	1	EVERGREEN HEARTWOOD AVE	5/1/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1044 HEARTWOOD AVE	None	VALLEJO	CA	94591	5637	48	06095	38.10528165	-122.2114266	Solano County
266436	Fee-for-Service	1770692303	1770692303	1	1	ESPINOZA, JULI LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
266481	Fee-for-Service	1942288725	1942288725	1	1	ENNIX, COYNESS L JR MD	9/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	39990	33	Thoracic Surgery	0	In state provider	INC	3300 WEBSTER ST	STE 404	OAKLAND	CA	94609	3149	01	06001	37.82132826	-122.2621843	Alameda County
266630	Fee-for-Service	1982142170	1982142170	1	1	EMERALD GARDENS HOSPICE, INC	3/29/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	600 N MOUNTAIN AVE	UNIT C206	UPLAND	CA	91786	4367	36	06071	34.10094187	-117.6700806	San Bernardino County
266740	Fee-for-Service	1821104522	1821104522	1	1	ERCOLI, LINDA M PHD	11/1/2001	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
266764	Fee-for-Service	1942288725	1942288725	1	1	ENNIX, COYNESS L JR MD	9/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	39990	06	Cardiovascular Disease (M.D. only)	0	In state provider	INC	3300 WEBSTER ST	STE 404	OAKLAND	CA	94609	3149	01	06001	37.82132826	-122.2621843	Alameda County
266916	Fee-for-Service	1982142170	1982142170	1	1	EMERALD GARDENS HOSPICE, INC	3/29/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	600 N MOUNTAIN AVE	UNIT C206	UPLAND	CA	91786	4367	36	06071	34.10094187	-117.6700806	San Bernardino County
266930	Fee-for-Service	1669994810	1669994810	1	1	ELYASZADEH, GHAZALEH LMFT	10/7/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1551 GREENFIELD AVE.	#101	BEVERLY HILLS	CA	90025	0000	19	06037	34.05083001	-118.4432038	Los Angeles County
266957	Fee-for-Service	1023723897	1023723897	1	1	EVANS, MELISSA R	1/24/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 E BIDWELL ST	#101	FOLSOM	CA	95630	3452	34	06067	38.66841	-121.151025	Sacramento County
267021	Fee-for-Service	1205423449	1205423449	1	1	ELITE CAREGIVERS INC	8/27/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14329 VICTORY BLVD	STE 302	VAN NUYS	CA	91401	1945	19	06037	34.18669349	-118.44531	Los Angeles County
267150	Fee-for-Service	1740496934	1740496934	1	1	ELITE MED TRANSPORT OF TEXAS	7/23/2008	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1000 TEXAS AVE	None	EL PASO	TX	79901	0000	00	None	31.7633451	-106.4800756	El Paso County
267165	Fee-for-Service	1326000670	1326000670	2	1	ENNS, GORDON MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	280 MAPLE	None	ASHLAND	OR	97520	1552	00	None	42.20644248	-122.724936	Jackson County
267170	Fee-for-Service	1992714646	1992714646	1	1	ENCARNACION, NORMA LMFT	8/2/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	595 E COLORADO BLVD	STE 710	PASADENA	CA	91101	2012	19	06037	34.14588202	-118.1380722	Los Angeles County
267174	Fee-for-Service	1104438977	1104438977	1	1	ERMANITA CORPORATION	8/2/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	17441 DEVONSHIRE ST	None	NORTHRIDGE	CA	91325	1544	19	06037	34.25761369	-118.5147777	Los Angeles County
267207	Fee-for-Service	1508465790	1508465790	1	1	ECB HOME HEALTHCARE LLC	5/26/2022	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	15728 WOODRUFF AVE	None	BELLFLOWER	CA	90706	4018	19	06037	33.8906193	-118.1173215	Los Angeles County
267213	Fee-for-Service	1619946654	1619946654	1	1	EL-BERSHAWI, AHMED S MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90658	None	None	0	In state provider	None	1310 W STEWART DR	STE 410	ORANGE	CA	92868	3855	30	06059	33.78236048	-117.8664975	Orange County
267305	Fee-for-Service	1205423449	1205423449	1	1	ELITE CAREGIVERS INC	8/27/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14329 VICTORY BLVD	STE 302	VAN NUYS	CA	91401	1945	19	06037	34.18669349	-118.44531	Los Angeles County
267324	Fee-for-Service	1780107797	1780107797	1	3	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	6380 CLARK AVE	SUITE C-1	DUBLIN	CA	94568	3036	01	06001	37.70451998	-121.9205494	Alameda County
267461	Fee-for-Service	1871894303	1871894303	1	1	EZELL, SEAN M PT	3/15/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4650 PALM AVE	None	SAN DIEGO	CA	92154	8404	37	06073	32.5839467	-117.0337851	San Diego County
267481	Fee-for-Service	1437219664	1437219664	1	1	EXCELLENT HEALTH INC	8/1/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE PHARMACY	223 N GARFIELD AVE	STE 101	MONTEREY PARK	CA	91754	1700	19	06037	34.0646166	-118.1228948	Los Angeles County
267523	Fee-for-Service	1639297096	1639297096	1	1	ESHAGHIAN, MICHAEL	9/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96648	None	None	0	In state provider	None	450 N BEDFORD DR	STE 209	BEVERLY HILLS	CA	90210	4306	19	06037	34.06885525	-118.4059408	Los Angeles County
267566	Fee-for-Service	1750388526	1750388526	1	1	ELSON, NATHAN R MD	5/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	39356	10	Gastroenterology (M.D. only)	0	In state provider	None	2001 SANTA MONICA BLVD	STE 1170W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
267607	Fee-for-Service	1780107797	1780107797	1	4	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	400 TAYLOR BLVD	SUITE 201	PLEASANT HILL	CA	94523	2163	07	06013	37.96132631	-122.0740275	Contra Costa County
267701	Fee-for-Service	1346760386	1346760386	1	1	EMERLING, ALEC MD	11/27/2023	207P00000X	NA	Other	026	PHYSICIANS	191092	None	None	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
267879	Fee-for-Service	1639449135	1639449135	1	2	EMILY REKUC D.O., INC.	1/13/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	09	Gynecology (D.O. only)	0	In state provider	None	81719 DOCTOR CARREON	C-1	INDIO	CA	92201	0600	33	06065	33.70738353	-116.2386945	Riverside County
268101	Fee-for-Service	1083238976	1083238976	1	1	ESCOBAR, MARY D NP	6/22/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	202 W WILLOW AVE	SUITE 502	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
268120	Fee-for-Service	1609162734	1609162734	1	1	ENGLAND, LINH N MD	5/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	117370	40	Pediatrics	0	In state provider	None	4050 BARRANCA PKWY	STE 200	IRVINE	CA	92604	1723	30	06059	33.68293726	-117.8067799	Orange County
268127	Fee-for-Service	1780107797	1780107797	1	23	EPIC CARE	7/9/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1240 CENTRAL BLVD	STE A2	BRENTWOOD	CA	94513	2228	07	06013	37.93884851	-121.6980845	Contra Costa County
268138	Fee-for-Service	1629851258	1629851258	1	1	EMPOWERED FAMILY THERAPY SER	3/5/2025	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	VICES INC	121 W MAIN ST	SUITE G	TURLOCK	CA	95380	4845	50	06099	37.49361627	-120.8474261	Stanislaus County
268164	Fee-for-Service	1639449135	1639449135	1	2	EMILY REKUC D.O., INC.	1/13/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	81719 DOCTOR CARREON	C-1	INDIO	CA	92201	0600	33	06065	33.70738353	-116.2386945	Riverside County
268371	Fee-for-Service	1245302736	1245302736	1	1	ELKADI, TAREK S MD	8/3/2023	207L00000X	NA	Other	026	PHYSICIANS	102614	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
268401	Fee-for-Service	1144529876	1144529876	1	1	ELIZABETH PERRY MD	1/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 E WHEELER RD	None	MOSES LAKE	WA	98837	1820	00	None	47.128302	-119.2653765	Grant County
268451	Fee-for-Service	1922497700	1922497700	1	1	ELKIND, JAE MD	8/20/2021	207ZP0105X	NA	Other	026	PHYSICIANS	152642	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
268452	Fee-for-Service	1588901532	1588901532	1	18	EXER MEDICAL CORPORATION	10/26/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4730 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6902	19	06037	33.98008975	-118.4384514	Los Angeles County
268495	Fee-for-Service	1306005806	1306005806	1	3	ELIZABETH ROBERT M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5171 W OLIVE AVE	None	GLENDALE	AZ	85302	4204	00	None	33.567093	-112.1719365	Maricopa County
268550	Fee-for-Service	1144299801	1144299801	1	1	EWALD, PETER J MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	34963	40	Pediatrics	0	In state provider	None	380 90TH ST	None	DALY CITY	CA	94015	1807	41	06081	37.69110985	-122.4742036	San Mateo County
268734	Fee-for-Service	1588901532	1588901532	1	18	EXER MEDICAL CORPORATION	2/23/2024	261QU0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4730 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6902	19	06037	33.98008975	-118.4384514	Los Angeles County
268794	Fee-for-Service	1730765157	1730765157	1	1	ELIAS, PAUL M MD	3/21/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181557	08	Family Practice	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
268842	Fee-for-Service	1033142260	1033142260	1	1	ERDOSH, MONICA LCSW	12/31/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11521 BLOCKER DR.	102	AUBURN	CA	95603	4654	31	06061	38.9034802	-121.0828595	Placer County
268871	Fee-for-Service	1942355268	1942355268	1	1	EDELSTEIN, MARY R PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1333 RALSTON AVE	STE C	BELMONT	CA	94002	1904	41	06081	37.51657558	-122.2816457	San Mateo County
268896	Fee-for-Service	1992266654	1992266654	1	1	ECHAVERRY, MARLON E MD	8/25/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180485	None	None	0	In state provider	None	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	10	06019	36.74333844	-119.7831874	Fresno County
268997	Fee-for-Service	1780879239	1780879239	1	1	EPSTEIN, STACEY E	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67121	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
269016	Fee-for-Service	1588901532	1588901532	1	18	EXER MEDICAL CORPORATION	2/12/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4730 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6902	19	06037	33.98008975	-118.4384514	Los Angeles County
269037	Fee-for-Service	1124008149	1124008149	1	1	ETESHAM, SOHEIL MD	12/1/1994	174400000X	NA	Other	026	PHYSICIANS	50143	None	None	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
269073	Fee-for-Service	1356330294	1356330294	1	1	ENGASSER, PATRICIA G MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	9134	07	Dermatology	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
269142	Fee-for-Service	1184796583	1184796583	1	1	ENCARNACION, MARILOU C NP	10/1/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
269150	Fee-for-Service	1043254329	1043254329	1	1	EASTON, JOHN D MD	3/10/2010	2084N0400X	NA	Neurology	026	PHYSICIANS	13426	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.76344756	-122.4581992	San Francisco County
269155	Fee-for-Service	1245311554	1245311554	1	1	ESCOBER, WILFREDO T MD	2/21/2010	174400000X	NA	Other	026	PHYSICIANS	43026	13	Neurology (M.D. only)	0	In state provider	None	17400 IRVINE BLVD	SUITE M	TUSTIN	CA	92780	3030	30	06059	33.74814651	-117.828558	Orange County
269283	Fee-for-Service	1073034229	1073034229	1	1	ESCOBAR, ALYSSA	12/26/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4211 B VALLEY VIEW AVE	None	NORCO	CA	92860	3502	33	06065	33.943446	-117.5498725	Riverside County
269294	Fee-for-Service	1508837279	1508837279	1	1	EDINGTON, PHILIP A	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	58380	None	None	0	In state provider	None	6244 EL CAJON BLVD	STE 22	SAN DIEGO	CA	92115	3918	37	06073	32.76342577	-117.0636924	San Diego County
269325	Fee-for-Service	1124063623	1124063623	1	1	EL YOUSEF, SABA J MD	7/31/1995	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	42360	30	Radiology	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
269433	Fee-for-Service	1770970139	1770970139	1	1	ECHOLS, LAMARR MD	11/25/2019	207P00000X	NA	Other	026	PHYSICIANS	148156	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
269491	Fee-for-Service	1225474786	1225474786	1	1	EMMERT, DAVID A PHD	8/21/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5755 COTTLE ROAD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
269507	Fee-for-Service	1023428117	1023428117	2	1	ETIENNE, ANTHONIE O	8/7/2023	101YP1600X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14201 KENTWOOD BLVD	2	VICTORVILLE	CA	92392	2472	36	06071	34.508862	-117.327461	San Bernardino County
269522	Fee-for-Service	1770756330	1770756330	1	1	ESCOBEDO, ANTONIO E MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	95736	41	Internal Medicine	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	2347	19	06037	33.94435533	-117.9931159	Los Angeles County
269660	Fee-for-Service	1740338011	1740338011	1	1	ELK GROVE UNIFIED SD	3/31/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	9510 ELK GROVE FLORIN RD	None	ELK GROVE	CA	95624	1801	34	06067	38.413008	-121.372344	Sacramento County
269710	Fee-for-Service	1174729412	1174729412	1	1	EMERALD CORPORATION	4/25/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	13771 ROSEWELL AVENUE	STE H	CHINO	CA	91710	5465	36	06071	34.0025659	-117.7217714	San Bernardino County
269751	Fee-for-Service	1922179803	1922179803	1	1	ESHILIAN-OATES, LIZA MD	12/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73531	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
269844	Fee-for-Service	1346714425	1346714425	1	1	EMERALD BLOSSOM MANOR LLC	12/17/2018	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5301 GERINE BLOSSOM DR	None	SAN JOSE	CA	95123	2118	43	06085	37.25876259	-121.8120118	Santa Clara County
269964	Fee-for-Service	1912352261	1912352261	1	1	EGBERT, RYAN C MD	8/16/2021	163WX0800X	NA	Other	026	PHYSICIANS	171293	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
269967	Fee-for-Service	1821010729	1821010729	1	2	EVERGREEN PHARMACEUTICAL OF	10/4/2019	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	NIA	8220 REMMET AVE	None	CANOGA PARK	CA	91304	4156	19	06037	34.217991	-118.6002715	Los Angeles County
270008	Fee-for-Service	1093712374	1093712374	1	17	EL CAMINO HOSP	6/25/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2495 HOSPITAL DRIVE	2ND FLOOR STE 2F60	MOUNTAIN VIEW	CA	94040	4119	43	06085	37.369341	-122.0817635	Santa Clara County
270027	Fee-for-Service	1134262157	1134262157	2	1	ENGBLADE, JOY K MD	5/27/2014	207R00000X	NA	Other	026	PHYSICIANS	107444	41	Internal Medicine	0	In state provider	None	152 PIONEER LANE	STE C	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
270119	Fee-for-Service	1255403093	1255403093	1	1	ESPINOZA, AUGUSTINE F MD	10/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	68565	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
270121	Fee-for-Service	1295326452	1295326452	1	1	EXQUISITE TOUCH HOSPICE	12/17/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	401 N BRAND BLVD	SUITE 336	GLENDALE	CA	91203	4427	19	06037	34.151958	-118.255149	Los Angeles County
270218	Fee-for-Service	1386649499	1386649499	1	2	EVARISTO, CATHERINE	1/26/2023	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	50 N HILL AVE	302	PASADENA	CA	91106	1903	19	06037	34.146963	-118.121344	Los Angeles County
270356	Fee-for-Service	1093778326	1093778326	1	1	ENGELMAN, CHRISTOPHER MD	3/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69913	18	Ophthalmology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
270384	Fee-for-Service	1053170043	1053170043	1	1	ESCHENBERG, MAGDALENA BIRTH	3/14/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	49	06097	0	0	None
270385	Fee-for-Service	1235210089	1235210089	2	1	EASTSIDE ORTHOPEDIC MEDICAL	2/11/2021	207X00000X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ASSOCIATES	880 S ATLANTIC BLVD	SUITE 205	MONTEREY PARK	CA	91754	4782	19	06037	34.05038485	-118.1383456	Los Angeles County
270398	Fee-for-Service	1295326452	1295326452	1	1	EXQUISITE TOUCH HOSPICE	12/17/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	401 N BRAND BLVD	SUITE 336	GLENDALE	CA	91203	4427	19	06037	34.151958	-118.255149	Los Angeles County
270427	Fee-for-Service	1255353769	1255353769	1	1	ERIC T SPIER M.D.	5/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1395 GEORGE DIETER DR	None	EL PASO	TX	79936	7499	00	None	31.73238192	-106.3017411	El Paso County
270450	Fee-for-Service	1477714897	1477714897	1	1	EL-SHERIEF, KARIM H MD	1/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103787	41	Internal Medicine	0	In state provider	None	1180 E SHAW AVE	STE 101	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
270470	Fee-for-Service	1407966260	1407966260	1	1	EASLEY, DYLAN A MD	6/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95106	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
270487	Fee-for-Service	1578940300	1578940300	1	1	ELIAS, DALIA MD	8/21/2018	207R00000X	NA	Other	026	PHYSICIANS	154482	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
270522	Fee-for-Service	1497779508	1497779508	1	1	ENCE, THOMAS J MD	12/1/1980	174400000X	NA	Other	026	PHYSICIANS	30027	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	5525 ETIWANDA AVE	STE 112	TARZANA	CA	91356	6115	19	06037	34.17046451	-118.5308463	Los Angeles County
270581	Fee-for-Service	1093712374	1093712374	1	16	EL CAMINO HOSP	6/25/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2495 HOSPITAL DRIVE	2ND FLOOR STE 2F60	MOUNTAIN VIEW	CA	94040	4119	43	06085	37.369341	-122.0817635	Santa Clara County
270587	Fee-for-Service	1356390983	1356390983	1	1	EL DORADO ANESTHESIA	2/25/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	MARSHALL WAY	None	PLACERVILLE	CA	95667	0000	09	06017	38.72587744	-120.791388	El Dorado County
270616	Fee-for-Service	1124157144	1124157144	1	1	EARNEST, KEVIN J LMFT	6/25/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2001 NORTH CHESTER	None	BAKERSFIELD	CA	93308	2654	15	06029	35.42456102	-119.0213307	Kern County
270681	Fee-for-Service	1407899479	1407899479	1	1	ERICKSON, JOEL S MD	8/22/1995	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54218	66	Emergency Medicine (Urgent Care)	0	In state provider	None	500 DOYLE PARK DR	STE 205	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
270701	Fee-for-Service	1588901532	1588901532	1	57	EXER MEDICAL CORPORATION	3/6/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2968 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5826	19	06037	33.9731851	-118.215729	Los Angeles County
270727	Fee-for-Service	1275673162	1275673162	1	1	EMERGECNY PHYSICIANS MED	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	GUILLERMO, GLEN MD	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
270809	Fee-for-Service	1437588514	1437588514	1	1	EMPIRE HOSPICE CARE INC	10/21/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	13701 RIVERSIDE DRIVE	#512	SHERMAN OAKS	CA	91423	2467	19	06037	34.15762986	-118.4316325	Los Angeles County
270817	Fee-for-Service	1790733913	1790733913	1	1	ETWARU, GUPTA MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	83765	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
270845	Fee-for-Service	1942971593	1942971593	1	1	EXCELLING HOME HEALTH INC	8/12/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3357 CAHUENGA BLVD W	SUITE 55	LOS ANGELES	CA	90068	1327	19	06037	34.13130457	-118.3515446	Los Angeles County
270868	Fee-for-Service	1437274495	1437274495	1	1	EYE SURGICAL CENTER OF SAN	8/11/2017	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	FRANCISCO LLC	1160 POST STREET	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
270911	Fee-for-Service	1437207313	1437207313	1	1	ESKANDER, SHERIF S MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69762	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
270978	Fee-for-Service	1588901532	1588901532	1	57	EXER MEDICAL CORPORATION	3/6/2024	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2968 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5826	19	06037	33.9731851	-118.215729	Los Angeles County
271044	Fee-for-Service	1063785988	1063785988	1	1	ESSILFIE, GILBERT MD	1/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119929	None	None	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
271085	Fee-for-Service	1437588514	1437588514	1	1	EMPIRE HOSPICE CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	13701 RIVERSIDE DRIVE	#512	SHERMAN OAKS	CA	91423	2467	19	06037	34.15762986	-118.4316325	Los Angeles County
271122	Fee-for-Service	1306569884	1306569884	1	1	ESPINO, ESMERALDA B AU	3/17/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	G AID SERVICE	146 HARDER ROAD	C	HAYWARD	CA	94544	2559	01	06001	37.6495222	-122.0763794	Alameda County
271179	Fee-for-Service	1013466994	1013466994	1	1	EDDY, KRISTEN V PSYD	6/21/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
271188	Fee-for-Service	1437207313	1437207313	1	1	ESKANDER, SHERIF S MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69762	01	General Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
271231	Fee-for-Service	1558934877	1558934877	1	1	EVER LASTING POSITIVE CHANGE	8/1/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	, INC.	4231 LARWIN AVE	None	CYPRESS	CA	90630	4147	30	06059	33.8173113	-118.0593165	Orange County
271237	Fee-for-Service	1093817819	1093817819	1	1	EPSTEIN, ANDREW MD	10/31/1988	208800000X	NA	Other	026	PHYSICIANS	46519	34	Urology and Urological Surgery	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
271258	Fee-for-Service	1588901532	1588901532	1	57	EXER MEDICAL CORPORATION	6/5/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2968 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5826	19	06037	33.9731851	-118.215729	Los Angeles County
271336	Fee-for-Service	1184728479	1184728479	2	1	ETEHAD, SIAMAK P MD	3/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	43714	41	Internal Medicine	0	In state provider	None	17075 DEVONSHIRE ST	SUITE 100	NORTHRIDGE	CA	91325	5405	19	06037	34.25755945	-118.50471	Los Angeles County
271386	Fee-for-Service	1134201791	1134201791	1	1	ELSAYAD, NABIL I MD	5/6/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	41141	68	Hematology	0	In state provider	None	24845 NARBONNE AVE	None	LOMITA	CA	90717	1549	19	06037	33.79846168	-118.3200179	Los Angeles County
271392	Fee-for-Service	1417132499	1417132499	1	1	ESHAGHIAN, SHAHROOZ MD	10/11/2022	207RH0003X	NA	Oncology	026	PHYSICIANS	100734	None	None	0	In state provider	None	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	19	06037	34.05362775	-118.2661889	Los Angeles County
271454	Fee-for-Service	1104974187	1104974187	1	1	EZEOKOLI, NJIDEKA C MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63846	40	Pediatrics	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
271462	Fee-for-Service	1528015526	1528015526	1	1	EDWARDS, LISA P LCSW	4/7/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20101 LAKE CHABOT RD	1ST FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
271463	Fee-for-Service	1548870314	1548870314	1	1	ESSEFF, GINA M	9/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27951 SMYTH DR	None	VALENCIA	CA	91355	1224	19	06037	34.44222202	-118.5700452	Los Angeles County
271480	Fee-for-Service	1821375924	1821375924	1	1	EGERTSON, KAREN M LMFT	6/13/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3855 ALAMO ST	None	SIMI VALLEY	CA	93063	2104	56	06111	34.28644751	-118.721655	Ventura County
271516	Fee-for-Service	1093988974	1093988974	1	1	EISEMON, ERIC O MD	11/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131741	20	Orthopedic Surgery	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
271585	Fee-for-Service	1083746887	1083746887	1	1	ELVIN, LISA V NP	8/11/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
271590	Fee-for-Service	1124252655	1124252655	1	1	EDWARDS, KARLA J LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
271651	Fee-for-Service	1952075145	1952075145	1	1	ESCOBEDO, ANGELINE LMFT	4/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39159 PASEO PADRE PKWY	STE 121	FREMONT	CA	94538	1600	01	06001	37.5531875	-121.9805141	Alameda County
271661	Fee-for-Service	1134201791	1134201791	1	1	ELSAYAD, NABIL I MD	5/6/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	41141	41	Internal Medicine	0	In state provider	None	24845 NARBONNE AVE	None	LOMITA	CA	90717	1549	19	06037	33.79846168	-118.3200179	Los Angeles County
271742	Fee-for-Service	1336196138	1336196138	1	1	ELSPAS, SHERMAN R MD	3/15/1996	207L00000X	NA	Other	026	PHYSICIANS	56589	05	Anesthesiology	0	In state provider	None	333 N PRAIRIE AVE	None	INGLEWOOD	CA	90301	4501	19	06037	33.9670722	-118.3439911	Los Angeles County
271874	Fee-for-Service	1588469985	1588469985	1	1	EROLIN, SARAH S	2/20/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
271935	Fee-for-Service	1134201791	1134201791	1	1	ELSAYAD, NABIL I MD	5/6/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	41141	08	Family Practice	0	In state provider	None	24845 NARBONNE AVE	None	LOMITA	CA	90717	1549	19	06037	33.79846168	-118.3200179	Los Angeles County
272035	Fee-for-Service	1003229402	1003229402	1	1	ELSHARKAWY, MOHAMED Y MD	8/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	143988	01	General Practice	0	In state provider	None	1770 N ORANGE GROVE AVE	STE 101	POMONA	CA	91767	3027	19	06037	34.07637624	-117.7492622	Los Angeles County
272048	Fee-for-Service	1942845888	1942845888	1	1	ELATION HOSPICE CARE INC	1/13/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14621 TITUS ST	SUITE 214	VAN NUYS	CA	91402	4906	19	06037	34.21972652	-118.451799	Los Angeles County
272110	Fee-for-Service	1912485475	1912485475	1	1	EMEKA-NWONOVO, CHINELO MD	7/1/2024	106S00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
272235	Fee-for-Service	1003866120	1003866120	1	6	EMERGENCY ASSOCIATES COR	2/8/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
272321	Fee-for-Service	1942845888	1942845888	1	1	ELATION HOSPICE CARE INC	1/13/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14621 TITUS ST	SUITE 214	VAN NUYS	CA	91402	4906	19	06037	34.21972652	-118.451799	Los Angeles County
272371	Fee-for-Service	1033222989	1033222989	2	1	EMPIRE SURGERY CENTER	3/19/2024	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	4101 EMPIRE DR	STE 130	BAKERSFIELD	CA	93309	0681	15	06029	35.37449372	-119.0467779	Kern County
272407	Fee-for-Service	1003866120	1003866120	1	5	EMERGENCY ASSOCIATES COR	6/26/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
272418	Fee-for-Service	1982883948	1982883948	1	1	EHSAN, ALEX A MD	3/29/2023	207RX0202X	NA	Oncology	026	PHYSICIANS	88317	None	None	0	In state provider	None	18433 ROSCOE BLVD	SUITE 106	NORTHRIDGE	CA	91325	4129	19	06037	34.22076747	-118.534725	Los Angeles County
272488	Fee-for-Service	1578642617	1578642617	1	1	ERICKSON, ROBERT F MD	9/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81503	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
272492	Fee-for-Service	1104182856	1104182856	1	1	ESTHER YOON MD, INC	2/16/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	1901 BROADVIEW DR	None	GLENDALE	CA	91208	1201	19	06037	34.20399715	-118.2268778	Los Angeles County
272507	Fee-for-Service	1003866120	1003866120	1	6	EMERGENCY ASSOCIATES COR	9/15/2011	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
272677	Fee-for-Service	1003866120	1003866120	1	5	EMERGENCY ASSOCIATES COR	9/1/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
272713	Fee-for-Service	1174169031	1174169031	1	1	EITOKU LAWTON INC	12/20/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	S CENTER	537 FRONT ST	None	SOLEDAD	CA	93960	3014	27	06053	36.42660428	-121.3286943	Monterey County
272719	Fee-for-Service	1104110071	1104110071	1	1	EZRA, NAVID MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135378	07	Dermatology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
272730	Fee-for-Service	1124039052	1124039052	1	1	ETCHIE, SAMUEL O MD	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	53857	36	Psychiatry	0	In state provider	None	234 N MAGNOLIA AVE	None	EL CAJON	CA	92020	3906	37	06073	32.7970926	-116.9623736	San Diego County
272744	Fee-for-Service	1639521115	1639521115	1	1	ENG, SHU M PSYD	7/26/2020	225C00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
272790	Fee-for-Service	1023420726	1023420726	1	1	ENLOE MEDICAL CENTER	1/2/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1665 ESPLANDE	None	CHICO	CA	95926	3312	04	06007	39.74388808	-121.8503372	Butte County
272828	Fee-for-Service	1861107260	1861107260	1	1	EGOROVA, ELIZAVETA LMFT	4/14/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	435 LOMA VISTA ST	None	EL SEGUNDO	CA	90245	2918	19	06037	33.92194416	-118.4218104	Los Angeles County
272837	Fee-for-Service	1184719809	1184719809	1	1	EAST BAY NEPHROLOGY MEDICAL	1/1/1990	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP	127 HOSPITAL DR	204	VALLEJO	CA	94589	2562	48	06095	38.13103371	-122.2387342	Solano County
272877	Fee-for-Service	1215140397	1215140397	1	1	EAST LOS ANGELES REMARKABLE	3/15/2012	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	CITIZENS ASSOCIATION	4008 FLORENCE AVENUE	None	BELL	CA	90201	3404	19	06037	33.97118267	-118.1965704	Los Angeles County
272924	Fee-for-Service	1053094862	1053094862	1	1	EMPOWERING INITIATIVE LICENS	11/5/2023	103TP2700X	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2560 INVERNESS DR	None	LINCOLN	CA	95648	9576	31	06061	38.89786544	-121.3267635	Placer County
272925	Fee-for-Service	1710577358	1710577358	1	1	ESSENTIAL PSYCHIATRIC SERVIC	6/14/2023	261QM0850X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ES, A PROFESSIONAL NURSI	3160 RAMSEY ST	None	BANNING	CA	92220	3724	33	06065	33.92559942	-116.9104797	Riverside County
272997	Fee-for-Service	1124039052	1124039052	1	1	ETCHIE, SAMUEL O MD	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	53857	66	Emergency Medicine (Urgent Care)	0	In state provider	None	234 N MAGNOLIA AVE	None	EL CAJON	CA	92020	3906	37	06073	32.7970926	-116.9623736	San Diego County
273079	Fee-for-Service	1043233661	1043233661	1	1	ETTENGER, ROBERT MD	1/1/1980	2080P0210X	NA	Nephrology	026	PHYSICIANS	36820	40	Pediatrics	0	In state provider	U C LOS ANGELES	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
273107	Fee-for-Service	1184719809	1184719809	1	1	EAST BAY NEPHROLOGY MEDICAL	1/1/1990	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	GROUP	127 HOSPITAL DR	204	VALLEJO	CA	94589	2562	48	06095	38.13103371	-122.2387342	Solano County
273122	Fee-for-Service	1740723774	1740723774	1	1	ERICK R MORALES MD INC	12/7/2016	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	None	None	0	In state provider	None	1100 N VENTURA RD	112	OXNARD	CA	93030	3841	56	06111	34.212771	-119.1944035	Ventura County
273140	Fee-for-Service	1902112782	1902112782	1	1	EPPEY, RICHARD J II MD	1/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	103591	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	63532 29 PALMS HWY	STE D	JOSHUA TREE	CA	92252	3343	36	06071	34.13510347	-116.277102	San Bernardino County
273156	Fee-for-Service	1255369336	1255369336	1	1	EAST BAY RADIATION ONCOL	7/1/1983	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	SPLIT BILLING	20126 STANTON AVE	None	CASTRO VALLEY	CA	94546	5271	01	06001	37.69722866	-122.090936	Alameda County
273192	Fee-for-Service	1710577358	1710577358	1	1	ESSENTIAL PSYCHIATRIC SERVIC	6/14/2023	261QM0850X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ES, A PROFESSIONAL NURSI	3160 RAMSEY ST	None	BANNING	CA	92220	3724	33	06065	33.92559942	-116.9104797	Riverside County
273239	Fee-for-Service	1215938873	1215938873	1	1	ELIZABETH CLAXTOO	11/18/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
273276	Fee-for-Service	1013386630	1013386630	1	1	ENNIS, BRIANNA K MD	8/8/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	178770	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
273309	Fee-for-Service	1861425845	1861425845	1	1	EFFRON, CHERYL L MD	7/24/2020	174400000X	NA	Other	026	PHYSICIANS	34396	07	Dermatology	0	In state provider	None	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	33	06065	33.90336622	-117.49394	Riverside County
273386	Fee-for-Service	1780680140	1780680140	1	1	ETZKORN, EDWARD R MD	5/5/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	57149	41	Internal Medicine	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
273464	Fee-for-Service	1710577358	1710577358	1	1	ESSENTIAL PSYCHIATRIC SERVIC	10/5/2022	261QM0850X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	ES, A PROFESSIONAL NURSI	3160 RAMSEY ST	None	BANNING	CA	92220	3724	33	06065	33.92559942	-116.9104797	Riverside County
273505	Fee-for-Service	1255885034	1255885034	1	1	EAGLE, ASHLEY LMFT	8/25/2024	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
273535	Fee-for-Service	1770599920	1770599920	1	1	ERLE, DAVID J MD	8/1/1989	207RP1001X	NA	Pulmonology	026	PHYSICIANS	56077	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	# 5H	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
273648	Fee-for-Service	1568527901	1568527901	1	1	ERICKSON, SANDRA L CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
273679	Fee-for-Service	1356308696	1356308696	1	1	ELBL, BARBARA A LMFT	10/15/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4333 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1376	38	06075	37.78481763	-122.4641142	San Francisco County
273712	Fee-for-Service	1366620049	1366620049	1	1	EGGERS, JEANNA AU	5/5/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
273722	Fee-for-Service	1487914693	1487914693	1	1	ELCHICO, ERICK R F MD	7/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129059	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
273799	Fee-for-Service	1801944731	1801944731	1	1	EHRLICH, THEODORE MD	4/25/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	13528	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
273899	Fee-for-Service	1932936564	1932936564	1	1	ESTRADA, EMILY	12/17/2024	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4211 B VALLEY VIEW AVE	None	NORCO	CA	92860	3502	33	06065	33.943446	-117.5498725	Riverside County
273934	Fee-for-Service	1972565307	1972565307	1	1	EGUIA, JOSE M MD	6/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	75495	77	Infectious Disease	0	In state provider	None	1 SHRADER ST	STE 500	SAN FRANCISCO	CA	94117	1044	38	06075	37.77467326	-122.4529451	San Francisco County
274074	Fee-for-Service	1801944731	1801944731	1	1	EHRLICH, THEODORE MD	4/25/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	13528	30	Radiology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
274182	Fee-for-Service	1487066098	1487066098	1	1	EL AHMADIEH, TAREK MD	9/1/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	178742	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
274202	Fee-for-Service	1972565307	1972565307	1	1	EGUIA, JOSE M MD	6/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	75495	41	Internal Medicine	0	In state provider	None	1 SHRADER ST	STE 500	SAN FRANCISCO	CA	94117	1044	38	06075	37.77467326	-122.4529451	San Francisco County
274266	Fee-for-Service	1639449135	1639449135	1	1	EMILY REKUC D.O., INC.	1/17/2012	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	11655	09	Gynecology (D.O. only)	0	In state provider	None	79440 HIGHWAY 111	STE 104 & 105	LA QUINTA	CA	92253	7243	33	06065	33.70748202	-116.2785511	Riverside County
274285	Fee-for-Service	1184632390	1184632390	1	1	ENGLUND, GARY L OD APC	1/1/1996	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1112 VINE ST	None	PASO ROBLES	CA	93446	5505	40	06079	35.62602516	-120.6938682	San Luis Obispo County
274335	Fee-for-Service	1144418104	1144418104	1	1	ESPIRITU, CESAR L JR MD	11/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	123043	01	General Practice	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
274414	Fee-for-Service	1902191281	1902191281	1	1	ESCOBAR, FRANCISCA E OD	10/29/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	16255 VENTURA BLVD	STE 705	ENCINO	CA	91436	2311	19	06037	34.15693902	-118.4876816	Los Angeles County
274430	Fee-for-Service	1891032652	1891032652	1	2	EMMADA PSYCHOLOGY CENTER, IN	2/19/2020	103G00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	C.	595 E. COLORADO BLVD	SUITE #211	PASADENA	CA	91101	2053	19	06037	34.14588202	-118.1380722	Los Angeles County
274515	Fee-for-Service	1639449135	1639449135	1	1	EMILY REKUC D.O., INC.	1/17/2012	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	11655	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	79440 HIGHWAY 111	STE 104 & 105	LA QUINTA	CA	92253	7243	33	06065	33.70748202	-116.2785511	Riverside County
274537	Fee-for-Service	1780107797	1780107797	1	16	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	2999 REGENT ST	STE 700	BERKELEY	CA	94705	2122	01	06001	37.85592021	-122.2566436	Alameda County
274586	Fee-for-Service	1093712374	1093712374	1	2	EL CAMINO HOSP	4/11/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
274601	Fee-for-Service	1144418104	1144418104	1	1	ESPIRITU, CESAR L JR MD	11/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	123043	08	Family Practice	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
274696	Fee-for-Service	1891032652	1891032652	1	2	EMMADA PSYCHOLOGY CENTER, IN	2/19/2020	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	C.	595 E. COLORADO BLVD	SUITE #211	PASADENA	CA	91101	2053	19	06037	34.14588202	-118.1380722	Los Angeles County
274801	Fee-for-Service	1780107797	1780107797	1	16	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	2999 REGENT ST	STE 700	BERKELEY	CA	94705	2122	01	06001	37.85592021	-122.2566436	Alameda County
274811	Fee-for-Service	1144226184	1144226184	1	1	ELIHU, MAURICE MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88076	10	Gastroenterology (M.D. only)	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
274847	Fee-for-Service	1093712374	1093712374	1	2	EL CAMINO HOSP	4/11/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
274867	Fee-for-Service	1417185406	1417185406	1	1	ECKERBERG, HELENA PSYD	10/7/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
274923	Fee-for-Service	1962464776	1962464776	1	1	EISENSTAT, SAUL MD INC	5/13/1991	208600000X	NA	General Surgery	026	PHYSICIANS	18507	02	General Surgery	0	In state provider	None	2204 GRANT RD	STE 203	MOUNTAIN VIEW	CA	94040	3877	43	06085	37.37193085	-122.0779465	Santa Clara County
275011	Fee-for-Service	1790806370	1790806370	1	1	ELHAJJAR, ANTOINE J MD INC	2/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	53481	None	None	0	In state provider	None	41990 COOK ST	STE A-101	PALM DESERT	CA	92211	6101	33	06065	33.748371	-116.356173	Riverside County
275046	Fee-for-Service	1780107797	1780107797	1	20	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	27206 CALAROGA AVE	SUITE 208	HAYWARD	CA	94545	4300	01	06001	37.632357	-122.0868765	Alameda County
275062	Fee-for-Service	1780107797	1780107797	1	16	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2999 REGENT ST	STE 700	BERKELEY	CA	94705	2122	01	06001	37.85592021	-122.2566436	Alameda County
275071	Fee-for-Service	1003475369	1003475369	1	1	ESCARRA, SHANNON R PT	7/2/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1200 41ST AVE	SUITE H	CAPITOLA	CA	95010	3900	44	06087	36.969003	-121.964871	Santa Cruz County
275099	Fee-for-Service	1255457388	1255457388	1	1	EBRAHIM, JALALEDIN MFT	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	50838	-	NOT APPLICABLE	0	In state provider	None	86 SOUTH 14TH STREET	None	SAN JOSE	CA	95112	2015	43	06085	37.34109735	-121.8760463	Santa Clara County
275188	Fee-for-Service	1639797962	1639797962	1	1	EPPERSON, JILL C RCP	8/28/2020	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
275322	Fee-for-Service	1841785029	1841785029	1	1	ENG, MICHAEL W MD	8/20/2023	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	165874	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
275634	Fee-for-Service	1396741807	1396741807	1	1	EAST BAY ENDOSCOPY	3/30/2000	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER LP	5858 HORTON ST	STE 100	EMERYVILLE	CA	94608	2007	01	06001	37.84005777	-122.2911541	Alameda County
275675	Fee-for-Service	1205808284	1205808284	1	1	EBBELING, WILLIAM L MD	6/28/2019	207K00000X	NA	Other	026	PHYSICIANS	50225	03	Allergy	0	In state provider	None	7471 N FRESNO ST	None	FRESNO	CA	93720	2457	10	06019	36.84632065	-119.783885	Fresno County
275923	Fee-for-Service	1962608653	1962608653	1	1	ELMARIAH, SARINA B MD	2/16/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	184296	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
275924	Fee-for-Service	1851351795	1851351795	1	1	ESTES, BEVERLY A MD	12/11/2002	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	19892	40	Pediatrics	0	In state provider	BAYSIDE PEDIATRICS	3100 TELEGRAPH AVE	None	OAKLAND	CA	94609	3210	01	06001	37.82037533	-122.2667839	Alameda County
275950	Fee-for-Service	1124012505	1124012505	1	1	ESAGOFF, ASHER E	4/1/1985	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HEPPS PRESCRIPTION PHMCY	240 S LA CIENEGA BLVD	# 100	BEVERLY HILLS	CA	90211	3324	19	06037	34.06392928	-118.3761548	Los Angeles County
276041	Fee-for-Service	1861461972	1861461972	1	1	EVANS, ROBERT L OD	5/7/1971	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	510 S MAGNOLIA AVE	None	EL CAJON	CA	92020	6011	37	06073	32.79032481	-116.9624211	San Diego County
276234	Fee-for-Service	1225456866	1225456866	1	1	ELLISON, LYNNE M DO	8/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15619	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	12311 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
276434	Fee-for-Service	1407412067	1407412067	1	1	EGIAZARIAN, LOUSINE NP	8/15/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
276490	Fee-for-Service	1609431964	1609431964	1	1	EMIRZIAN, ANA DPM	6/25/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
276536	Fee-for-Service	1699015388	1699015388	1	1	ELESWARAPU, SRIRAM V MD	5/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155388	34	Urology and Urological Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
276652	Fee-for-Service	1780107797	1780107797	1	2	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2700 GRANT STREET	SUITE 316	CONCORD	CA	94520	2272	07	06013	37.98417931	-122.0361585	Contra Costa County
276699	Fee-for-Service	1326084708	1326084708	1	1	EAKIN,PAUL J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1319 PUNAHOU STREET	None	HONOLULU	HI	96826	1001	00	None	21.30030321	-157.8342762	Honolulu County
276855	Fee-for-Service	1568791127	1568791127	1	1	ELIZABETH REED MD	4/5/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	None	LITTLE ROCK	AR	72205	6321	00	None	34.744437	-92.3813595	Pulaski County
276900	Fee-for-Service	1780107797	1780107797	1	2	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	2700 GRANT STREET	SUITE 316	CONCORD	CA	94520	2272	07	06013	37.98417931	-122.0361585	Contra Costa County
276914	Fee-for-Service	1851787238	1851787238	1	1	EAKIN, CORTNEY M MD	12/15/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	158760	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
276920	Fee-for-Service	1306005806	1306005806	1	1	ELIZABETH ROBERT M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1833 N POWER RD	None	MESA	AZ	85205	3799	00	None	33.449229	-111.6835875	Maricopa County
276940	Fee-for-Service	1578009593	1578009593	1	1	EMKAY & SONS	10/23/2020	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ON	9521 FOLSOM BLVD.	SUITE R	SACRAMENTO	CA	95827	1204	34	06067	38.570373	-121.341762	Sacramento County
276942	Fee-for-Service	1144595125	1144595125	1	1	ESPINOSA DE LOS MONTEROS,	4/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119401	01	General Practice	0	In state provider	MARCELA MD	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
276992	Fee-for-Service	1205982980	1205982980	1	1	EDWARD A STENEHJEM	12/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5121 S COTTONWOOD ST	None	MURRAY	UT	84107	5701	00	None	40.659588	-111.891798	Salt Lake County
277126	Fee-for-Service	1225039886	1225039886	1	1	ERDMAN, STEVEN H MD	8/4/2017	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
277138	Fee-for-Service	1376543785	1376543785	1	1	EL-HAJJAOUI, ZAID R MD	3/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	48751	41	Internal Medicine	0	In state provider	None	15576 MAIN ST	None	HESPERIA	CA	92345	3482	36	06071	34.42464781	-117.322468	San Bernardino County
277147	Fee-for-Service	1780107797	1780107797	1	2	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	2700 GRANT STREET	SUITE 316	CONCORD	CA	94520	2272	07	06013	37.98417931	-122.0361585	Contra Costa County
277190	Fee-for-Service	1144595125	1144595125	1	1	ESPINOSA DE LOS MONTEROS,	4/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119401	08	Family Practice	0	In state provider	MARCELA MD	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
277356	Fee-for-Service	1992890057	1992890057	1	1	ETTIE LEE HOMES, INC	8/30/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	160 E HOLT AVE	SUITE B	POMONA	CA	91767	5407	19	06037	34.06239649	-117.7489613	Los Angeles County
277386	Fee-for-Service	1982805495	1982805495	1	1	ENG, JEFFREY G C MD	8/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116913	18	Ophthalmology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
277418	Fee-for-Service	1003866120	1003866120	1	3	EMERGENCY ASSOCIATES COR	9/15/2011	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
277424	Fee-for-Service	1649222480	1649222480	1	1	ENGELHART, JAMES A MD	2/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56010	None	None	0	In state provider	None	5924 STONERIDGE DR	SUITE 105	PLEASANTON	CA	94588	2828	01	06001	37.69132593	-121.8988844	Alameda County
277484	Fee-for-Service	1912956525	1912956525	1	1	EL ASMAR, IMAD A MD	1/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	61923	41	Internal Medicine	0	In state provider	HEALTHCARE MED CLINIC	822 N GAREY AVE	None	POMONA	CA	91767	4616	19	06037	34.06563676	-117.7509698	Los Angeles County
277656	Fee-for-Service	1194443440	1194443440	1	1	EDWARDS, KAYLE R	11/18/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
277662	Fee-for-Service	1003866120	1003866120	1	3	EMERGENCY ASSOCIATES COR	10/5/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
277684	Fee-for-Service	1871754853	1871754853	1	1	ERICA MARIA GARCIA, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
277749	Fee-for-Service	1093712374	1093712374	1	11	EL CAMINO HOSP	2/9/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2400 GRANT RD	SUITE G101	MOUNTAIN VIEW	CA	94040	4326	43	06085	37.370592	-122.077946	Santa Clara County
277759	Fee-for-Service	1235694985	1235694985	1	1	EJIKEME, CHINYERE C NP	12/5/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2350 W WHITENDALE AVE	None	VISALIA	CA	93277	6136	54	06107	36.307377	-119.316285	Tulare County
277810	Fee-for-Service	1184789810	1184789810	1	1	EAVES, SUZANNE S PHD	7/5/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
277878	Fee-for-Service	1699483032	1699483032	1	1	ESPARZA, STEPHANIE PT	12/8/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3989 STETSON	105	HEMET	CA	92545	9695	33	06065	33.72929866	-117.0132375	Riverside County
277883	Fee-for-Service	1336393990	1336393990	1	1	EASTMAN, AMELIA S DO	2/8/2015	390200000X	NA	Other	026	PHYSICIANS	11643	25	Physical Medicine and Rehabilitation	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
277905	Fee-for-Service	1003866120	1003866120	1	3	EMERGENCY ASSOCIATES COR	9/28/2022	207P00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
277907	Fee-for-Service	1801057781	1801057781	1	1	EZON, ISAAC C MD	7/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120923	18	Ophthalmology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
277923	Fee-for-Service	1114040623	1114040623	1	1	EDWARD C. HILTNER, M.D.	1/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	3118	00	None	35.208594	-111.645099	Coconino County
278018	Fee-for-Service	1033170485	1033170485	1	1	EGAN, GAIL M NP	2/25/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
278097	Fee-for-Service	1437164126	1437164126	1	1	EZEOKEKE, OGO C NP	10/1/2002	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2460 SAMARITAN DR	None	SAN JOSE	CA	95124	3907	43	06085	37.25105952	-121.948542	Santa Clara County
278164	Fee-for-Service	1255489225	1255489225	1	1	ESCALERA, ROBERT L MD	3/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72136	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
278302	Fee-for-Service	1356424386	1356424386	1	1	EBBERT, NANCY E MD	4/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	35534	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
278407	Fee-for-Service	1841499381	1841499381	1	1	ELIA, RICHARD K MD	10/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100727	08	Family Practice	0	In state provider	None	275 W HERNDON AVE	None	CLOVIS	CA	93612	0204	10	06019	36.83766747	-119.715174	Fresno County
278413	Fee-for-Service	1588907422	1588907422	1	1	ENCOLL CORP.	7/13/2020	3336I0012X	NA	Pharmacies	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	4576 ENTERPRISE ST	None	FREMONT	CA	94538	6315	01	06001	37.50472884	-121.9594216	Alameda County
278461	Fee-for-Service	1437129939	1437129939	1	1	EASTMAN, WILFRED W MD JR	2/8/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	39623	20	Orthopedic Surgery	0	In state provider	None	202 LAWRENCE LN	None	YREKA	CA	96097	3341	47	06093	41.72076114	-122.6413367	Siskiyou County
278487	Fee-for-Service	1053645887	1053645887	1	1	EDINGER, LARA K DO	2/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14194	01	General Practice	0	In state provider	None	300 UCLA MEDICAL PLAZA	STE B200	LOS ANGELES	CA	90045	5655	19	06037	34.06465655	-118.4461	Los Angeles County
278524	Fee-for-Service	1063662682	1063662682	1	1	ESKANDARI, HAMID MD	3/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101402	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
278548	Fee-for-Service	1972130011	1972130011	1	1	ETEMAD, SHERVIN MD	7/19/2024	208600000X	NA	General Surgery	026	PHYSICIANS	189034	02	General Surgery	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
278679	Fee-for-Service	1023420726	1023420726	1	2	ENLOE MEDICAL CENTER	1/2/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1405 MAGNOLIA AVE	STE A	CHICO	CA	95926	0000	04	06007	39.74046859	-121.8497839	Butte County
278699	Fee-for-Service	1437129939	1437129939	1	1	EASTMAN, WILFRED W MD JR	2/8/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	39623	02	General Surgery	0	In state provider	None	202 LAWRENCE LN	None	YREKA	CA	96097	3341	47	06093	41.72076114	-122.6413367	Siskiyou County
278720	Fee-for-Service	1053645887	1053645887	1	1	EDINGER, LARA K DO	2/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14194	13	Neurology (M.D. only)	0	In state provider	None	300 UCLA MEDICAL PLAZA	STE B200	LOS ANGELES	CA	90045	5655	19	06037	34.06465655	-118.4461	Los Angeles County
278798	Fee-for-Service	1790250967	1790250967	1	1	EMERGENCY PHYSICIANS ASSOCIA	11/28/2018	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	TES FREMONT PC	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
278805	Fee-for-Service	1629194881	1629194881	1	1	ESTABROOK, LARA N CRNA	6/24/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
278844	Fee-for-Service	1881771251	1881771251	1	1	EDGCOMB, JOHN S MD	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	1600 MEDICAL PARKWAY	None	CARSON CITY	NV	89703	4625	00	None	39.202263	-119.7841095	Consolidated Municipality of Carson City
278896	Fee-for-Service	1124562079	1124562079	1	1	ESKAROS, JAKLEEN CRNA	4/25/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
278944	Fee-for-Service	1649465469	1649465469	1	1	EL GHAZAL, ROLAND MD	8/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115604	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
278983	Fee-for-Service	1134844509	1134844509	1	1	ENAITALLA, AHMED PHD	2/4/2025	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2810 E DEL MAR BLVD	None	PASADENA	CA	91107	4320	19	06037	34.14212984	-118.092328	Los Angeles County
279033	Fee-for-Service	1790250967	1790250967	1	1	EMERGENCY PHYSICIANS ASSOCIA	5/14/2025	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	TES FREMONT PC	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
279107	Fee-for-Service	1053859710	1053859710	1	1	EDWARD SALL DENTAL CORPORATI	12/22/2022	332BC3200X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	L DENTAL PRACTICE	5471 KEARNY VILLA RD	201	SAN DIEGO	CA	92123	1151	37	06073	32.83480543	-117.138158	San Diego County
279141	Fee-for-Service	1538282587	1538282587	1	1	ENGSTROM, TODD W MD	4/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	89358	41	Internal Medicine	0	In state provider	None	4806 CARPINTERIA AVE	None	CARPINTERIA	CA	93013	1935	42	06083	34.40044819	-119.5201354	Santa Barbara County
279206	Fee-for-Service	1437695012	1437695012	1	1	EGAN-WILLIAMS, MOLLY L LCSW	7/6/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
279243	Fee-for-Service	1932287828	1932287828	1	1	EARWOOD, MICHAEL L MD	8/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85932	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
279336	Fee-for-Service	1861571903	1861571903	1	1	ELLZEY, KEN R MD	9/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40990	08	Family Practice	0	In state provider	None	2071 HERNDON AVE	None	CLOVIS	CA	93611	6101	10	06019	36.8375685	-119.6781105	Fresno County
279444	Fee-for-Service	1013912518	1013912518	1	1	EXPRESS DIAGNOSTICS INC	4/5/2011	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	15130 VENTURA BLVD	STE 221	SHERMAN OAKS	CA	91403	3372	19	06037	34.15320952	-118.4627115	Los Angeles County
279460	Fee-for-Service	1952843690	1952843690	1	1	ENZLER, CHRISTINE F CNP	2/3/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95005046	-	NOT APPLICABLE	0	In state provider	None	12917 CERISE AVE.	None	HAWTHORNE	CA	90250	5520	19	06037	33.914835	-118.3325365	Los Angeles County
279584	Fee-for-Service	1609029362	1609029362	1	1	EL DORADO COUNTY COMM	10/30/2008	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	4641 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6816	09	06017	38.69579093	-120.8237245	El Dorado County
279600	Fee-for-Service	1104067297	1104067297	1	1	ESPERANZA, SYLVIA S NP	7/14/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
279724	Fee-for-Service	1992937197	1992937197	1	1	ESTRADA, GLORIA OD	6/9/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2400 N BROADWAY	None	LOS ANGELES	CA	90031	2219	19	06037	34.07360257	-118.2166466	Los Angeles County
279727	Fee-for-Service	1457816829	1457816829	1	1	E T CHILDS GROUP INC	8/17/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11650 RIVERSIDE DR	STE 7	STUDIO CITY	CA	91602	1066	19	06037	34.15760548	-118.387413	Los Angeles County
279730	Fee-for-Service	1306162235	1306162235	1	1	ESQUIVEL, MARTHA L PSYD	6/23/2020	103TF0200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
279798	Fee-for-Service	1699016212	1699016212	1	1	EARLE, WENDY LCSW	7/11/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2617 K ST	SUITE 125	SACRAMENTO	CA	95816	5133	34	06067	38.573595	-121.4715825	Sacramento County
279813	Fee-for-Service	1609029362	1609029362	1	1	EL DORADO COUNTY COMM	10/30/2008	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	4641 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6816	09	06017	38.69579093	-120.8237245	El Dorado County
279863	Fee-for-Service	1023420726	1023420726	1	6	ENLOE MEDICAL CENTER	9/28/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	1405 MAGNOLIA AVE	STE A	CHICO	CA	95926	3226	04	06007	39.74046859	-121.8497839	Butte County
279930	Fee-for-Service	1487866562	1487866562	1	1	EARLY CHIROPRACTIC CORP	1/1/1996	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3507 TULLY RD	STE 300	MODESTO	CA	95356	1036	50	06099	37.689912	-121.0125475	Stanislaus County
280071	Fee-for-Service	1295341121	1295341121	1	1	ESCALANTE, LARISA LMFT	7/17/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3960 INDUSTRIAL BLVD	200	WEST SACRAMENTO	CA	95691	5024	57	06113	38.57029234	-121.5767941	Yolo County
280090	Fee-for-Service	1023420726	1023420726	1	6	ENLOE MEDICAL CENTER	9/28/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	None	1405 MAGNOLIA AVE	STE A	CHICO	CA	95926	3226	04	06007	39.74046859	-121.8497839	Butte County
280176	Fee-for-Service	1942662945	1942662945	1	1	EDWARDS, JOSHUA J MD	9/22/2019	208M00000X	NA	Other	026	PHYSICIANS	162762	41	Internal Medicine	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
280267	Fee-for-Service	1639898935	1639898935	1	1	ERICA BOOKER LICENSED CLINIC	8/25/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	AL SOCIAL WORKER, INC.	119 FIGUEROA ST	None	VENTURA	CA	93001	2756	56	06111	34.27916165	-119.2977526	Ventura County
280317	Fee-for-Service	1023420726	1023420726	1	6	ENLOE MEDICAL CENTER	9/28/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	1405 MAGNOLIA AVE	STE A	CHICO	CA	95926	3226	04	06007	39.74046859	-121.8497839	Butte County
280464	Fee-for-Service	1972169340	1972169340	1	1	ERICSON, CODY CNP	12/4/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5400 W HILLSDALE AVE	None	VISALIA	CA	93291	6238	54	06107	36.330327	-119.351943	Tulare County
280510	Fee-for-Service	1912503616	1912503616	1	1	EZ ACU & HERB INC.	4/6/2021	261QH0100X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1619 S H ST	None	BAKERSFIELD	CA	93304	4931	15	06029	35.338986	-119.021336	Kern County
280591	Fee-for-Service	1093712374	1093712374	1	18	EL CAMINO HOSP	6/25/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2495 HOSPITAL DRIVE	1ST FLOOR STE 1F60	MOUNTAIN VIEW	CA	94040	4119	43	06085	37.369341	-122.0817635	Santa Clara County
280619	Fee-for-Service	1437800836	1437800836	1	1	EDWARD WONG	8/23/2024	207R00000X	NA	Other	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	1523 W AVENUE J	SUITE 2	LANCASTER	CA	93534	2819	19	06037	34.6894773	-118.1577712	Los Angeles County
280682	Fee-for-Service	1336560044	1336560044	1	1	EIVAZ MOHAMMADI, SAHAR MD	8/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126987	41	Internal Medicine	0	In state provider	None	555 TACHEVAH DR	2E 107	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
280812	Fee-for-Service	1396939682	1396939682	1	1	EYE ASSOCIATES OF NORTHE	3/10/2008	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	RN CALIFORNIA MEDICAL GR	696 3RD ST WEST	None	SONOMA	CA	95476	6805	49	06097	38.28926391	-122.4639439	Sonoma County
280817	Fee-for-Service	1700606969	1700606969	1	1	EL-HADDAD, HANNA CCC-SP	11/22/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
280948	Fee-for-Service	1376633206	1376633206	1	1	EL MONTE OPTOMETRY INC	1/1/1998	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11230 GARVEY AVE	SUITE J	EL MONTE	CA	91733	2475	19	06037	34.06282552	-118.0311435	Los Angeles County
281088	Fee-for-Service	1528513389	1528513389	1	1	EPIONE HOSPICE INC	6/15/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	21151 S WESTERN AVE	STE 273	TORRANCE	CA	90501	1724	19	06037	33.83695304	-118.3092655	Los Angeles County
281161	Fee-for-Service	1417396326	1417396326	1	1	EDGE, ISABEL G MD	8/27/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	134329	08	Family Practice	0	In state provider	None	1520 SAN PABLO ST	STE 1300	LOS ANGELES	CA	90033	5312	19	06037	34.06269295	-118.2030006	Los Angeles County
281215	Fee-for-Service	1861716318	1861716318	1	1	ESHAGHIAN, BABAK MD	12/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111635	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	11550 INDIAN HILLS RD	STE 301	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
281306	Fee-for-Service	1528513389	1528513389	1	1	EPIONE HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	21151 S WESTERN AVE	STE 273	TORRANCE	CA	90501	1724	19	06037	33.83695304	-118.3092655	Los Angeles County
281307	Fee-for-Service	1740045897	1740045897	1	1	EDELSHTAIN, YULIA M	2/19/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
281319	Fee-for-Service	1821034422	1821034422	1	1	ENSELEIT,STEPHEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2222 PHILADELPHIA DR	None	DAYTON	OH	45406	0000	00	None	39.78749248	-84.23490647	Montgomery County
281433	Fee-for-Service	1861716318	1861716318	1	1	ESHAGHIAN, BABAK MD	12/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111635	41	Internal Medicine	0	In state provider	None	11550 INDIAN HILLS RD	STE 301	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
281448	Fee-for-Service	1043604440	1043604440	1	2	ENGLISH, CARTER W	7/15/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	144224	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
281579	Fee-for-Service	1720072317	1720072317	1	1	EDWARDS, JAMES B MD	10/4/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	81201	None	None	0	In state provider	None	74785 US HIGHWAY 111	STE 101	INDIAN WELLS	CA	92210	7129	33	06065	33.72131925	-116.360116	Riverside County
281736	Fee-for-Service	1760841191	1760841191	1	1	EXCELLENT HEARING AIDS	3/2/2018	332S00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3418 LOMA VISTA RD	5A	VENTURA	CA	93003	3039	56	06111	34.27643562	-119.2503132	Ventura County
281820	Fee-for-Service	1760408769	1760408769	1	1	ELKIN, GEORGE D MD	2/28/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	61697	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1001 POTRERO AVE	RM 7M	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
281834	Fee-for-Service	1306005806	1306005806	1	4	ELIZABETH ROBERT M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1064 E RAY RD	None	CHANDLER	AZ	85225	1542	00	None	33.32124	-111.822273	Maricopa County
281873	Fee-for-Service	1447584792	1447584792	1	1	EMPIRE DRUG COMPANY INC	12/16/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	FORESTVILLE PHARMACY	6652 FRONT ST	None	FORESTVILLE	CA	95436	9688	49	06097	38.4736045	-122.892615	Sonoma County
281915	Fee-for-Service	1164588133	1164588133	1	1	EXPRESS LENS LAB INC	9/17/2018	No Taxonomy Provided	NA	None	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	17150 NEWHOPE ST	STE 305	FOUNTAIN VALLEY	CA	92708	4251	30	06059	33.71373	-117.9283535	Orange County
282000	Fee-for-Service	1649344953	1649344953	1	1	EVANS, RICHARD F MD	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	22284	30	Radiology	0	In state provider	RADIATION ONCOLOGY	UNIV OF CAL MED CTR	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.76140244	-122.4583252	San Francisco County
282076	Fee-for-Service	1245596204	1245596204	1	1	EVERS, JACOB I MD	3/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
282079	Fee-for-Service	1376157404	1376157404	1	1	ELBRUS HOSPICE INC	6/23/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	19725 SHERMAN WAY	STE 310	WINNETKA	CA	91306	3665	19	06037	34.20117847	-118.563057	Los Angeles County
282101	Fee-for-Service	1841385150	1841385150	1	1	ERICKSON, JAMES A MFT	1/9/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	343 MAIN STREET	SUITE 811	STOCKTON	CA	95202	2980	39	06077	37.95334019	-121.2862084	San Joaquin County
282258	Fee-for-Service	1447571716	1447571716	1	1	EUGENE DUKE	9/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	375 DIXMYTH AVE	None	CINCINNATI	OH	45220	2475	00	None	39.14076839	-84.52169161	Hamilton County
282284	Fee-for-Service	1376157404	1376157404	1	1	ELBRUS HOSPICE INC	6/23/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	19725 SHERMAN WAY	STE 310	WINNETKA	CA	91306	3665	19	06037	34.20117847	-118.563057	Los Angeles County
282333	Fee-for-Service	1457423204	1457423204	1	1	ELMASIAN, CATHERINE C MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65792	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
282334	Fee-for-Service	1053383505	1053383505	1	1	ECKEL, GREGORY M MD	2/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72806	30	Radiology	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
282353	Fee-for-Service	1447708045	1447708045	1	1	ESCOBAR, CYNTHIA LMFT	5/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43112 N 15TH WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
282397	Fee-for-Service	1518221381	1518221381	1	1	ECK, THOMAS W MD	5/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140920	18	Ophthalmology	0	In state provider	None	7901 FROST STREET	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
282613	Fee-for-Service	1588629414	1588629414	1	1	EARWOOD, THOMAS MD	4/24/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	108693	36	Psychiatry	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
282645	Fee-for-Service	1689052235	1689052235	1	1	EKEKEZIE, CHIAZOTAM N MD	6/16/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	163006	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
282676	Fee-for-Service	1043449812	1043449812	1	1	EPPANAPALLY, SABITHA MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	106645	41	Internal Medicine	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
282734	Fee-for-Service	1538249099	1538249099	1	2	ENGH, DOUGLAS M MD	7/2/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	50142	18	Ophthalmology	0	In state provider	None	10614 RIVERSIDE DR	None	NORTH HOLLYWOOD	CA	91602	2373	19	06037	34.15217655	-118.362069	Los Angeles County
282747	Fee-for-Service	1548983836	1548983836	1	1	EK PSYCH - EMOTIVE KNOWLEDGE	2/17/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1441 SUPERIOR AVE.	SUITE F	NEWPORT BEACH	CA	92663	2704	30	06059	33.62665852	-117.9330695	Orange County
282774	Fee-for-Service	1942761861	1942761861	1	1	ESTESS, RUDOLF	9/26/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19475	None	None	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
282872	Fee-for-Service	1043449812	1043449812	1	1	EPPANAPALLY, SABITHA MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	106645	45	Nephrology (Renal-Kidney)	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
282943	Fee-for-Service	1003866120	1003866120	1	4	EMERGENCY ASSOCIATES COR	9/15/2011	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
282944	Fee-for-Service	1548983836	1548983836	1	1	EK PSYCH - EMOTIVE KNOWLEDGE	2/17/2023	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1441 SUPERIOR AVE.	SUITE F	NEWPORT BEACH	CA	92663	2704	30	06059	33.62665852	-117.9330695	Orange County
283114	Fee-for-Service	1013378348	1013378348	1	1	ERKIN-CAKMAK, AYCA MD	6/9/2021	2080P0205X	NA	Endocrinology	026	PHYSICIANS	156704	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
283208	Fee-for-Service	1336908276	1336908276	1	1	ERICK LU INC	5/22/2024	207RC0200X	NA	Other	026	PHYSICIANS	None	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	500 N GARFIELD AVE	STE 204	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
283216	Fee-for-Service	1417038209	1417038209	1	1	ELISABETH GUENTHER, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 MARIO CAPECCHI DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
283225	Fee-for-Service	1558534354	1558534354	1	1	ESLAMI, PARVIZ AU	12/8/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
283236	Fee-for-Service	1629242854	1629242854	1	1	EDMONDS, MATHEW S MD	2/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	700 SOUTH J STREET	None	LAKEVIEW	OR	97630	1623	00	None	42.181335	-120.351489	Lake County
283284	Fee-for-Service	1841992732	1841992732	1	1	EDWARDS, KRISTA L LCSW	6/4/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
283289	Fee-for-Service	1457375388	1457375388	1	1	EVERETT R CASTLE MD	8/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 EL CAMINO REAL	None	SIERRA VISTA	AZ	85635	2812	00	None	31.55138182	-110.2724136	Cochise County
283355	Fee-for-Service	1093712374	1093712374	1	1	EL CAMINO HOSP	12/31/1992	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
283455	Fee-for-Service	1497235923	1497235923	1	1	ELLISON, CLAIRE E LCSW	10/5/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5330 CARROLL CANYON	120	SAN DIEGO	CA	92121	3756	37	06073	32.8917216	-117.1927751	San Diego County
283475	Fee-for-Service	1467800268	1467800268	1	1	ELIA, MADELEINE W MD	9/7/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	173981	None	None	0	In state provider	None	7910 FROST ST	STE 350	SAN DIEGO	CA	92123	2753	37	06073	32.80027449	-117.153846	San Diego County
283488	Fee-for-Service	1467407809	1467407809	1	1	ELYASI, SIAMAK MD	4/11/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	50205	08	Family Practice	0	In state provider	None	2220 GLADSTONE DR	STE 3	PITTSBURG	CA	94565	5123	07	06013	38.00689525	-121.8661724	Contra Costa County
283491	Fee-for-Service	1891962155	1891962155	1	1	ELIHU, MAURICE MD INC	1/5/2009	193400000X	NA	Other	026	PHYSICIANS	88076	10	Gastroenterology (M.D. only)	0	In state provider	None	2080 CENTURY PARK EAST	SUITE 1804	LOS ANGELES	CA	90067	2021	19	06037	34.05887194	-118.4122914	Los Angeles County
283520	Fee-for-Service	1376072561	1376072561	1	1	EVANS, ERIN LCSW	7/1/2024	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2830 I ST	UNIT 202	SACRAMENTO	CA	95816	4311	34	06067	38.574423	-121.467717	Sacramento County
283524	Fee-for-Service	1619593142	1619593142	1	1	EICHMAN, MALORY M NP	1/6/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
283544	Fee-for-Service	1093712374	1093712374	1	1	EL CAMINO HOSP	12/31/1992	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
283579	Fee-for-Service	1881985877	1881985877	1	1	ELIA, JENNIFER M MD	12/4/2019	207L00000X	NA	Other	026	PHYSICIANS	123979	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
283615	Fee-for-Service	1649324443	1649324443	1	2	EAST VALLEY COMMUNITY HEALTH	10/18/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2211 N ORANGE GROVE AVE	None	POMONA	CA	91767	2319	19	06037	34.08341648	-117.7456467	Los Angeles County
283652	Fee-for-Service	1962405878	1962405878	1	1	EL-KHOURY, GEORGE F MD	8/29/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	40394	05	Anesthesiology	0	In state provider	COMPR PAIN CARE MED CTR	2650 ELM AVE	STE 218	LONG BEACH	CA	90806	1653	19	06037	33.805521	-118.1882945	Los Angeles County
283677	Fee-for-Service	1891962155	1891962155	1	1	ELIHU, MAURICE MD INC	1/5/2009	193400000X	NA	Other	026	PHYSICIANS	88076	41	Internal Medicine	0	In state provider	None	2080 CENTURY PARK EAST	SUITE 1804	LOS ANGELES	CA	90067	2021	19	06037	34.05887194	-118.4122914	Los Angeles County
283690	Fee-for-Service	1336584101	1336584101	1	1	ELLENBOGEN, AMY L MD	8/10/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	172441	None	None	0	In state provider	None	8750 WILSHIRE BLVD	STE 100	BEVERLY HILLS	CA	90211	2713	19	06037	34.06685846	-118.3829408	Los Angeles County
283693	Fee-for-Service	1487656807	1487656807	1	1	ESHOE, LORENCE M MD	9/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83292	08	Family Practice	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
283717	Fee-for-Service	1235325986	1235325986	1	1	ENTERPRISE SCHOOL DIST	2/28/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1155 MISTLETOE LN	None	REDDING	CA	96002	0749	45	06089	40.57839055	-122.349897	Shasta County
283720	Fee-for-Service	1720216211	1720216211	1	1	ELHOFF, JUSTIN J MD	7/12/2022	2080P0203X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
283800	Fee-for-Service	1649324443	1649324443	1	2	EAST VALLEY COMMUNITY HEALTH	10/18/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2211 N ORANGE GROVE AVE	None	POMONA	CA	91767	2319	19	06037	34.08341648	-117.7456467	Los Angeles County
283837	Fee-for-Service	1023420726	1023420726	1	3	ENLOE MEDICAL CENTER	12/13/2017	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1423 MAGNOLIA AVE	SUITE B	CHICO	CA	95926	3226	04	06007	39.74063551	-121.8499048	Butte County
283841	Fee-for-Service	1336358464	1336358464	1	1	ELLIOTT, AUBEN L PHD	2/8/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2702 CLAYTON ROAD	None	CONCORD	CA	94519	2789	07	06013	37.97495822	-122.0271497	Contra Costa County
283910	Fee-for-Service	1740634385	1740634385	1	1	ERNEST, STACEY MD	7/1/2019	207P00000X	NA	Other	026	PHYSICIANS	151178	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
283928	Fee-for-Service	1942666433	1942666433	1	1	ECHOLS, JENNIFER M	3/26/2018	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1365 ELM STREET	None	CORONA	CA	92879	2626	33	06065	33.86535305	-117.5490078	Riverside County
283979	Fee-for-Service	1902805179	1902805179	1	1	EMERGENCY MEDICINE GROUP	5/25/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	COASTLINE EMERGENCY PHYS	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
284036	Fee-for-Service	1326337098	1326337098	1	1	EMBERLEY, ELIZABETH M DO	1/30/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	16556	None	None	0	In state provider	None	1010 MURRAY AVE	None	SAN LUIS OBISPO	CA	93405	1806	40	06079	35.292168	-120.6658665	San Luis Obispo County
284055	Fee-for-Service	1407065790	1407065790	1	1	ECONOMIDES, CHRISTINA H	9/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	87605	06	Cardiovascular Disease (M.D. only)	0	In state provider	MD	1245 WILSHIRE BLVD	STE 703	LOS ANGELES	CA	90017	4807	19	06037	34.05362775	-118.2661889	Los Angeles County
284110	Fee-for-Service	1942666433	1942666433	1	1	ECHOLS, JENNIFER M	3/26/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1365 ELM STREET	None	CORONA	CA	92879	2626	33	06065	33.86535305	-117.5490078	Riverside County
284131	Fee-for-Service	1376930065	1376930065	1	1	ESTRADA, MARCELA M MD	9/21/2020	207WX0110X	NA	Ophthalmology	026	PHYSICIANS	170233	18	Ophthalmology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
284235	Fee-for-Service	1407065790	1407065790	1	1	ECONOMIDES, CHRISTINA H	9/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	87605	41	Internal Medicine	0	In state provider	MD	1245 WILSHIRE BLVD	STE 703	LOS ANGELES	CA	90017	4807	19	06037	34.05362775	-118.2661889	Los Angeles County
284250	Fee-for-Service	1659966257	1659966257	1	1	EMIG, OLGA I NP	11/11/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
284306	Fee-for-Service	1093712374	1093712374	1	12	EL CAMINO HOSP	7/2/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2480 GRANT ROAD	None	MOUNTAIN VIEW	CA	94040	4333	43	06085	37.37004153	-122.077961	Santa Clara County
284424	Fee-for-Service	1003866120	1003866120	1	9	EMERGENCY ASSOCIATES COR	9/5/2023	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
284573	Fee-for-Service	1306005806	1306005806	1	5	ELIZABETH ROBERT M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7171 S 51ST AVE	None	LAVEEN	AZ	85339	2923	00	None	33.380613	-112.16745	Maricopa County
284604	Fee-for-Service	1700889342	1700889342	1	1	ERIC REINES MD	8/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6300 STEVENSON AVE	STE D	ALEXANDRIA	VA	22304	3554	00	None	38.81313282	-77.14095946	Alexandria city
284623	Fee-for-Service	1851621734	1851621734	2	1	ELITE BIOMECHANICAL DESIGN	2/22/2016	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	9 GOVERNORS LANE	None	CHICO	CA	95926	1991	04	06007	39.75490536	-121.8582641	Butte County
284643	Fee-for-Service	1487759726	1487759726	1	1	EXPRESS OPTICAL	3/24/1989	No Taxonomy Provided	NA	None	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	9208 VALLEY BLVD	None	ROSEMEAD	CA	91770	1900	19	06037	34.0809267	-118.069191	Los Angeles County
284811	Fee-for-Service	1023727914	1023727914	1	1	EMERGENCY PHYSICIANS URGENT	3/6/2024	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	29997 CANYON HILLS RD ST	None	LAKE ELSINORE	CA	92532	2581	33	06065	33.66754378	-117.2623698	Riverside County
284816	Fee-for-Service	1083247068	1083247068	1	1	ETERNAL PEACE HOSPICE INC	3/5/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1055 EL CAMINO DR	STE F112	COSTA MESA	CA	92626	5574	30	06059	33.67574971	-117.9012914	Orange County
284869	Fee-for-Service	1073540597	1073540597	1	1	ENRIQUEZ, ERIC A MD INC	9/8/2004	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	82702	08	Family Practice	0	In state provider	None	14623 HAWTHORNE BLVD	STE 202	LAWNDALE	CA	90260	1589	19	06037	33.898572	-118.3527775	Los Angeles County
284908	Fee-for-Service	1699546788	1699546788	1	1	ESTRADA, ABIGAIL G PT	4/9/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
284938	Fee-for-Service	1659079887	1659079887	1	2	EXCEL MEDICAL TRANSPORT INC	6/28/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3130 BONITA RD	200C	CHULA VISTA	CA	91910	1949	37	06073	32.64775748	-117.0566405	San Diego County
284982	Fee-for-Service	1083247068	1083247068	1	1	ETERNAL PEACE HOSPICE INC	3/5/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1055 EL CAMINO DR	STE F112	COSTA MESA	CA	92626	5574	30	06059	33.67574971	-117.9012914	Orange County
284984	Fee-for-Service	1831585140	1831585140	1	1	ESLAMI FARSANI, MAZIAR MD	12/20/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	165854	None	None	0	In state provider	None	2895 N TOWNE AVE	None	POMONA	CA	91767	2009	19	06037	34.098525	-117.7368955	Los Angeles County
285000	Fee-for-Service	1023727914	1023727914	1	1	EMERGENCY PHYSICIANS URGENT	1/13/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	29997 CANYON HILLS RD ST	None	LAKE ELSINORE	CA	92532	2581	33	06065	33.66754378	-117.2623698	Riverside County
285040	Fee-for-Service	1497898910	1497898910	1	1	EZRA, NANCY L PHD	5/9/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
285062	Fee-for-Service	1780107797	1780107797	1	17	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1133 EAST STANLEY BLVD	STE 117	LIVERMORE	CA	94550	4243	01	06001	37.67914693	-121.7810206	Alameda County
285098	Fee-for-Service	1548723059	1548723059	1	2	ENHANCE HOME HEALTH SERVICES	3/17/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6101 BOLLINGER CANYON RD	STE 380, 381	SAN RAMON	CA	94583	5118	07	06013	37.759761	-121.9559535	Contra Costa County
285154	Fee-for-Service	1467579763	1467579763	1	1	ESTAKHRI, MARY E MD	9/12/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	53902	02	General Surgery	0	In state provider	None	5575 W LAS POSITAS BLVD	STE 210	PLEASANTON	CA	94588	5802	01	06001	37.69214859	-121.8796532	Alameda County
285225	Fee-for-Service	1780107797	1780107797	1	17	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	1133 EAST STANLEY BLVD	STE 117	LIVERMORE	CA	94550	4243	01	06001	37.67914693	-121.7810206	Alameda County
285387	Fee-for-Service	1780107797	1780107797	1	17	EPIC CARE	2/15/2018	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	1133 EAST STANLEY BLVD	STE 117	LIVERMORE	CA	94550	4243	01	06001	37.67914693	-121.7810206	Alameda County
285603	Fee-for-Service	1609381730	1609381730	1	1	ENVOY HOSPICE CARE INC	3/26/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	500 N CENTRAL AVE	SUITE 510	GLENDALE	CA	91203	3940	19	06037	34.15321627	-118.2578985	Los Angeles County
285761	Fee-for-Service	1609381730	1609381730	1	1	ENVOY HOSPICE CARE INC	3/26/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	500 N CENTRAL AVE	SUITE 510	GLENDALE	CA	91203	3940	19	06037	34.15321627	-118.2578985	Los Angeles County
285770	Fee-for-Service	1669442331	1669442331	1	1	EVANS, STEVEN D MD	7/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
285821	Fee-for-Service	1003866120	1003866120	1	1	EMERGENCY ASSOCIATES COR	3/1/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
285845	Fee-for-Service	1790858413	1790858413	1	1	ENG, THOMAS T MD	2/28/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	40273	13	Neurology (M.D. only)	0	In state provider	None	341 MAGNOLIA AVE	STE 102	CORONA	CA	92879	3331	33	06065	33.85291987	-117.5664344	Riverside County
285955	Fee-for-Service	1174971402	1174971402	2	1	ETTA, BYRON MD	5/23/2023	207P00000X	NA	Other	026	PHYSICIANS	166911	None	None	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
285977	Fee-for-Service	1003866120	1003866120	1	1	EMERGENCY ASSOCIATES COR	9/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
286216	Fee-for-Service	1710092184	1710092184	1	1	ELIAS, THOMAS G JR MD	7/31/1982	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	45571	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
286345	Fee-for-Service	1316004757	1316004757	1	1	EL KABANY, MOHAMED M MD	9/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89043	None	None	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
286348	Fee-for-Service	1346982212	1346982212	1	1	EVEREST PHARMACY INC	12/28/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	21115 DEVONSHIRE ST	None	CHATSWORTH	CA	91311	2317	19	06037	34.25726352	-118.593585	Los Angeles County
286356	Fee-for-Service	1417336835	1417336835	1	1	EVERHART, TINA L LCSW	6/26/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11670 ATWOOD RD	None	AUBURN	CA	95603	9522	31	06061	38.93485327	-121.0988193	Placer County
286372	Fee-for-Service	1598841983	1598841983	1	1	EFFIOM, UDUAK R MD	4/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102157	41	Internal Medicine	0	In state provider	None	593 W 6TH ST	None	SAN PEDRO	CA	90731	2521	19	06037	33.73875253	-118.2899475	Los Angeles County
286444	Fee-for-Service	1205095742	1205095742	1	1	EYEMD ON CASS APC	9/4/2018	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	21 UPPER RAGSDALE DR	STE 201	MONTEREY	CA	93940	7860	27	06053	36.57578382	-121.810169	Monterey County
286515	Fee-for-Service	1093712374	1093712374	1	14	EL CAMINO HOSP	6/25/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2495 HOSPITAL DRIVE	1ST FLOOR STE 1F63	MOUNTAIN VIEW	CA	94040	4119	43	06085	37.369341	-122.0817635	Santa Clara County
286558	Fee-for-Service	1568421865	1568421865	1	1	ELK GROVE DIALYSIS	7/30/2004	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER LLC	9281 OFFICE PARK CIR	STE 105	ELK GROVE	CA	95758	8069	34	06067	38.418264	-121.39641	Sacramento County
286563	Fee-for-Service	1528389020	1528389020	1	2	EPERJESI, JAN S MD	7/8/2016	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	129250	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	350 POSADA LN	STE 202	TEMPLETON	CA	93465	4060	40	06079	35.55239522	-120.7215238	San Luis Obispo County
286590	Fee-for-Service	1205095742	1205095742	1	1	EYEMD ON CASS APC	9/4/2018	193400000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	PROFESSIONAL CORPORATION	21 UPPER RAGSDALE DR	STE 201	MONTEREY	CA	93940	7860	27	06053	36.57578382	-121.810169	Monterey County
286599	Fee-for-Service	1861488918	1861488918	1	1	EVERDEN, BLAKE I MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	59730	30	Radiology	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
286639	Fee-for-Service	1063698041	1063698041	1	1	ERESO, VIRGILIO C MD	8/25/2008	261QP2300X	NA	Other	026	PHYSICIANS	30308	41	Internal Medicine	0	In state provider	None	500 COFFEE RD	STE A	MODESTO	CA	95355	4926	50	06099	37.65105	-120.9755325	Stanislaus County
286640	Fee-for-Service	1841558657	1841558657	1	1	ELBASHIR, ASAAD MD	8/6/2018	2080P0205X	NA	Endocrinology	026	PHYSICIANS	155240	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
286744	Fee-for-Service	1861488918	1861488918	1	1	EVERDEN, BLAKE I MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	59730	41	Internal Medicine	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
286780	Fee-for-Service	1063698041	1063698041	1	1	ERESO, VIRGILIO C MD	8/25/2008	261QP2300X	NA	Other	026	PHYSICIANS	30308	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	500 COFFEE RD	STE A	MODESTO	CA	95355	4926	50	06099	37.65105	-120.9755325	Stanislaus County
286811	Fee-for-Service	1093148702	1093148702	1	1	ECKEL, GREGORY M MD APC	6/13/2014	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	72806	30	Radiology	0	In state provider	None	14516 HAWTHORNE BLVD	None	LAWNDALE	CA	90260	1519	19	06037	33.899472	-118.3523735	Los Angeles County
286894	Fee-for-Service	1083631949	1083631949	1	1	EVERAKES, ROBERT MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	11372	18	Ophthalmology	0	In state provider	None	3055 W ORANGE AVE	STE 104	ANAHEIM	CA	92804	3152	30	06059	33.8247435	-117.99621	Orange County
286983	Fee-for-Service	1104939503	1104939503	1	1	ELLIOTT, GLEN R MD	11/29/2010	2084P0804X	NA	Psychiatry	026	PHYSICIANS	44741	36	Psychiatry	0	In state provider	None	725 WELCH RD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
287026	Fee-for-Service	1861548208	1861548208	1	1	EGERT, ROBERT MD	4/2/1996	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	49684	25	Physical Medicine and Rehabilitation	0	In state provider	None	251 COHASSET RD	None	CHICO	CA	95926	2241	04	06007	39.75090044	-121.8522609	Butte County
287032	Fee-for-Service	1306005806	1306005806	1	2	ELIZABETH ROBERT M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5401 BASSWOOD BLVD	None	FT WORTH	TX	76137	6909	00	None	32.87429952	-97.2681975	Tarrant County
287121	Fee-for-Service	1104939503	1104939503	1	1	ELLIOTT, GLEN R MD	11/29/2010	2084P0804X	NA	Psychiatry	026	PHYSICIANS	44741	26	Psychiatry (child)	0	In state provider	None	725 WELCH RD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
287124	Fee-for-Service	1154630820	1154630820	1	1	EITING, ERICK A MD	4/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115413	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18321 CLARK ST	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
287218	Fee-for-Service	1801367461	1801367461	1	1	ETHOS HOME HEALTH CARE	8/18/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	150 E OLIVE AVE	STE 212	BURBANK	CA	91502	1850	19	06037	34.18064474	-118.3089507	Los Angeles County
287225	Fee-for-Service	1275704587	1275704587	1	1	EVANGELISTA, JOSEPHINE A CNP	7/24/2024	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2020 SANTA MONICA BLVD	210, 220, 230, 240	SANTA MONICA	CA	90404	2000	19	06037	34.02901811	-118.4795396	Los Angeles County
287254	Fee-for-Service	1033512421	1033512421	1	1	EVANS, SABRINA A MD	8/1/2019	208G00000X	NA	General Surgery	026	PHYSICIANS	137169	33	Thoracic Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
287281	Fee-for-Service	1386871788	1386871788	1	1	EMANUEL MEDICAL CENTER	9/20/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	MONTE VISTA	2240 W MONTE VISTA AVE	None	TURLOCK	CA	95382	9667	50	06099	37.52173653	-120.8741705	Stanislaus County
287356	Fee-for-Service	1831393974	1831393974	1	1	ELDER, JOHN H LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
287384	Fee-for-Service	1477722791	1477722791	1	1	ESCURRA, HEIDI L MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	102739	01	General Practice	0	In state provider	None	147 N BRENT STREET	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
287442	Fee-for-Service	1356326060	1356326060	1	1	EVANS, CHRISTOPHER P MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	70289	78	Neoplastic Diseases/Oncology	0	In state provider	None	4301 X ST	STE 2210	SACRAMENTO	CA	95817	2214	34	06067	38.5536003	-121.455135	Sacramento County
287506	Fee-for-Service	1023514445	1023514445	1	1	EL-MENSHAWI, MOHAMED MD	2/16/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	183618	36	Psychiatry	0	In state provider	None	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
287556	Fee-for-Service	1639697097	1639697097	1	1	ERDELYI, AMY L LCSW	10/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
287572	Fee-for-Service	1356326060	1356326060	1	1	EVANS, CHRISTOPHER P MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	70289	34	Urology and Urological Surgery	0	In state provider	None	4301 X ST	STE 2210	SACRAMENTO	CA	95817	2214	34	06067	38.5536003	-121.455135	Sacramento County
287574	Fee-for-Service	1134534902	1134534902	1	1	ESSENTIAL CARE GROUP, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	224 E OLIVE AVE	SUITE 217	BURBANK	CA	91502	1239	19	06037	34.18109046	-118.3084839	Los Angeles County
287583	Fee-for-Service	1942637707	1942637707	1	1	ENGLISH, SARAH A LCSW	8/23/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3711 LONG BEACH BLVD	601	LONG BEACH	CA	90807	3315	19	06037	33.824583	-118.1893785	Los Angeles County
287701	Fee-for-Service	1134534902	1134534902	1	1	ESSENTIAL CARE GROUP, INC	6/15/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	224 E OLIVE AVE	SUITE 217	BURBANK	CA	91502	1239	19	06037	34.18109046	-118.3084839	Los Angeles County
287814	Fee-for-Service	1982358339	1982358339	1	1	E & S HOME HEALTH CARE INC	6/8/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	401 N BRAND BLVD	STE 828	GLENDALE	CA	91203	4451	19	06037	34.151958	-118.255149	Los Angeles County
287875	Fee-for-Service	1609127554	1609127554	1	1	EMURIAN, ARMEN LMFT	6/1/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15082 ROSECRANS AVE	None	LA MIRADA	CA	90638	4741	19	06037	33.89843387	-118.009518	Los Angeles County
287906	Fee-for-Service	1629127519	1629127519	1	2	ELLEN SHUHAM, OD	2/1/1991	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8447 LAUREL CANYON BLVD	None	SUN VALLEY	CA	91352	3817	19	06037	34.223589	-118.3987755	Los Angeles County
288137	Fee-for-Service	1023420726	1023420726	1	7	ENLOE MEDICAL CENTER	2/1/2024	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	101 W 2ND AVE	None	CHICO	CA	95926	3810	04	06007	39.73866711	-121.8468521	Butte County
288252	Fee-for-Service	1023420726	1023420726	1	7	ENLOE MEDICAL CENTER	2/1/2024	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	101 W 2ND AVE	None	CHICO	CA	95926	3810	04	06007	39.73866711	-121.8468521	Butte County
288369	Fee-for-Service	1023420726	1023420726	1	7	ENLOE MEDICAL CENTER	2/1/2024	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	None	101 W 2ND AVE	None	CHICO	CA	95926	3810	04	06007	39.73866711	-121.8468521	Butte County
288523	Fee-for-Service	1023420726	1023420726	1	4	ENLOE MEDICAL CENTER	7/21/2022	207V00000X	NA	Obstetrics & Gynecology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1665 ESPLANADE	None	CHICO	CA	95926	3312	04	06007	39.74388808	-121.8503372	Butte County
288546	Fee-for-Service	1265479521	1265479521	1	1	ERB,JR. BLAIR D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	905 HIGHLAND BLVD	None	BOZEMAN	MT	59715	6901	00	None	45.669717	-111.020148	Gallatin County
288564	Fee-for-Service	1568691608	1568691608	1	1	EARL, WANDA L LMFT	10/14/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CE	1849 SAWTELLE BLVD.	610	LOS ANGELES	CA	90025	9998	19	06037	34.04266851	-118.4451527	Los Angeles County
288639	Fee-for-Service	1023420726	1023420726	1	4	ENLOE MEDICAL CENTER	2/17/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	None	1665 ESPLANADE	None	CHICO	CA	95926	3312	04	06007	39.74388808	-121.8503372	Butte County
288749	Fee-for-Service	1023420726	1023420726	1	4	ENLOE MEDICAL CENTER	2/17/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	1665 ESPLANADE	None	CHICO	CA	95926	3312	04	06007	39.74388808	-121.8503372	Butte County
288762	Fee-for-Service	1134237134	1134237134	1	1	EMERGENCY MEDICAL SERVICES	8/3/2004	193400000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	GROUP A MEDICAL CORP	100 E NORTH STREET	None	TAFT	CA	93268	3606	15	06029	35.13962803	-119.4517471	Kern County
288788	Fee-for-Service	1679685994	1679685994	1	2	EVERGREEN PHARMACEUTICAL OF	10/23/2019	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13825 CERRITOS CORPORATE	A & A2	CERRITOS	CA	90703	2471	19	06037	33.88461396	-118.0372551	Los Angeles County
288855	Fee-for-Service	1023420726	1023420726	1	4	ENLOE MEDICAL CENTER	1/10/2020	207V00000X	NA	Obstetrics & Gynecology	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1665 ESPLANADE	None	CHICO	CA	95926	3312	04	06007	39.74388808	-121.8503372	Butte County
288979	Fee-for-Service	1447355573	1447355573	1	1	ERNEST Y. LEE, O.D. INC	7/23/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8716 CORD AVE	None	PICO RIVERA	CA	90660	5507	19	06037	33.95543046	-118.1010026	Los Angeles County
289068	Fee-for-Service	1457490567	1457490567	1	1	EREREN, ERKAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	38915	01	General Practice	0	In state provider	PLACENTIA MEDICAL CLINIC	1211 W LA PALMA AVE	STE 605	ANAHEIM	CA	92801	2813	30	06059	33.84718298	-117.933758	Orange County
289237	Fee-for-Service	1205973963	1205973963	1	1	ERICKSON, PETER R PT	12/22/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2660 WHITSON	100	SELMA	CA	93662	2622	10	06019	36.57397495	-119.6219919	Fresno County
289329	Fee-for-Service	1154892149	1154892149	1	1	EMRICH, SARA C CNP	8/3/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
289413	Fee-for-Service	1891203196	1891203196	1	1	EVANS, CARA S CCC-SLP	6/16/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
289473	Fee-for-Service	1386114643	1386114643	1	1	EAGLE AMBULANCE	3/15/2019	341600000X	NA	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3251 FRANKLIN CANYON	None	RODEO	CA	94572	2123	07	06013	38.00789217	-122.2209409	Contra Costa County
289490	Fee-for-Service	1104408459	1104408459	1	1	EZEOKWELUME, OGE OYOYO	10/28/2021	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	605 W PLEASANT STREET	None	COALINGA	CA	93210	0332	10	06019	36.13460348	-120.3716205	Fresno County
289574	Fee-for-Service	1104408459	1104408459	1	1	EZEOKWELUME, OGE OYOYO	10/28/2021	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	605 W PLEASANT STREET	None	COALINGA	CA	93210	0332	10	06019	36.13460348	-120.3716205	Fresno County
289633	Fee-for-Service	1033314794	1033314794	1	1	EXLEY, TRACY R MD	8/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108233	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
289706	Fee-for-Service	1053954784	1053954784	1	1	EDNA HOSPICE INC	5/6/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	225 E BROADWAY	SUITE B111	GLENDALE	CA	91504	2660	19	06037	34.14633765	-118.2529554	Los Angeles County
289780	Fee-for-Service	1053954784	1053954784	1	1	EDNA HOSPICE INC	5/6/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	225 E BROADWAY	SUITE B111	GLENDALE	CA	91504	2660	19	06037	34.14633765	-118.2529554	Los Angeles County
289866	Fee-for-Service	1457342164	1457342164	1	1	EMERY, CEDRIC B MD	2/8/2015	208800000X	NA	Other	026	PHYSICIANS	13489	34	Urology and Urological Surgery	0	In state provider	VENTURA COUNTY MED CTR	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
289900	Fee-for-Service	1154401164	1154401164	1	1	ESHELMAN, CE M LMFT	11/21/2016	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3336 BRADSHAW RD	STE 175	SACRAMENTO	CA	95827	2631	34	06067	38.562597	-121.33692	Sacramento County
289935	Fee-for-Service	1396341129	1396341129	1	1	EVARISTO, JESSICA PT	11/14/2021	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
289978	Fee-for-Service	1013313691	1013313691	1	1	EDICINE IM PLLC	2/7/2024	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	1	Border provider	None	1905 MCDANIEL ST	102	NORTH LAS VEGAS	NV	89030	7169	00	None	36.194535	-115.1208615	Clark County
290069	Fee-for-Service	1396724399	1396724399	1	1	ELTAWIL, KHALID M MD	8/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	66752	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3701 SKYPARK DR	STE 200	TORRANCE	CA	90505	4749	19	06037	33.81114782	-118.349449	Los Angeles County
290127	Fee-for-Service	1538686456	1538686456	1	1	ELK COMMUNITY SERVICES DISTR	12/8/2022	3416L0300X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ICT AMBULANCE	6129 S HIGHWAY 1	None	ELK	CA	95432	0000	23	06045	39.12859033	-123.7159723	Mendocino County
290128	Fee-for-Service	1396724399	1396724399	1	1	ELTAWIL, KHALID M MD	8/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	66752	41	Internal Medicine	0	In state provider	None	3701 SKYPARK DR	STE 200	TORRANCE	CA	90505	4749	19	06037	33.81114782	-118.349449	Los Angeles County
290284	Fee-for-Service	1851800197	1851800197	1	1	EVEXIA HEALTH SERVICES, LLC	12/8/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	601 E FLORIDA AVE	None	HEMET	CA	92543	4335	33	06065	33.74753447	-116.966052	Riverside County
290331	Fee-for-Service	1851800197	1851800197	1	1	EVEXIA HEALTH SERVICES, LLC	12/8/2017	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	None	601 E FLORIDA AVE	None	HEMET	CA	92543	4335	33	06065	33.74753447	-116.966052	Riverside County
290349	Fee-for-Service	1164926382	1164926382	1	1	ELY, DYLAN F MD	4/21/2021	207P00000X	NA	Other	026	PHYSICIANS	164488	None	None	0	In state provider	None	525 W ACACIA ST	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
290388	Fee-for-Service	1023420726	1023420726	1	5	ENLOE MEDICAL CENTER	9/28/2021	176B00000X	NA	Licensed Midwife	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	1423 MAGNOLIA	None	CHICO	CA	95926	3226	04	06007	39.74063551	-121.8499048	Butte County
290432	Fee-for-Service	1023420726	1023420726	1	5	ENLOE MEDICAL CENTER	7/21/2022	176B00000X	NA	Licensed Midwife	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1423 MAGNOLIA	None	CHICO	CA	95926	3226	04	06007	39.74063551	-121.8499048	Butte County
290441	Fee-for-Service	1447637517	1447637517	1	1	ENERIZ-CHAMPION, DIANALUCY	8/30/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	28100 BOUQUET CANYON RD.	SUITE 218	SANTA CLARITA	CA	91350	2009	19	06037	34.45052733	-118.497654	Los Angeles County
290449	Fee-for-Service	1154315604	1154315604	1	1	ELLIS, KAREN A MD	6/10/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	54822	22	Pathology (M.D. only)	0	In state provider	None	4929 VAN NUYS BLVD	None	VAN NUYS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
290476	Fee-for-Service	1023420726	1023420726	1	5	ENLOE MEDICAL CENTER	9/28/2021	176B00000X	NA	Licensed Midwife	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	None	1423 MAGNOLIA	None	CHICO	CA	95926	3226	04	06007	39.74063551	-121.8499048	Butte County
290515	Fee-for-Service	1023420726	1023420726	1	5	ENLOE MEDICAL CENTER	9/28/2021	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1423 MAGNOLIA	None	CHICO	CA	95926	3226	04	06007	39.74063551	-121.8499048	Butte County
290560	Fee-for-Service	1023420726	1023420726	1	5	ENLOE MEDICAL CENTER	9/28/2021	176B00000X	NA	Licensed Midwife	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	1423 MAGNOLIA	None	CHICO	CA	95926	3226	04	06007	39.74063551	-121.8499048	Butte County
290574	Fee-for-Service	1376658872	1376658872	1	1	EVANS, SHAWN MD	12/6/2023	208M00000X	NA	Other	026	PHYSICIANS	191779	None	None	0	In state provider	None	ONE MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
290831	Fee-for-Service	1356356729	1356356729	1	1	EVANS-TRESTLER, GLENDORA	2/27/2009	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1532	34	06067	38.546091	-121.447305	Sacramento County
290847	Fee-for-Service	1992552533	1992552533	1	1	EMPRESS MEDICAL TRANSPORATIO	5/2/2024	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	N LLC	9815 FORT SANDERS AVE	None	BAKERSFIELD	CA	93311	4634	15	06029	35.2929413	-119.111846	Kern County
290856	Fee-for-Service	1811295728	1811295728	1	1	EBERE, SHANITA CCC-SLP	6/24/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	78034 CALLE BARCELONA	SUITE A	LA QUINTA	CA	92253	2997	33	06065	33.67411686	-116.3029449	Riverside County
290927	Fee-for-Service	1891911830	1891911830	1	1	ENCOMPASS COMMUNITY SERVICES	3/14/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	106 MAPLE AVE	None	WATSONVILLE	CA	95076	4709	44	06087	36.90992773	-121.7546894	Santa Cruz County
290957	Fee-for-Service	1891786240	1891786240	3	1	EDEN EMERGENCY MEDICAL GROUP	9/14/2020	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	, INC.	20103 LAKE CHABOT	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
291036	Fee-for-Service	1922455864	1922455864	1	1	ESTEBAN, MARCUS JUAN L MD	10/28/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	173226	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
291039	Fee-for-Service	1801841630	1801841630	1	1	ELO, KEVIN S	10/8/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5061 SHASTA DAM BLVD	None	SHASTA LAKE	CA	96019	9405	45	06089	40.68027851	-122.3557875	Shasta County
291042	Fee-for-Service	1104172782	1104172782	1	1	ERIC HARTMAN	2/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4801 W 81ST ST	STE 108	MINNEAPOLIS	MN	55437	1111	00	None	44.85623947	-93.34035	Hennepin County
291049	Fee-for-Service	1518990084	1518990084	1	1	ERARIO, MADELIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3300 GALLOWS RD	None	FALLS CHURCH	VA	22042	3307	00	None	38.858193	-77.226426	City of Fairfax
291109	Fee-for-Service	1699206532	1699206532	1	1	ERONDU, MGBECHI U MD	1/4/2023	207L00000X	NA	Other	026	PHYSICIANS	179832	None	None	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
291215	Fee-for-Service	1972534212	1972534212	1	1	ECARMA, ALEX MD	1/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82368	41	Internal Medicine	0	In state provider	None	1911 JOHNSON AVE	None	SAN LUIS OBISPO	CA	93401	4131	40	06079	35.27851417	-120.6501092	San Luis Obispo County
291291	Fee-for-Service	1124243092	1124243092	1	1	ELLIOTT, AMY B MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	92492	83	Rheumatology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
291312	Fee-for-Service	1003866120	1003866120	1	8	EMERGENCY ASSOCIATES COR	6/27/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11500 BROOKSHIRE AVE	None	DOWNEY	CA	90241	4917	19	06037	33.93500365	-118.1321119	Los Angeles County
291530	Non-Physician Medical Practitioner	None	1154631315	0	0	ERICKSON, NEIL S	11/15/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12608 STABLEGATE DRIVE	None	BAKERSFIELD	CA	93312	6549	00	06000	35.42199681	-119.1425327	Kern County
291544	Non-Physician Medical Practitioner	None	1699448126	0	0	ECKRICH-GAUB, AMANDA A NP	9/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	00	06000	38.66314048	-121.794696	Yolo County
291587	Non-Physician Medical Practitioner	None	1366536278	0	0	ELLIS, ZACKRY C	2/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14862 ALDER LN	None	TUSTIN	CA	92780	6743	00	06000	33.71741333	-117.8163955	Orange County
291611	Non-Physician Medical Practitioner	None	1699028803	0	0	EHRHART, JASON J PA	12/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12 UPPER RAGSDALE	None	MONTEREY	CA	93940	5730	00	06000	36.57482436	-121.8101797	Monterey County
291628	Non-Physician Medical Practitioner	None	1124020706	0	0	ESCARCEGA, ARNOLD V	5/24/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35784 MANON AVE	None	MADERA	CA	93636	8418	00	06000	36.93519119	-119.8980217	Madera County
291661	Non-Physician Medical Practitioner	None	1154730828	0	0	EL PROYECTO DEL BARRIO,INC	9/26/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3942 MAINE AVE	None	BALDWIN PARK	CA	91706	4220	00	06000	34.0845949	-117.961636	Los Angeles County
291847	Non-Physician Medical Practitioner	None	1780130039	0	0	ESTRELLA, LELAND R NP	1/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1651 COBBLESTONE CT	None	HOLLISTER	CA	95023	6744	00	06000	36.8445818	-121.3719334	San Benito County
291871	Non-Physician Medical Practitioner	None	1194702548	0	0	EARON, SHIRL G	4/14/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4860 Y ST	STE 2200	SACRAMENTO	CA	95817	2307	00	06000	38.552211	-121.449429	Sacramento County
291884	Non-Physician Medical Practitioner	None	1457648446	0	0	ETCHEPARE, MARIA NP	7/9/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2207 STONEWOOD CT	None	SAN PEDRO	CA	90732	1345	00	06000	33.76412329	-118.3081331	Los Angeles County
291914	Non-Physician Medical Practitioner	None	1114571023	0	0	EDILLON, ERIC E PA-C	10/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	00	06000	34.062852	-117.9446658	Los Angeles County
291918	Non-Physician Medical Practitioner	None	1700830296	0	0	EAST VALLEY COMMUNITY CLINIC, INC.	7/1/1994	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2470 ALVIN AVE	SUITE 60	SAN JOSE	CA	95121	1664	00	06000	37.31946663	-121.8268813	Santa Clara County
291936	Non-Physician Medical Practitioner	None	1275313686	0	0	ENTWISTLE, ALLYSON PA-C	11/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	00	06000	34.13502	-117.2758635	San Bernardino County
292012	Non-Physician Medical Practitioner	None	1912984535	0	0	EHLERS, JUSTUS K PA	11/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25495 MEDICAL CENTER DR	STE 102	MURRIETA	CA	92562	4903	00	06000	33.55804188	-117.1834064	Riverside County
292040	Non-Physician Medical Practitioner	None	1386065241	0	0	EVANS, LAURA L NP	7/29/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2792 HOLLAND PLACE	None	WOODLAND	CA	95776	5329	00	06000	38.65137494	-121.7296782	Yolo County
292057	Non-Physician Medical Practitioner	None	1750735411	0	0	ESMAEILI, MERCEDEH NP	8/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18021 SKY PARK CIRCLE	STE G	IRVINE	CA	92614	6569	00	06000	33.68904995	-117.8542045	Orange County
292066	Non-Physician Medical Practitioner	None	1891021762	0	0	EBADAT, FARNOOSH N NP	4/24/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	686 ARDIS AVE	None	SAN JOSE	CA	95117	2203	00	06000	37.314207	-121.9576815	Santa Clara County
292074	Non-Physician Medical Practitioner	None	1902410632	0	0	EVERETT, LINDSEY L PA-C	4/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1662 DOMINICAN WAY	None	SANTA CRUZ	CA	95065	1816	00	06000	36.99033079	-121.9816507	Santa Cruz County
292122	Non-Physician Medical Practitioner	None	1245584606	0	0	EILLIS, EDITH B	1/30/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	535 EVERETT AVENUE	104	PALO ALTO	CA	94301	1514	00	06000	37.45048151	-122.1611675	Santa Clara County
292193	Non-Physician Medical Practitioner	None	1609200187	0	0	ELGART, SARAH M NP	6/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
292386	Non-Physician Medical Practitioner	None	1992120042	0	0	ENDERICA, JOANN F PA	12/5/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	00	06000	34.072245	-117.4319685	San Bernardino County
292394	Non-Physician Medical Practitioner	None	1366711558	0	0	EDWARDS, CHARLES S	10/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1081 LONG BEACH BLVD	SUITE 527	LONG BEACH	CA	90813	3431	00	06000	33.78049622	-118.1894927	Los Angeles County
292652	Non-Physician Medical Practitioner	None	1124426234	0	0	EVANGELISTA, ERIC C	5/24/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1002 EAST FREELAND ST	None	LONG BEACH	CA	90807	1653	00	06000	33.83981233	-118.1816668	Los Angeles County
292738	Non-Physician Medical Practitioner	None	1730987637	0	0	ELCONIN, BROOKE PA-C	3/18/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	350 30TH ST	100	OAKLAND	CA	94609	3422	00	06000	37.81892183	-122.2640154	Alameda County
292801	Non-Physician Medical Practitioner	None	1730667049	0	0	ELLINGWOOD, JOYCE E A NP	1/8/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6782 GILDDEN ST	K5	SAN DIEGO	CA	92111	7304	00	06000	32.775442	-117.1741802	San Diego County
292809	Non-Physician Medical Practitioner	None	1063026185	0	0	EOM, LINDA J NP	11/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
292825	Non-Physician Medical Practitioner	None	1992761670	0	0	ESTIS, ROBERT JOHN	6/1/1995	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	819 FOOTHILL BLVD	HARRIET TUBMAN MEDICAL O	OAKLAND	CA	94606	3011	00	06000	37.7944387	-122.2491132	Alameda County
292949	Non-Physician Medical Practitioner	None	1801224217	0	0	ENTEEN, LAUREN NP	9/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2740 GRANT ST	None	CONCORD	CA	94520	2265	00	06000	37.98580944	-122.0385574	Contra Costa County
293010	Non-Physician Medical Practitioner	None	1689119596	0	0	ECORO NZANG, SARA NP	4/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 E ROMIE LN	A	SALINAS	CA	93901	4031	00	06000	36.65998191	-121.6461895	Monterey County
293058	Non-Physician Medical Practitioner	None	1487344933	0	0	ENCINARES, RICHARD A PA-C	10/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2720 N HARBOR BOULEVARD	SUITE 210	FULLERTON	CA	92835	2626	00	06000	33.90126238	-117.9292154	Orange County
293077	Non-Physician Medical Practitioner	None	1689944274	0	0	EWING, CHRISTY NP	3/14/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4950 BARRANCA PARKWAY	SUITE 104	IRVINE	CA	92604	4630	00	06000	33.67620851	-117.7948348	Orange County
293106	Non-Physician Medical Practitioner	None	1619157831	0	0	ESTERS, LATAVIA S PA-C	12/31/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3751 E SHIELDS AVE	None	FRESNO	CA	93726	0000	00	06000	36.7796958	-119.7618088	Fresno County
293181	Non-Physician Medical Practitioner	None	1710058813	0	0	EDMONDS, NEYDI S	5/27/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1831 SERENA AVE	None	CLOVIS	CA	93619	2843	00	06000	36.86589751	-119.6833023	Fresno County
293234	Non-Physician Medical Practitioner	None	1245716943	0	0	ESCOBAR, TONYA S NP	7/15/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2960 CAMINO DIABLO	105	WALNUT CREEK	CA	94597	3988	00	06000	37.89859467	-122.0843018	Contra Costa County
293274	Non-Physician Medical Practitioner	None	1376081208	0	0	ENG, STEPHANIE S PA-C	8/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3772 HOWE ST	None	OAKLAND	CA	94611	5311	00	06000	37.8243542	-122.2566075	Alameda County
293479	Non-Physician Medical Practitioner	None	1356983068	0	0	EDMONDSON, JANELLE R NP	5/21/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1508 ALHAMBRA BLVD	200	SACRAMENTO	CA	95816	6510	00	06000	38.567007	-121.468068	Sacramento County
293635	Non-Physician Medical Practitioner	None	1477690386	0	0	ECHOLS, SALLY W NP	7/27/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	185 E 7TH AVE	STE A	CHICO	CA	95926	3356	00	06000	39.74473059	-121.8488381	Butte County
293683	Non-Physician Medical Practitioner	None	1386729358	0	0	ESFANDIER, MIKHAIL S	7/18/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5927 E SAN JUAN DR	None	ORANGE	CA	92869	1431	00	06000	33.81147979	-117.7899837	Orange County
293734	Non-Physician Medical Practitioner	None	1851785828	0	0	EZENWATA, CHINOMSO D NP	5/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	06000	36.132948	-115.136874	Clark County
293745	Non-Physician Medical Practitioner	None	1609525963	0	0	ENRIQUEZ, FAUSTINO NP	6/23/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	00	06000	35.3687456	-119.1106561	Kern County
293819	Non-Physician Medical Practitioner	None	1568810117	0	0	EDWARDS, KATINA D NP	3/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4049 BROCKTON AVE	None	RIVERSIDE	CA	92501	3440	00	06000	33.98177617	-117.3807605	Riverside County
293860	Non-Physician Medical Practitioner	None	1093860660	0	0	ELLIOTT, NANCY A	8/2/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	980 42ND ST	None	OAKLAND	CA	94608	3712	00	06000	37.83264356	-122.2752172	Alameda County
293868	Non-Physician Medical Practitioner	None	1982854618	0	0	ELLIOTT, JERROLD P III	5/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1718 ARROYO SIERRA CIRCL	None	SANTA ROSA	CA	95405	7762	00	06000	38.438829	-122.6656485	Sonoma County
293898	Non-Physician Medical Practitioner	None	1851393524	0	0	EDWARDS, LIANNA MARIE	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	00	06000	38.72845186	-121.2904134	Placer County
293992	Non-Physician Medical Practitioner	None	1518127729	0	0	ELOUL, YAROM A PA-C	2/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11631 VICTORY BLVD	STE 101	NORTH HOLLYWOOD	CA	91606	3572	00	06000	34.18671045	-118.385712	Los Angeles County
294045	Non-Physician Medical Practitioner	None	1447859533	0	0	EDELSON, BROOKE D PA	3/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
294058	Non-Physician Medical Practitioner	None	1790043248	0	0	ELIZONDO, BERNARDO PA-C	11/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	869 N CHERRY ST	None	TULARE	CA	93274	2207	00	06000	36.220932	-119.337698	Tulare County
294227	Non-Physician Medical Practitioner	None	1174079115	0	0	ERICKSEN-MILLER, KRISTI M NP	1/30/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	411 SUNFLOWER	None	LAKE FOREST	CA	92630	8452	00	06000	33.67780734	-117.6751763	Orange County
294253	Non-Physician Medical Practitioner	None	1275909525	0	0	EDWARDS, KONEECHIA C	1/11/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	920 EAST REDWOOD CIR	None	HANFORD	CA	93230	2383	00	06000	36.35784644	-119.6318557	Kings County
294302	Non-Physician Medical Practitioner	None	1306522073	0	0	ESCARO, EDWIN NP	1/16/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
294399	Non-Physician Medical Practitioner	None	1629676358	0	0	EISAMAN, SAWYER F PA-C	5/11/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10590 TOWN CENTER DR	170	RANCHO CUCAMONGA	CA	91730	0360	00	06000	34.11101693	-117.5740616	San Bernardino County
294504	Non-Physician Medical Practitioner	None	1366876450	0	0	ESQUIVEL, LARAINE I NP	12/2/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	748 FAST GREEN WAY	None	LAS VEGAS	NV	89148	5231	00	06000	36.03457909	-115.2848062	Clark County
294550	Non-Physician Medical Practitioner	None	1821177254	0	0	EZAKI, SACHI LYNNE	5/28/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	147 W COLLEGE ST	None	COVINA	CA	91723	2008	00	06000	34.0875033	-117.8914472	Los Angeles County
294603	Non-Physician Medical Practitioner	None	1356356729	0	0	EVANS-TRESTLER, GLENDORA NP	3/6/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1632 STONE WAY	None	AUBURN	CA	95603	5965	00	06000	38.87107974	-121.0776529	Placer County
294774	Non-Physician Medical Practitioner	None	1487224663	0	0	ESHOO, MADDISON A	7/12/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20101 LAKE CHABOT RD	4TH FLOOR	CASTRO VALLEY	CA	94546	5305	00	06000	37.69819004	-122.0873124	Alameda County
294841	Non-Physician Medical Practitioner	None	1598855017	0	0	EVENSON, ANN	4/8/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15611 POMERADO RD	None	POWAY	CA	92064	2437	00	06000	32.99706	-117.05544	San Diego County
294846	Non-Physician Medical Practitioner	None	1023703725	0	0	ENGALING, JOHN NP	12/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
294875	Non-Physician Medical Practitioner	None	1093576423	0	0	EISON, TYLEA CNM	7/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1423 MAGNOLIA	None	CHICO	CA	95926	3226	00	06000	39.74063551	-121.8499048	Butte County
294923	Non-Physician Medical Practitioner	None	1083198394	0	0	EKPENYONG, RACHEL NP	10/15/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	230 SAN JOSE STREET	None	SALINAS	CA	93901	3901	00	06000	36.65837657	-121.6469645	Monterey County
294973	Non-Physician Medical Practitioner	None	1205241528	0	0	ECHEVESTE, SILVIA	9/16/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	140 W HAZELWOOD PL	None	LEMOORE	CA	93245	2331	00	06000	36.31597591	-119.7831827	Kings County
295010	Non-Physician Medical Practitioner	None	1811056526	0	0	ECHANDI, RENEE M	3/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4939 LONE ACRES CT	None	RANCHO CUCAMONGA	CA	91737	6740	00	06000	34.164252	-117.565141	San Bernardino County
295075	Non-Physician Medical Practitioner	None	1821271768	0	0	EVANGELISTA, CINDY C	9/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2106 NORTH 6TH STREET	None	BURBANK	CA	91504	2436	00	06000	34.19986596	-118.3234734	Los Angeles County
295121	Non-Physician Medical Practitioner	None	1972547107	0	0	EGGE, MARIE CECILE	8/19/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2100 POWELL STREET	STE 920	EMERYVILLE	CA	94608	1803	00	06000	37.83953006	-122.2990736	Alameda County
295170	Non-Physician Medical Practitioner	None	1992057004	0	0	ELGRABLY, ALONYA NP	10/31/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3851 BLACK BUTTE ROAD	None	WEST SACRAMENTO	CA	95691	6287	00	06000	38.53284372	-121.5803425	Yolo County
295186	Non-Physician Medical Practitioner	None	1104675065	0	0	EVANGELISTA, PATRICK NP	12/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6555 COYLE	SUITE 220	CARMICHAEL	CA	95608	0303	00	06000	38.66859	-121.3118055	Sacramento County
295320	Non-Physician Medical Practitioner	None	1194185397	0	0	EINSELE, PEGGY M NP	6/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 6TH STREET	None	GRENADA	CA	96038	9603	00	06000	41.643486	-122.5244115	Siskiyou County
295344	Non-Physician Medical Practitioner	None	1043528987	0	0	EVANS, STACEY D NP	9/20/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6798 LEMON AVE	None	LONG BEACH	CA	90805	1528	00	06000	33.87809876	-118.1792558	Los Angeles County
295349	Non-Physician Medical Practitioner	None	1720282718	0	0	ESTY, TRESSA M PA-C	3/20/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	990 PACIFIC STREET	None	SAN LUIS OBISPO	CA	93401	6309	00	06000	35.27942504	-120.6598668	San Luis Obispo County
295391	Non-Physician Medical Practitioner	None	1033170485	0	0	EGAN, GAIL M NP	4/11/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11700 LOISDALE WAY	None	RANCHO CORDOVA	CA	95742	8028	00	06000	38.553237	-121.2414165	Sacramento County
295504	Non-Physician Medical Practitioner	None	1801625009	0	0	ELLIOTT, BETHANY	11/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	00	06000	35.39052148	-119.0070765	Kern County
295511	Non-Physician Medical Practitioner	None	1043885270	0	0	ESTRADA, MARIA I NP	8/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	00	06000	34.27771547	-119.2540344	Ventura County
295672	Non-Physician Medical Practitioner	None	1770765547	0	0	EGHRERINIOVO, MAUREEN N	5/31/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1307 WEST SIXTH STREET	105	CORONA	CA	92882	3294	00	06000	33.87790309	-117.589666	Riverside County
295687	Non-Physician Medical Practitioner	None	1487979001	0	0	ETHRIDGE, KRISTEN E NP	12/9/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1735 SWEET BRIAR PLACE	None	THOUSAND OAKS	CA	91362	1256	00	06000	34.21880685	-118.8469893	Ventura County
295709	Non-Physician Medical Practitioner	None	1821534587	0	0	ESPINOZA, ELBA NP	6/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	185 E 7TH AVE	STE A	CHICO	CA	95926	3356	00	06000	39.74473059	-121.8488381	Butte County
295871	Non-Physician Medical Practitioner	None	1689275059	0	0	ELIE, COLIN R PA-C	11/10/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
295939	Non-Physician Medical Practitioner	None	1134620768	0	0	ERVIN, MARIAM H	2/7/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7608 PLUMARIA DR	None	FONTANA	CA	92336	1657	00	06000	34.11573647	-117.4776803	San Bernardino County
295946	Non-Physician Medical Practitioner	None	1841694361	0	0	ELBO, WINCHELL NP	3/26/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2651 S C ST	200	OXNARD	CA	93033	3560	00	06000	34.17497898	-119.1811966	Ventura County
295988	Non-Physician Medical Practitioner	None	1619101516	0	0	ESTRADA, SYLVIA S	4/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15544 ROJAS ST	None	HACIENDA HEIGHTS	CA	91745	5231	00	06000	33.98927444	-117.9787293	Los Angeles County
295998	Non-Physician Medical Practitioner	None	1982170544	0	0	ENDO, BRITTNEY PA	10/28/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23181 VERDUGO DR STE 103	None	LAGUNA HILLS	CA	92653	1313	00	06000	33.62609529	-117.7293191	Orange County
296191	Non-Physician Medical Practitioner	None	1366831653	0	0	EFENDY, YOGGIE C NP	6/4/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10960 BEECHWOOD DR	None	ALTA LOMA	CA	91737	2432	00	06000	34.15219765	-117.5654767	San Bernardino County
296194	Non-Physician Medical Practitioner	None	1982058582	0	0	ENGELMAN, ALLISON D PA-C	4/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3939 J ST	STE 320	SACRAMENTO	CA	95819	3666	00	06000	38.570211	-121.45374	Sacramento County
296283	Non-Physician Medical Practitioner	None	1033506498	0	0	ESTRELLA, ENRICO D NP	9/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13365 W WASHINGTON BLVD	None	CULVER CITY	CA	90066	5134	00	06000	33.99238471	-118.4439832	Los Angeles County
296375	Non-Physician Medical Practitioner	None	1346561057	0	0	EVANS, LISA M NP	5/19/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	30 ROSSANO	None	IRVINE	CA	92620	2549	00	06000	33.71524985	-117.7746656	Orange County
296460	Non-Physician Medical Practitioner	None	1629451729	0	0	ESSER, NICHOLAS R	7/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3113 S STEVENSON STREET	None	VISALIA	CA	93277	7494	00	06000	36.302823	-119.299374	Tulare County
296467	Non-Physician Medical Practitioner	None	1538417522	0	0	ESTRADA, TARA E NP	8/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3435 E RIOPELLE AVENUE	None	QUEEN CREEK	AZ	85298	9107	00	06000	33.226407	-111.7154925	Maricopa County
296536	Non-Physician Medical Practitioner	None	1821250929	0	0	ENDRIGA, GEMMALIN R NP	8/16/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15002 ALDA PLACE	None	NORTH HILLS	CA	91343	3459	00	06000	34.2376435	-118.459062	Los Angeles County
296547	Non-Physician Medical Practitioner	None	1073873741	0	0	EASTMAN, COURTNEY A PA-C	12/6/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35 CASA ST	SUITE 320	SAN LUIS OBISPO	CA	93405	1894	00	06000	35.29359615	-120.6654304	San Luis Obispo County
296552	Non-Physician Medical Practitioner	None	1154968923	0	0	EISENBERG, NATALIE PA-C	5/29/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6926 BROCKTON AVE	SUITE 6	RIVERSIDE	CA	92506	3804	00	06000	33.947919	-117.3967225	Riverside County
296557	Non-Physician Medical Practitioner	None	1235141078	0	0	EVERTSON, LESLIE CHANG	1/14/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1245 16TH ST	SUITE 208	SANTA MONICA	CA	90404	1235	00	06000	34.02726451	-118.4857138	Los Angeles County
296651	Non-Physician Medical Practitioner	None	1427489483	0	0	ELEVAZO, ROY ALLAN O NP	12/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18672 FLORIDA ST	#100	HUNTINGTON BEACH	CA	92648	1917	00	06000	33.691185	-117.9910425	Orange County
296696	Non-Physician Medical Practitioner	None	1053918011	0	0	ESCUDERO, CARLO RAPHAEL F PA-C	11/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10350 BARNES CANYON RD	STE 200	SAN DIEGO	CA	92121	2709	00	06000	32.9005814	-117.1946684	San Diego County
296718	Non-Physician Medical Practitioner	None	1184960890	0	0	EGWUONWU, CHINENYE	4/9/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3791 KATELLA AVE	STE. 108	LOS ALAMITOS	CA	90720	3105	00	06000	33.80318449	-118.0672965	Orange County
296789	Non-Physician Medical Practitioner	None	1275869760	0	0	ESTRADA, SAMUEL ANTONIO	2/23/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2545 W HAMMER LN	None	STOCKTON	CA	95209	2839	00	06000	38.0214303	-121.3461515	San Joaquin County
296815	Non-Physician Medical Practitioner	None	1598252173	0	0	EDWARDS, MELISSA NP	9/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 VICTORIA STREET	None	COSTA MESA	CA	92627	1995	00	06000	33.65258952	-117.9121545	Orange County
296816	Non-Physician Medical Practitioner	None	1932475720	0	0	EL DORADO COMMUNITY SERVICE CENTER	8/10/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1101 CAPP ST	None	SAN FRANCISCO	CA	94110	4697	00	06000	37.748871	-122.4170205	San Francisco County
296967	Non-Physician Medical Practitioner	None	1568677235	0	0	ELDORADO COMMUNITY SERVICE CENTER	8/19/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5200 SAN GABRIEL PL	STE B & C	PICO RIVERA	CA	90660	0000	00	06000	33.99848052	-118.0840108	Los Angeles County
297032	Non-Physician Medical Practitioner	None	1356638332	0	0	EBERLE, BRYAN J	1/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 VLAARDINGEN LN	None	PETALUMA	CA	94952	9210	00	06000	38.32467624	-122.7926637	Sonoma County
297118	Non-Physician Medical Practitioner	None	1245406503	0	0	ESTRADA, RAUL PA	11/13/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	00	06000	32.83133206	-117.1252363	San Diego County
297164	Non-Physician Medical Practitioner	None	1932338241	0	0	EL DORADO COMMUNITY SERVICE CENTER	9/28/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1733 EUCLID AVE	None	SAN DIEGO	CA	92105	5414	00	06000	32.72248701	-117.0848929	San Diego County
297218	Non-Physician Medical Practitioner	None	1053882076	0	0	ENG, MICHAEL D PA	7/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1901 TOWN AND COUNTRY DR	SUITE 104	NORCO	CA	92860	3611	00	06000	33.92721419	-117.561448	Riverside County
297257	Non-Physician Medical Practitioner	None	1558010165	0	0	EMMONS, MICHELLE NP	4/25/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
297358	Non-Physician Medical Practitioner	None	1871983114	0	0	EUMONT, KRISTY PA	5/15/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22110 ROSCOE BLVD	STE 201	CANOGA PARK	CA	91304	3861	00	06000	34.21957849	-118.6082685	Los Angeles County
297407	Non-Physician Medical Practitioner	None	1528424330	0	0	ESTES, SAMANTHA K PA-C	1/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3969 4TH AVE	STE 208	SAN DIEGO	CA	92103	3165	00	06000	32.74948151	-117.1615826	San Diego County
297426	Non-Physician Medical Practitioner	None	1649324443	0	0	EAST VALLEY COMMUNITY HEALTH CENTER, INC.	6/2/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1555 S GAREY AVE	None	POMONA	CA	91766	5222	00	06000	34.04317024	-117.7497127	Los Angeles County
297599	Non-Physician Medical Practitioner	None	1770908725	0	0	ELICA HEALTH CENTERS	2/10/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1860 HOWE AVE	None	SACRAMENTO	CA	95825	1073	00	06000	38.59947	-121.4142525	Sacramento County
297682	Non-Physician Medical Practitioner	None	1356622708	0	0	ESPARZA AVILA, FERNANDO	7/3/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	30860 DONALD AVE	None	MADERA	CA	93636	1479	00	06000	36.9929643	-119.985907	Madera County
297715	Non-Physician Medical Practitioner	None	1255001228	0	0	EVANS, MICHELLE I NP	7/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15400 LOS GATOS BLVD	None	LOS GATOS	CA	95032	2502	00	06000	37.24572659	-121.957997	Santa Clara County
297758	Non-Physician Medical Practitioner	None	1730203456	0	0	ESQUIVEL, PAMELA ANN	10/3/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	133655 JAMES ST	None	MORENO VALLEY	CA	92555	2802	00	06000	33.92559458	-117.2083499	Riverside County
297820	Non-Physician Medical Practitioner	None	1073094918	0	0	EATON, ELIZABETH A NP	8/24/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
297822	Non-Physician Medical Practitioner	None	1689106031	0	0	EVANS, JENNIFER L NP	8/22/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2328 MAIN STREET	None	GENOA	NV	89411	0246	00	06000	39.00611283	-119.8449961	Douglas County
297825	Non-Physician Medical Practitioner	None	1215329099	0	0	ELLO, DALE T NP	7/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2712 PEACH DRIVE	None	LITTLE ELM	TX	75068	5644	00	06000	33.17771407	-96.90542799	Denton County
297842	Non-Physician Medical Practitioner	None	1194768663	0	0	ELIAS, JULIE M	6/5/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7053 SITIO FRONTERA	None	CARLSBAD	CA	92009	2045	00	06000	33.10179223	-117.2237619	San Diego County
297877	Non-Physician Medical Practitioner	None	1689217630	0	0	EISHER, EVAN PA-C	9/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	00	06000	34.28924598	-118.7439214	Ventura County
297919	Non-Physician Medical Practitioner	None	1588390629	0	0	EMERUWA, BEN NP	2/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 N. VERMONT AVE.	None	LOS ANGELES	CA	90027	6098	00	06000	34.0956033	-118.2916918	Los Angeles County
297920	Non-Physician Medical Practitioner	None	1104852532	0	0	ERLICH, KIMBERLY J NP	10/6/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1557 ALAMEDA	None	SAN CARLOS	CA	94070	4552	00	06000	37.48664842	-122.2602626	San Mateo County
298043	Non-Physician Medical Practitioner	None	1356089171	0	0	ECHEVARRIA, CAROLINE E PA-C	1/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4001 J STREET	None	SACRAMENTO	CA	95819	3626	00	06000	38.570526	-121.4521695	Sacramento County
298128	Non-Physician Medical Practitioner	None	1447592266	0	0	ERNEST, KIMBERLY GAIL	6/27/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 W MACARTHUR	None	OAKLAND	CA	94611	5641	00	06000	37.82397231	-122.2578822	Alameda County
298266	Non-Physician Medical Practitioner	None	1518599109	0	0	ENRIQUEZ, CZARINA NP	11/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4312 WOODMAN AVENUE	SUITE 102	SHERMAN OAKS	CA	91423	5546	00	06000	34.148637	-118.4312035	Los Angeles County
298272	Non-Physician Medical Practitioner	None	1326796210	0	0	EVANS, SARAH NP	2/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15611 POMERADO RD	STE 400	POWAY	CA	92064	2437	00	06000	32.99706	-117.05544	San Diego County
298287	Non-Physician Medical Practitioner	None	1841036464	0	0	ERIBAL, NICOLE CARMELA	10/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
298473	Non-Physician Medical Practitioner	None	1265775340	0	0	EVANS, CHARIE M PA-C	1/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6978	00	06000	37.78594176	-122.421322	San Francisco County
298479	Non-Physician Medical Practitioner	None	1790876381	0	0	ECKERMAN, JENNIFER K PA-C	8/9/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1310 LAS TABLAS RD	STE 201	TEMPLETON	CA	93465	9747	00	06000	35.55442349	-120.722643	San Luis Obispo County
298508	Non-Physician Medical Practitioner	None	1306557608	0	0	ESCOBAR, RICARDO A PA	2/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	00	06000	34.047153	-117.2611485	San Bernardino County
298550	Non-Physician Medical Practitioner	None	1982249587	0	0	ELLIS, TIFFANY NP	2/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	00	06000	34.13998921	-118.7070142	Los Angeles County
298601	Non-Physician Medical Practitioner	None	1396261673	0	0	ESCUDERO, ANNA RUTH T NP	11/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 CITY DR S	# B10	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
298726	Non-Physician Medical Practitioner	None	1356677454	0	0	EKEJIUBA, ROSE NNEKA	7/17/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	00	06000	34.05855992	-118.209755	Los Angeles County
298743	Non-Physician Medical Practitioner	None	1700261682	0	0	EBNEYAMIN, SOHA	6/26/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1537 15TH STREET	APT 106	SANTA MONICA	CA	90404	3350	00	06000	34.0227242	-118.4822184	Los Angeles County
298801	Non-Physician Medical Practitioner	None	1235500661	0	0	ESPINO, ALEJANDRO D	10/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11438 LOCH LOMOND DR	None	WHITTIER	CA	90606	1006	00	06000	33.98120873	-118.0594866	Los Angeles County
298900	Non-Physician Medical Practitioner	None	1164664306	0	0	ELO, KRISTIN MARIE	9/8/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	00	06000	32.781483	-117.007182	San Diego County
298935	Non-Physician Medical Practitioner	None	1255374245	0	0	ENGEL, CAROL	8/12/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	HI-DESERT MEDICAL CENTER	6601 WHITE FEATHER ROAD	JOSHUA TREE	CA	92252	0000	00	06000	34.14735796	-116.2998959	San Bernardino County
298975	Non-Physician Medical Practitioner	None	1962892950	0	0	EATON, TRACEY M NP	3/12/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	602 LA VERNE AVE	None	SANTA ROSA	CA	95404	2418	00	06000	38.462796	-122.7152835	Sonoma County
298982	Non-Physician Medical Practitioner	None	1124440524	0	0	ESPINOZA, FREDDY NP	9/21/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	00	06000	36.74333844	-119.7831874	Fresno County
299026	Non-Physician Medical Practitioner	None	1144252370	0	0	ELHAZIN, BRIDGEIDA D	8/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22775 VAN BUREN ST	None	GRAND TERRACE	CA	92354	5748	00	06000	34.02658528	-117.3072203	San Bernardino County
299043	Non-Physician Medical Practitioner	None	1205087699	0	0	ERARD, CARLY M	11/26/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6124 LAWSON WAY	None	RIVERSIDE	CA	92506	2535	00	06000	33.95893701	-117.3896765	Riverside County
299061	Non-Physician Medical Practitioner	None	1811488141	0	0	ESGUERRA, JILLIAN V	6/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14618 CLARK AVE	None	BELLFLOWER	CA	90706	5211	00	06000	33.899922	-118.134031	Los Angeles County
299282	Non-Physician Medical Practitioner	None	1811021405	0	0	EAST BAY PERINATAL CENTER DBA ALTA BATES SUMMIT PE	8/28/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	350 30TH ST	STE 205	OAKLAND	CA	94609	3425	00	06000	37.81892183	-122.2640154	Alameda County
299296	Non-Physician Medical Practitioner	None	1417983909	0	0	ENGELBERG, STEVEN	1/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7119 ROSECRANS ST	None	LAS VEGAS	NV	89166	7126	00	06000	36.290538	-115.326067	Clark County
299349	Non-Physician Medical Practitioner	None	1306484555	0	0	EDELMAN, LAUREN E NP	12/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
299466	Non-Physician Medical Practitioner	None	1811583263	0	0	EITEL, KEVIN R PA	2/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	00	06000	37.36893518	-122.0779448	Santa Clara County
299514	Non-Physician Medical Practitioner	None	1598030587	0	0	ESLER, HYAESUN NP	4/15/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9891 N PRICE AVE	None	FRESNO	CA	93720	4688	00	06000	36.879804	-119.7468955	Fresno County
299553	Non-Physician Medical Practitioner	None	1316502099	0	0	ESTEY, JENNIFER I NP	5/23/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1403 LOMITA BLVD.	307	HARBOR CITY	CA	90710	2085	00	06000	33.79783692	-118.30188	Los Angeles County
299645	Non-Physician Medical Practitioner	None	1174674527	0	0	ERICKSON, SUZANNE KAY	10/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5044 N BARTON AVE	None	FRESNO	CA	93740	0001	00	06000	36.80942142	-119.7496436	Fresno County
299651	Non-Physician Medical Practitioner	None	1023004033	0	0	ELLIOTT, DANIEL R.	5/1/2003	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18277 PASADENA ST	STE 109	LAKE ELSINORE	CA	92530	2790	00	06000	33.68897179	-117.3449906	Riverside County
299653	Non-Physician Medical Practitioner	None	1043657547	0	0	ELPIDIO, YVETTE A NP	4/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3151 AIRWAY AVE	SUITE G1	COSTA MESA	CA	92626	4624	00	06000	33.67783408	-117.8720921	Orange County
299747	Non-Physician Medical Practitioner	None	1982038121	0	0	EXEDAHL, SHARON L NP	8/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	578 SUTTON WAY	NUMBER 197	GRASS VALLEY	CA	95945	5390	00	06000	39.23319097	-121.0359874	Nevada County
299866	Non-Physician Medical Practitioner	None	1306089032	0	0	ELKINS, MICHAEL	4/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9400 N NAME UNO	None	GILROY	CA	95020	3528	00	06000	37.03498475	-121.5729235	Santa Clara County
299934	Non-Physician Medical Practitioner	None	1720495112	0	0	ETHERIDGE, MARCI C NP	11/6/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	11302 QUIETGROVE ROAD	None	SMYRNA	TN	37167	2986	00	06000	35.97710125	-86.57758624	Rutherford County
299940	Non-Physician Medical Practitioner	None	1144491259	0	0	EVERARDO, MEJIA PA	4/21/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11725 GARVEY AVE	STE 5B	EL MONTE	CA	91732	4534	00	06000	34.06287148	-118.02222	Los Angeles County
299953	Non-Physician Medical Practitioner	None	1932185246	0	0	EBERSOLE, KAUFFMAN D	2/17/2003	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1095 MARSHALL WAY	None	PLACERVILLE	CA	95667	5722	00	06000	38.7257686	-120.7910663	El Dorado County
300082	Non-Physician Medical Practitioner	None	1184978207	0	0	ENGLERT, KAI T PA	11/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1235 W VINE ST	None	LODI	CA	95240	5144	00	06000	38.12279179	-121.2879362	San Joaquin County
300128	Non-Physician Medical Practitioner	None	1548694938	0	0	EDELSTEIN, SHAWN M	4/28/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4262 W 1ST ST	APT 201	LOS ANGELES	CA	90004	4342	00	06000	34.07367919	-118.3046492	Los Angeles County
300195	Non-Physician Medical Practitioner	None	1215779673	0	0	EASTMAN-SMITH, MICHELLE NP	8/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19901 1ST ST	SUITE 4	HILMAR	CA	95324	9071	00	06000	37.40785823	-120.8481857	Merced County
300209	Non-Physician Medical Practitioner	None	1386345288	0	0	EVANS, DANIELLE D PA	4/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	00	06000	33.78785649	-117.8276715	Orange County
300215	Non-Physician Medical Practitioner	None	1679687719	0	0	EDWARDS, PATRICIA A PA	10/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	00	06000	37.666053	-120.996222	Stanislaus County
300225	Non-Physician Medical Practitioner	None	1346539616	0	0	EKBERG, SARAH M	7/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1146 SANTA LUCIA DR	None	PITTSBURG	CA	94565	7615	00	06000	38.01544166	-121.9628325	Contra Costa County
300229	Non-Physician Medical Practitioner	None	1780602318	0	0	EMERY, DAVID S	5/16/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26287 IRIS AVE	UNIT A	MORENO VALLEY	CA	92555	3046	00	06000	33.89240074	-117.2032809	Riverside County
300311	Non-Physician Medical Practitioner	None	1558125815	0	0	ESTRADA, OSCAR NP	11/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19042 SOLEDAD CANYON RD	A	SANTA CLARITA	CA	91351	3362	00	06000	34.4156522	-118.46848	Los Angeles County
300325	Non-Physician Medical Practitioner	None	1407206956	0	0	EWING, ANNETTE M NP	1/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 CANAL ST	None	KING CITY	CA	93930	3432	00	06000	36.20731142	-121.1325532	Monterey County
300337	Non-Physician Medical Practitioner	None	1972984870	0	0	ESSEX, TAKESHA	4/3/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
300339	Non-Physician Medical Practitioner	None	1932294568	0	0	ENGEL, PALOMA	4/11/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3317 CHANATE ROAD	SUITE 2C	SANTA ROSA	CA	95404	0000	00	06000	38.470896	-122.708889	Sonoma County
300413	Non-Physician Medical Practitioner	None	1992257778	0	0	EICHWALD, PETER NP	11/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2107 AIRPARK DR	None	REDDING	CA	96001	2433	00	06000	40.57493327	-122.4048185	Shasta County
300454	Non-Physician Medical Practitioner	None	1184796583	0	0	ENCARNACION, MARILOU C	10/24/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	DEPARTMENT OF PEDIATRICS	COLTON	CA	92324	1818	00	06000	34.073505	-117.3505995	San Bernardino County
300456	Non-Physician Medical Practitioner	None	1437617982	0	0	EDWARDS, BRITTANY CNM	7/12/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	290 N WAYTE LANE	None	FRESNO	CA	93701	2124	00	06000	36.74643429	-119.7837416	Fresno County
300557	Non-Physician Medical Practitioner	None	1437782554	0	0	EDWARDS, TAMAR M PA-C	10/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	00	06000	38.746836	-121.250529	Placer County
300679	Non-Physician Medical Practitioner	None	1982345674	0	0	ERICKSON, KATELIN PA-C	7/6/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
300724	Non-Physician Medical Practitioner	None	1619021466	0	0	ESAENWI, TAMBARI NULOG	3/3/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	401 S FAIR OAKS AVE	None	PASADENA	CA	91105	2603	00	06000	34.13887038	-118.1504485	Los Angeles County
300731	Non-Physician Medical Practitioner	None	1598256075	0	0	ENGLE, JAMIE L	11/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 NORTH PEPPER AVENUE	None	COLTON	CA	92324	1819	00	06000	34.073505	-117.3505995	San Bernardino County
300783	Non-Physician Medical Practitioner	None	1811327810	0	0	ELY, KIMBERLY A	4/4/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	122 WHITING STREET	NO 3	EL SEGUNDO	CA	90245	6004	00	06000	33.91710677	-118.4206494	Los Angeles County
300785	Non-Physician Medical Practitioner	None	1194836494	0	0	EMERSON, DIANA L NP	10/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	571 FRANCISCO ST	None	EL GRANADA	CA	94018	0000	00	06000	37.50601242	-122.4689792	San Mateo County
300944	Non-Physician Medical Practitioner	None	1144853482	0	0	ESPINUEVA, ANNE LOU D NP	11/11/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2545 S BRUCE ST	STE 200	LAS VEGAS	NV	89169	1731	00	06000	36.143271	-115.1254975	Clark County
300960	Non-Physician Medical Practitioner	None	1205096435	0	0	ELDAKAR, ELIZABETH K	2/10/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2077 PATRICIA ST	None	OXNARD	CA	93036	2720	00	06000	34.2232863	-119.1982542	Ventura County
300961	Non-Physician Medical Practitioner	None	1417015090	0	0	E, MARTINEK J	6/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5974 PENTZ RD	EMERGENCY DEPT.	PARADISE	CA	95969	5509	00	06000	39.75705992	-121.572292	Butte County
301008	Non-Physician Medical Practitioner	None	1063949550	0	0	ELLIS, KATE A	5/22/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9 OVERSEER CT	None	CHICO	CA	95928	6370	00	06000	39.73845693	-121.8072105	Butte County
301082	Non-Physician Medical Practitioner	None	1952310898	0	0	ESQUER, EDNA R NP	3/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1209 PLAZA DR	None	CALEXICO	CA	92231	3211	00	06000	32.68142343	-115.4853791	Imperial County
301086	Non-Physician Medical Practitioner	None	1174611099	0	0	EGAN, SARAH C CNM	2/6/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1135 DIAMOND AVE	None	SOUTH PASADENA	CA	91030	3113	00	06000	34.11246416	-118.1563305	Los Angeles County
301088	Non-Physician Medical Practitioner	None	1093181448	0	0	EL PROYECTO DEL BARRIO INC	2/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18250 ROSCOE BLVD	SUITE 200	NORTHRIDGE	CA	91325	4226	00	06000	34.22076142	-118.5313223	Los Angeles County
301272	Non-Physician Medical Practitioner	None	1528743697	0	0	ESCALA, GRETHEL JOY R	11/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2200 TUOLUMNE ST	None	VALLEJO	CA	94589	2523	00	06000	38.13006948	-122.2399634	Solano County
301312	Non-Physician Medical Practitioner	None	1548335672	0	0	ELIAS, STEVEN LEE	4/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27303 SLEEPY HOLLOW AVEN	None	HAYWARD	CA	94545	4203	00	06000	37.63208871	-122.0939191	Alameda County
301404	Non-Physician Medical Practitioner	None	1750975769	0	0	EMERSON, ELLEN F NP	11/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
301453	Non-Physician Medical Practitioner	None	1235188145	0	0	ESCUDERO, RONNIE J	3/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4 SANTA SOPHIA	None	RANCHO SANTA MARG	CA	92688	2671	00	06000	33.6297766	-117.6094479	Orange County
301536	Non-Physician Medical Practitioner	None	1659719599	0	0	ENCARNACION, CATHLEEN	12/31/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2272 PETRUCHIO WAY	None	ROSEVILLE	CA	95661	3223	00	06000	38.7682504	-121.2376784	Placer County
301664	Non-Physician Medical Practitioner	None	1073141180	0	0	EBILANE, KERWIN K PA	5/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24329 CRENSHAW BLVD	STE. A	TORRANCE	CA	90505	5334	00	06000	33.804612	-118.327997	Los Angeles County
301688	Non-Physician Medical Practitioner	None	1578932026	0	0	ELORTA, FLORINALE C NP	10/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	536 PIONEER DR	None	GLENDALE	CA	91203	1635	00	06000	34.15480854	-118.2662955	Los Angeles County
301709	Non-Physician Medical Practitioner	None	1619453131	0	0	EVANS, VANNESSA V NP	1/21/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	00	06000	34.19395645	-118.463265	Los Angeles County
301740	Non-Physician Medical Practitioner	None	1063452811	0	0	ELTON, SUSANNAH REAY	3/8/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	00	06000	34.12632952	-117.1956652	San Bernardino County
301821	Non-Physician Medical Practitioner	None	1942073218	0	0	ELLARD, SARAH E NP	4/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	123 ATLANTIC AVENUE	None	LONG BEACH	CA	90802	5121	00	06000	33.7685184	-118.1850803	Los Angeles County
301928	Non-Physician Medical Practitioner	None	1851046411	0	0	EZEAMAMA, CHARITY PA	9/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	800 S MAIN ST	None	CORONA	CA	92882	3420	00	06000	33.872958	-117.568359	Riverside County
301952	Non-Physician Medical Practitioner	None	1699864207	0	0	EVANS, CAROL ELAINE	4/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	00	06000	37.92699561	-122.0292732	Contra Costa County
302023	Non-Physician Medical Practitioner	None	1851673610	0	0	ELAMPARO, KAYE L NP	2/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16934 VASQUEZ WAY	92	SAN DIEGO	CA	92127	6826	00	06000	33.0222687	-117.1120368	San Diego County
302058	Non-Physician Medical Practitioner	None	1548816150	0	0	ESHRAGHI, PEGAH PA-C	12/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	760 OTAY LAKES RD	None	CHULA VISTA	CA	91910	6915	00	06000	32.64603447	-117.0015068	San Diego County
302090	Non-Physician Medical Practitioner	None	1710382833	0	0	ELLIS, ALEXANDRA K	2/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	879 TREHOWELL DR	None	ROSEVILLE	CA	95678	6128	00	06000	38.77441245	-121.2768793	Placer County
302186	Non-Physician Medical Practitioner	None	1881771897	0	0	EVILSIZOR, CHRISTY L NP	5/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	632 W GIBSON RD	None	WOODLAND	CA	95695	5169	00	06000	38.66314048	-121.794696	Yolo County
302206	Non-Physician Medical Practitioner	None	1053078295	0	0	ELMS, RUSSELL M NP	2/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4910 E ASHLAN AVENUE	SUITE 116	FRESNO	CA	93726	3020	00	06000	36.79411387	-119.7309194	Fresno County
302275	Non-Physician Medical Practitioner	None	1093284564	0	0	EATMON, CIARA L NP	1/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2904 FOWLER RD	APT B	CERES	CA	95307	2162	00	06000	37.60198684	-120.9402735	Stanislaus County
302302	Non-Physician Medical Practitioner	None	1902362155	0	0	ESCOBEDO, GADIEL A NP	5/14/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	00	06000	36.327888	-119.294919	Tulare County
302338	Non-Physician Medical Practitioner	None	1124347000	0	0	EASTER SEALS NORTHERN CALIFORNIA	2/14/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20 PIMENTEL CT STE A1	None	NOVATO	CA	94949	5656	00	06000	38.07474087	-122.5355042	Marin County
302341	Non-Physician Medical Practitioner	None	1255378410	0	0	ELIZABETH, WEISS H	5/21/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	225 NORTH JACKSON AVENUE	None	SAN JOSE	CA	95116	0000	00	06000	37.36217918	-121.8472051	Santa Clara County
302373	Non-Physician Medical Practitioner	None	1336707496	0	0	ESPINOZA, ALDO D NP	1/21/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	00	06000	34.06238259	-118.2030986	Los Angeles County
302477	Non-Physician Medical Practitioner	None	1053663476	0	0	EMBRADOR, ROSSANA	9/20/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1701 E CESAR E CHAVEZ AV	#402	LOS ANGELES	CA	90033	2464	00	06000	34.05112725	-118.2173921	Los Angeles County
302521	Non-Physician Medical Practitioner	None	1891991923	0	0	EGOLF, JOHN D NP	12/13/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	863 SUNRIVER LANE	None	REDDING	CA	96001	0169	00	06000	40.58834266	-122.4286748	Shasta County
302606	Non-Physician Medical Practitioner	None	1790271534	0	0	ESMAIL KHAN GHASRI, ROJIN NP	10/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11527 PRIVET PLACE	None	BAKERSFIELD	CA	93311	9334	00	06000	35.34265338	-119.1310253	Kern County
302640	Non-Physician Medical Practitioner	None	1801904362	0	0	EILERMAN, LISA M PA	6/17/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10251 VISTA SORRENTO PAR	SUITE 280	SAN DIEGO	CA	92121	3776	00	06000	32.89524013	-117.2142063	San Diego County
302722	Non-Physician Medical Practitioner	None	1033341722	0	0	ELIZABETH, BEGGS B	8/25/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1122 S ST STE 102	None	FRESNO	CA	93721	1430	00	06000	36.74165866	-119.7817335	Fresno County
302734	Non-Physician Medical Practitioner	None	1487278453	0	0	EVANS, JORDAN G PA	10/31/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	00	06000	33.93112671	-118.2035532	Los Angeles County
302763	Non-Physician Medical Practitioner	None	1730676040	0	0	ESCALANTE VARELA, JOSE I PA-C	10/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1071 BLOSSOM HILL RD	None	SAN JOSE	CA	95123	1103	00	06000	37.2509447	-121.8743507	Santa Clara County
302816	Non-Physician Medical Practitioner	None	1821506536	0	0	EITNER, SAMANTHA C PA	9/27/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1050 LINDEN AVE	None	LONG BEACH	CA	90813	3393	00	06000	33.78003775	-118.1866604	Los Angeles County
302924	Non-Physician Medical Practitioner	None	1477152163	0	0	ENRIQUEZ, CHRISTOPHER G NP	8/29/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4550 PANAMA LN	100	BAKERSFIELD	CA	93313	3436	00	06000	35.29597153	-119.05353	Kern County
302935	Non-Physician Medical Practitioner	None	1467834838	0	0	EDMONDS, ROBERT S	11/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	353 E BONNEVILLE AVE	APT 457	LAS VEGAS	NV	89101	6656	00	06000	36.16415675	-115.1462166	Clark County
302959	Non-Physician Medical Practitioner	None	1407203573	0	0	EAGAL, TRINA M NP	6/7/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6118 RIVERBANK CIRCLE	None	STOCKTON	CA	95219	2524	00	06000	37.99364704	-121.3659207	San Joaquin County
303011	Non-Physician Medical Practitioner	None	1790555860	0	0	ELIGIO, AUBREY MARIE NP	7/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1701 E CESAR E CHAVEZ AV	SUITE 128	LOS ANGELES	CA	90033	2464	00	06000	34.05112725	-118.2173921	Los Angeles County
303065	Non-Physician Medical Practitioner	None	1023382074	0	0	EDWARDS, LAUREN L	9/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4065 HAINES ST	None	SAN DIEGO	CA	92109	5374	00	06000	32.79314319	-117.2407737	San Diego County
303185	Non-Physician Medical Practitioner	None	1093061665	0	0	ESPARZA, LLUVIA A	12/19/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6349 SEASTONE WAY	None	SACRAMENTO	CA	95831	1145	00	06000	38.512566	-121.542003	Sacramento County
303203	Non-Physician Medical Practitioner	None	1912254418	0	0	EL DORADO COMMUNITY SERVICE CENTER	7/25/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	472 S CITRUS AVE	None	AZUSA	CA	91702	4733	00	06000	34.11482778	-117.8901388	Los Angeles County
303407	Non-Physician Medical Practitioner	None	1255619375	0	0	EL DORADO COMMUNITY SERVICE CENTER	9/20/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	609 E 18TH ST	None	BAKERSFIELD	CA	93305	5616	00	06000	35.37394083	-118.9949668	Kern County
303457	Non-Physician Medical Practitioner	None	1396067393	0	0	EVERETT, MIRANDA ESTELLE	6/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6425 LYNCH CANYON DR	None	MOUNTAIN MESA	CA	93240	9726	00	06000	35.63676438	-118.4054121	Kern County
303493	Non-Physician Medical Practitioner	None	1831595040	0	0	EBURUCHE, ANGELA	2/18/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
303519	Non-Physician Medical Practitioner	None	1477579142	0	0	ENDOZO, ROSALIE M	8/26/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9436 SLAUSON AVE	None	PICO RIVERA	CA	90660	4748	00	06000	33.96800305	-118.0956362	Los Angeles County
303561	Non-Physician Medical Practitioner	None	1790098473	0	0	ENGELHARDT, LISA MARIE	8/9/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	00	06000	34.47092468	-117.2977236	San Bernardino County
303645	Non-Physician Medical Practitioner	None	1770831521	0	0	ESTRADA, AILEEN SABIO	12/16/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 E VALENCIA MESA DR	SUITE 310	FULLERTON	CA	92835	3813	00	06000	33.89343304	-117.9279349	Orange County
303786	Non-Physician Medical Practitioner	None	1609631985	0	0	ESPIRITU, SHEYANNE	4/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18200 YORBA LINDA BLVD	SUITE 250	YORBA LINDA	CA	92886	4044	00	06000	33.88842824	-117.8154698	Orange County
303792	Non-Physician Medical Practitioner	None	1740552850	0	0	EARNHARDT, ARYN L	2/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3266 WYMAN ST	None	OAKLAND	CA	94619	3434	00	06000	37.77963802	-122.1880845	Alameda County
303823	Non-Physician Medical Practitioner	None	1285044990	0	0	EL DORADO COUNTY COMMUNITY HEALTH CENTER	12/30/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3104 PONTE MORINO DR	SUITE 110	CAMERON PARK	CA	95682	8282	00	06000	38.66304719	-120.9667044	El Dorado County
303855	Non-Physician Medical Practitioner	None	1023612637	0	0	ELORANTA, KASSI PA	10/19/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	00	06000	37.33578	-121.999329	Santa Clara County
304073	Non-Physician Medical Practitioner	None	1295999571	0	0	ESTRADA, VERONICA NP	3/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23802 PESARO	None	LAGUNA HILLS	CA	92653	1851	00	06000	33.61681272	-117.7387225	Orange County
304080	Non-Physician Medical Practitioner	None	1821245168	0	0	ESTANOL, RITA PA-C	3/2/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3000 Q STREET	4TH FLOOR	SACRAMENTO	CA	95816	7058	00	06000	38.564991	-121.4696565	Sacramento County
304084	Non-Physician Medical Practitioner	None	1386925329	0	0	EPPERSON, MARY LORIA	10/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	00	06000	40.57278686	-122.3958519	Shasta County
304143	Non-Physician Medical Practitioner	None	1467494906	0	0	EMBLAD, GILLIAN L	3/22/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2100 POWELL ST STE 920	None	EMERYVILLE	CA	94608	1844	00	06000	37.83953006	-122.2990736	Alameda County
304207	Non-Physician Medical Practitioner	None	1659548980	0	0	ELLISON, DENISE M CNM	6/10/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12104 ALDER GROVE ST	None	MOORPARK	CA	93021	3125	00	06000	34.26464721	-118.8932163	Ventura County
304235	Non-Physician Medical Practitioner	None	1003067141	0	0	ECHETA, ALICE CHINYERE	2/25/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	125 W F ST STE 103	None	ONTARIO	CA	91762	3262	00	06000	34.069302	-117.652158	San Bernardino County
304282	Non-Physician Medical Practitioner	None	1285046847	0	0	EAST VALLEY COMMUNITY HEALTH CENTER, INC.	3/3/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	276 WEST COLLEGE STREET	None	COVINA	CA	91723	1902	00	06000	34.08747441	-117.8941951	Los Angeles County
304294	Non-Physician Medical Practitioner	None	1023611100	0	0	ESAKI, ERIN E PA-C	8/11/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 TAYLOR	202	PLEASANT HILL	CA	94523	2147	00	06000	37.96132631	-122.0740275	Contra Costa County
304313	Non-Physician Medical Practitioner	None	1790427995	0	0	ENRIQUEZ, MARIA CRISTINA NP	7/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1850 W. FLORIDA AVE.	None	HEMET	CA	92545	6738	00	06000	33.74751552	-116.991432	Riverside County
304330	Non-Physician Medical Practitioner	None	1952870115	0	0	ESQUIVEL, CHRISTIE PA-C	5/4/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 W BASTANCHURY RD	220	FULLERTON	CA	92835	3424	00	06000	33.89397383	-117.9316737	Orange County
304335	Non-Physician Medical Practitioner	None	1477670750	0	0	ESCOBAR, OSCAR A	5/28/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5970 S CENTRAL AVE	None	LOS ANGELES	CA	90001	1150	00	06000	33.985584	-118.256433	Los Angeles County
304347	Non-Physician Medical Practitioner	None	1215365408	0	0	EFUETNGU, ERIC NP	11/15/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1123 NORTH TRUDY AVE	None	RIALTO	CA	92376	3282	00	06000	34.12046093	-117.3804426	San Bernardino County
304357	Non-Physician Medical Practitioner	None	1447872072	0	0	ESPINAL, MARIE N PA	7/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2829 WATT AVENUE	None	SACRAMENTO	CA	95821	6237	00	06000	38.615247	-121.383558	Sacramento County
304390	Non-Physician Medical Practitioner	None	1194305649	0	0	ELANGOVAN, KAVITHA NP	7/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
304414	Non-Physician Medical Practitioner	None	1487689865	0	0	ESMAILIAN, YVONNE A	11/19/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	SUITE 1000	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
304582	Non-Physician Medical Practitioner	None	1902364896	0	0	ELAD, JENNIFER B NP	3/3/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
304658	Non-Physician Medical Practitioner	None	1659193720	0	0	EZE, CRYSTAL	2/6/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2505 W HAMMER LN	None	STOCKTON	CA	95209	2839	00	06000	38.02139448	-121.347738	San Joaquin County
304727	Non-Physician Medical Practitioner	None	1083246623	0	0	ESTRADA, MILINDA C PA	5/18/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1835 SUNNYCREST DR	None	FULLERTON	CA	92835	3616	00	06000	33.89224326	-117.9312781	Orange County
304763	Non-Physician Medical Practitioner	None	1134999220	0	0	EGAL, ZAHRA NP	5/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
304775	Non-Physician Medical Practitioner	None	1366833840	0	0	ELDRIDGE, CRAIG M PA	3/12/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2340 CLAY ST	5TH FLOOR	SAN FRANCISCO	CA	94115	1932	00	06000	37.79101969	-122.43208	San Francisco County
304786	Non-Physician Medical Practitioner	None	1285292771	0	0	ESCUETA, AIDA NP	6/21/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	330 E. YOSEMITE AVE	STE 101	MERCED	CA	95340	9165	00	06000	37.33209853	-120.465324	Merced County
304796	Non-Physician Medical Practitioner	None	1689006819	0	0	ELLEDGE, HEATHER H	6/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1507 S WOLFE RD	None	SUNNYVALE	CA	94087	4854	00	06000	37.34442749	-122.0142519	Santa Clara County
304834	Non-Physician Medical Practitioner	None	1427650852	0	0	ESTOQUE, LIGAYA PA-C	6/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
304872	Non-Physician Medical Practitioner	None	1043503659	0	0	ECKHOFF, STEVEN A	3/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	11662 W ARLEN ST	None	BOISE	ID	83713	1505	00	06000	43.65248146	-116.327718	Ada County
304955	Non-Physician Medical Practitioner	None	1598159808	0	0	ESPITIA, ANA E NP	8/14/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 TRANCAS ST	STE 350	NAPA	CA	94558	2959	00	06000	38.32316569	-122.2981938	Napa County
305009	Non-Physician Medical Practitioner	None	1811467756	0	0	EADINGTON PILE, KATYA NP	1/21/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
305019	Non-Physician Medical Practitioner	None	1508270273	0	0	ESKIN, ALEXANDRA NP	3/3/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5243 YARMOUTH AVE	STE 35	ENCINO	CA	91316	3136	00	06000	34.16640417	-118.5202959	Los Angeles County
305036	Non-Physician Medical Practitioner	None	1477980639	0	0	ESCOBEDO, LIZBETH	10/7/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3063 W CHAPMAN AVE	2348	ORANGE	CA	92868	1763	00	06000	33.78817418	-117.884395	Orange County
305087	Non-Physician Medical Practitioner	None	1972132108	0	0	ENG, KRISTEN J PA-C	8/24/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39650 LIBERTY ST	STE 310	FREMONT	CA	94358	2227	00	06000	37.54662058	-121.9736002	Alameda County
305097	Non-Physician Medical Practitioner	None	1316307796	0	0	EMFIELD, MARY JO L PA-C	4/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	00	06000	33.93112671	-118.2035532	Los Angeles County
305124	Non-Physician Medical Practitioner	None	1922318781	0	0	ESPARZA, ERIC A	11/9/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	34316 BLOSSOM DRIVE	None	LAKE ELSINORE	CA	92532	2926	00	06000	33.66710792	-117.2394767	Riverside County
305198	Non-Physician Medical Practitioner	None	1538787239	0	0	EFUETNGU, MAVIS NP	2/2/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15431 ANACAPA RD	STE D	VICTORVILLE	CA	92392	2458	00	06000	34.50544107	-117.3250832	San Bernardino County
305207	Non-Physician Medical Practitioner	None	1912777418	0	0	ESCOBAR, ALEXANDER M PA-C	8/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	604 N MAGNOLIA AVE	100	CLOVIS	CA	93611	9204	00	06000	36.83939464	-119.6661479	Fresno County
305270	Non-Physician Medical Practitioner	None	1942311055	0	0	ELIZABETH, OBRIEN	4/19/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	00	06000	33.02257788	-117.0856332	San Diego County
305277	Non-Physician Medical Practitioner	None	1073598355	0	0	ERICKSON, MITCHELL PA	11/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	00	06000	32.781483	-117.007182	San Diego County
305387	Non-Physician Medical Practitioner	None	1184273617	0	0	ELLINGSON HIPOLITO, CHELSEA PA	4/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	00	06000	33.03623896	-117.2837308	San Diego County
305407	Non-Physician Medical Practitioner	None	1164596920	0	0	ESQUIVEL, JILL HOWIE	8/30/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1440 168TH AVE	None	SAN LEANDRO	CA	94578	2409	00	06000	37.69267082	-122.1070241	Alameda County
305417	Non-Physician Medical Practitioner	None	1003379959	0	0	EZENWA, KENNETH NP	4/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1656 W AVENUE J	None	LANCASTER	CA	93534	2814	00	06000	34.6893627	-118.1604668	Los Angeles County
305467	Non-Physician Medical Practitioner	None	1922511187	0	0	EVERETT, COREY H NP	4/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	00	06000	33.912117	-117.195849	Riverside County
305534	Non-Physician Medical Practitioner	None	1215366570	0	0	ESQUIVEL, MARIO	11/14/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13553 DEVONSHIRE LANE	None	CHINO	CA	91710	5379	00	06000	34.00728149	-117.6708978	San Bernardino County
305539	Non-Physician Medical Practitioner	None	1720384993	0	0	EDWARDS, BRIAN G NP	12/19/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1232 STRATTON DRIVE	None	DAYTON	NV	89403	1200	00	06000	39.294387	-119.513112	Lyon County
305595	Non-Physician Medical Practitioner	None	1720693682	0	0	ELIZAGA, CHANTAL PA-C	3/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4312 WOODMAN AVENUE	SUITE 102	SHERMAN OAKS	CA	91423	5546	00	06000	34.148637	-118.4312035	Los Angeles County
305615	Non-Physician Medical Practitioner	None	1083342307	0	0	ELLABOUDY, ANGIE NP	3/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26700 TOWNE CENTRE DR	SUITE 150	FOOTHILL RANCH	CA	92610	2845	00	06000	33.67455886	-117.6639195	Orange County
305706	Non-Physician Medical Practitioner	None	1225157852	0	0	ELLIOT, JASON A PA	7/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1886 NOBLE LN	None	TURLOCK	CA	95380	2287	00	06000	37.5112279	-120.8698083	Stanislaus County
305712	Non-Physician Medical Practitioner	None	1447032842	0	0	EDWARDS, AUBREE PA	1/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4234 RIVERWALK PKWY	SUITE 230	RIVERSIDE	CA	92505	3312	00	06000	33.90290859	-117.4941562	Riverside County
305717	Non-Physician Medical Practitioner	None	1780831909	0	0	EASTER, THOMAS D	5/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31397 ERIE RD	None	COARSEGOLD	CA	93614	9258	00	06000	37.205226	-119.674926	Madera County
305728	Non-Physician Medical Practitioner	None	1740874510	0	0	ERICSON, JENNIFER PA-C	3/5/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	6004	00	06000	38.571084	-121.471074	Sacramento County
305816	Non-Physician Medical Practitioner	None	1720387574	0	0	EVELYN, LOPEZ	9/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	430 W BADILLO ST	None	COVINA	CA	91723	1829	00	06000	34.08628272	-117.8976273	Los Angeles County
305889	Non-Physician Medical Practitioner	None	1336845007	0	0	EBALOBOR, STEVEN J PA-C	5/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1798 N GAREY AVE	None	POMONA	CA	91767	2918	00	06000	34.076894	-117.7522688	Los Angeles County
305900	Non-Physician Medical Practitioner	None	1053664912	0	0	EPPS, TIFFANY LA NETTE	12/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
305932	Non-Physician Medical Practitioner	None	1679716914	0	0	ERKKILA, KYLE	11/21/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1139 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	00	06000	38.91323462	-119.9965999	El Dorado County
306029	Non-Physician Medical Practitioner	None	1689013559	0	0	ENTROPO, MAIA NP	1/24/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1505 SOQUEL DR	STE 1	SANTA CRUZ	CA	95065	1716	00	06000	36.98803429	-121.9848045	Santa Cruz County
306179	Non-Physician Medical Practitioner	None	1053575746	0	0	EDLY, KIRT L PA	4/19/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39000 BOB HOPE DR	HARRY & DIANE RINKER BUI	RANCHO MIRAGE	CA	92270	3221	00	06000	33.763572	-116.4056895	Riverside County
306195	Non-Physician Medical Practitioner	None	1336246438	0	0	ELDRIDGE, CHERYL L	12/31/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4408 VIEW STREET	None	OAKLAND	CA	94611	4722	00	06000	37.83167377	-122.2502096	Alameda County
306216	Non-Physician Medical Practitioner	None	1255996658	0	0	EYONG, AGNES	6/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
306232	Non-Physician Medical Practitioner	None	1821048083	0	0	ESTRELLA, JENNIFER L	11/9/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11480 BROOKSHIRE AVE	SUITE 111	DOWNEY	CA	90241	5010	00	06000	33.93622932	-118.1311752	Los Angeles County
306390	Non-Physician Medical Practitioner	None	1417013681	0	0	EMBLEN, CIRRE NP	7/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5308 CAMELLIA AVE	None	SACRAMENTO	CA	95819	1716	00	06000	38.576403	-121.432752	Sacramento County
306442	Non-Physician Medical Practitioner	None	1093974065	0	0	ELICA HEALTH CENTERS	2/25/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3701 J STREET	SUITE 201	SACRAMENTO	CA	95816	0000	00	06000	38.571237	-121.4566245	Sacramento County
306493	Non-Physician Medical Practitioner	None	1457743759	0	0	ENGLAND, SAMUEL P	5/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	535 BELLA OAKS COURT	None	SPARKS	NV	89441	7291	00	06000	39.64715452	-119.6826316	Washoe County
306730	Non-Physician Medical Practitioner	None	1194952853	0	0	ELFTMAN, SUSAN N PA	1/26/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	700 W 19TH ST	None	COSTA MESA	CA	92627	3517	00	06000	33.64342564	-117.9280911	Orange County
306746	Non-Physician Medical Practitioner	None	1821632209	0	0	ESPINOZA, AGUEDA PA	12/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	317 WEST PUEBLO ST	None	SANTA BARBARA	CA	93105	4365	00	06000	34.42967671	-119.7228362	Santa Barbara County
306795	Non-Physician Medical Practitioner	None	1063955011	0	0	EMERDELLO, KATHLEEN D	1/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	00	06000	37.53039072	-122.2987772	San Mateo County
306832	Non-Physician Medical Practitioner	None	1730925074	0	0	ELIZARDE, ALJO BATIN NP	7/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4550 VAN NUYS BLVD	STE A4	SHERMAN OAKS	CA	91403	2844	00	06000	34.154658	-118.4486715	Los Angeles County
306913	Non-Physician Medical Practitioner	None	1053905901	0	0	EMEAHU, MITCHELL C	3/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2251 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	0000	00	06000	35.38868165	-118.9673556	Kern County
306929	Non-Physician Medical Practitioner	None	1194065060	0	0	EATON, WILLIAM J PA-C	6/17/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	74785 HIGHWAY 111	SUITE 100	INDIAN WELLS	CA	92210	7129	00	06000	33.72131925	-116.360116	Riverside County
306991	Non-Physician Medical Practitioner	None	1023411949	0	0	EVJE, TIMOTHY K	10/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	83734 ANDES CT	None	INDIO	CA	92203	4035	00	06000	33.74077708	-116.2040446	Riverside County
306993	Non-Physician Medical Practitioner	None	1841694189	0	0	EDWIN, BINDU L NP	7/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	00	06000	37.36797679	-122.0297112	Santa Clara County
307006	Non-Physician Medical Practitioner	None	1245600568	0	0	EDISON, BRIAN E	11/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26871 ALESSANDRO BLVD	SPC 35	MORENO VALLEY	CA	92555	3908	00	06000	33.914754	-117.1929015	Riverside County
307077	Non-Physician Medical Practitioner	None	1881175461	0	0	ELISHA, HADDAS S	9/24/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	718 LONG BRIDGE	STE 321	SAN FRANCISCO	CA	94158	2448	00	06000	37.77155378	-122.3939135	San Francisco County
307145	Non-Physician Medical Practitioner	None	1720048903	0	0	EMOND, FELIX D	5/9/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2575 E BIDWELL ST	STE 250	FOLSOM	CA	95630	6444	00	06000	38.658888	-121.1303835	Sacramento County
307151	Non-Physician Medical Practitioner	None	1538553128	0	0	ELHOFY, SUSAN N PA	9/12/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5600 CALIFORNIA AVE	STE 101	BAKERSFIELD	CA	93309	1614	00	06000	35.356203	-119.0612695	Kern County
307153	Non-Physician Medical Practitioner	None	1083845705	0	0	EVANS, JASON E NP	4/7/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	175 QUIVERA LANE	None	SPARKS	NV	89441	7272	00	06000	39.69393699	-119.6370498	Washoe County
307227	Non-Physician Medical Practitioner	None	1841355823	0	0	EPPS, KATHLEEN MCDAVID	12/17/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3555 WHIPPLE RD BLDG A	None	UNION CITY	CA	94587	1507	00	06000	37.60574038	-122.0836254	Alameda County
307261	Non-Physician Medical Practitioner	None	1639573801	0	0	EPPERSON, FRANCES E PA-C	5/15/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5400 W HILLSDALE AVE	None	VISALIA	CA	93291	6238	00	06000	36.330327	-119.351943	Tulare County
307281	Non-Physician Medical Practitioner	None	1780043224	0	0	EGWU, JOY O NP	6/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1640 227TH	APT 1	TORRANCE	CA	90501	6632	00	06000	33.82015018	-118.3078512	Los Angeles County
307518	Non-Physician Medical Practitioner	None	1639889488	0	0	ESCANO, JUSTINE A NP	2/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
307546	Non-Physician Medical Practitioner	None	1831635168	0	0	EWENS, DONALD G III	2/9/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7331 SHELBY PLACE	APT 141	RANCHO CUCAMONGA	CA	91739	5914	00	06000	34.119828	-117.51759	San Bernardino County
307606	Non-Physician Medical Practitioner	None	1821696576	0	0	ESPOSITO, COLLEEN M PA-C	11/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7500 HOSPITAL DRIVE	None	SACRAMENTO	CA	95823	5403	00	06000	38.463381	-121.416183	Sacramento County
307632	Non-Physician Medical Practitioner	None	1508973199	0	0	ESTRADA, DOREENA A	7/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1599 W TEDMAR AVE	None	ANAHEIM	CA	92802	1340	00	06000	33.82676484	-117.9362161	Orange County
307678	Non-Physician Medical Practitioner	None	1932267150	0	0	ELLINGSON, SANDRA L	7/12/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON BLVD	DAVIS 5	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
307750	Non-Physician Medical Practitioner	None	1801662168	0	0	EICHINGER, LAURA NP	10/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1144 65TH ST STE F	None	OAKLAND	CA	94608	1053	00	06000	37.84779018	-122.2868874	Alameda County
307751	Non-Physician Medical Practitioner	None	1588202493	0	0	ELDRIDGE, JOSEPH C NP	1/30/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	06000	36.1590063	-115.1674415	Clark County
307756	Non-Physician Medical Practitioner	None	1316608029	0	0	ENNIS, MEGAN A NP	4/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	00	06000	34.069509	-118.383743	Los Angeles County
307768	Non-Physician Medical Practitioner	None	1376881250	0	0	EARLY, BONNIE PA-C	4/4/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2121 3RD STREET	None	SAN FRANCISCO	CA	94107	3659	00	06000	37.76269444	-122.388628	San Francisco County
307951	Non-Physician Medical Practitioner	None	1518737089	0	0	ELLIOTT, LEAH E CNM	3/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	00	06000	35.39052148	-119.0070765	Kern County
307957	Non-Physician Medical Practitioner	None	1780763847	0	0	ENRIGHT, RITA L	4/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2025 MORSE AVE	#5900	SACRAMENTO	CA	95825	2115	00	06000	38.602089	-121.3925895	Sacramento County
308102	Non-Physician Medical Practitioner	None	1336511476	0	0	ESPARZA, CARLOS J A NP	6/29/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5405 HARMONY GREEN DR	UNIT 201	LAS VEGAS	NV	89149	0365	00	06000	36.26111857	-115.2622122	Clark County
308194	Non-Physician Medical Practitioner	None	1407303639	0	0	EARL, TREVOR M	12/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	820 W G ST	APT 157	SAN DIEGO	CA	92101	5934	00	06000	32.71254923	-117.1704779	San Diego County
308278	Non-Physician Medical Practitioner	None	1134834310	0	0	ELLIS, TYLER PA-C	5/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4312 WOODMAN AVENUE	SUITE 102	SHERMAN OAKS	CA	91423	5546	00	06000	34.148637	-118.4312035	Los Angeles County
308313	Non-Physician Medical Practitioner	None	1558021832	0	0	ELLAMIL-LEJARDE, DONNA PA-C	1/20/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	81715 DR CARREON BLVD	None	INDIO	CA	92201	5564	00	06000	33.7073825	-116.2385415	Riverside County
308332	Non-Physician Medical Practitioner	None	1902059629	0	0	ESQUEDA, FABIAN	2/3/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13307 SAN ANTONIO DR	None	NORWALK	CA	90650	2970	00	06000	33.91001328	-118.0753281	Los Angeles County
308448	Non-Physician Medical Practitioner	None	1942812029	0	0	ELSASSER, EMMA C	4/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	900 S MAIN ST	STE 108	CORONA	CA	92882	3401	00	06000	33.87190191	-117.5669613	Riverside County
308475	Non-Physician Medical Practitioner	None	1417511445	0	0	ERMITUS, WITHMAN J PA	9/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	00	06000	37.66508443	-120.9962589	Stanislaus County
308510	Non-Physician Medical Practitioner	None	1386912202	0	0	EAST VALLEY COMMUNITY HEALTH CENTER, INC.	9/27/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17840 VILLA CORTA ST	None	LA PUENTE	CA	91744	5342	00	06000	34.01804501	-117.9119303	Los Angeles County
308662	Non-Physician Medical Practitioner	None	1033779269	0	0	EGAN, TIMOTHY J PA	10/7/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 MARSHALL WAY	None	PLACERVILLE	CA	95667	6533	00	06000	38.72453536	-120.7921649	El Dorado County
308695	Non-Physician Medical Practitioner	None	1558668772	0	0	EUGENIO, JENNA L	4/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5207 LA CUMBRE AVE	None	RIVERSIDE	CA	92505	2572	00	06000	33.92454958	-117.4946082	Riverside County
308709	Non-Physician Medical Practitioner	None	1528666740	0	0	EGAN, SCHEREZADE PA	8/4/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	41540 WINCHESTER	None	TEMECULA	CA	92590	4877	00	06000	33.52069117	-117.1653103	Riverside County
308740	Non-Physician Medical Practitioner	None	1497457238	0	0	EVANSON, SABRINA C PA-C	8/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	00	06000	34.06287152	-118.2029433	Los Angeles County
308769	Non-Physician Medical Practitioner	None	1548989650	0	0	ENNIS, MELISSA C NP	4/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7300 MEDICAL CENTER DR.	None	WEST HILLS	CA	91307	1902	00	06000	34.20289797	-118.6294006	Los Angeles County
308833	Non-Physician Medical Practitioner	None	1013458561	0	0	EDMOND, WENDY P NP	5/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
308842	Non-Physician Medical Practitioner	None	1023628120	0	0	EDANO, ALLYN M NP	10/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	00	06000	34.06238259	-118.2030986	Los Angeles County
308880	Non-Physician Medical Practitioner	None	1962688762	0	0	EVANS, ELIZABETH NP	3/15/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	655 VIA MIRA VALLE	None	NIPOMO	CA	93444	9327	00	06000	35.01259956	-120.5196882	San Luis Obispo County
308908	Non-Physician Medical Practitioner	None	1508219718	0	0	ESKANDR, JAQUOLIN NP	1/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18021 SKY PARK CIRCLE	STE G	IRVINE	CA	92614	6569	00	06000	33.68904995	-117.8542045	Orange County
308920	Non-Physician Medical Practitioner	None	1134817166	0	0	EZE, PASCAL	9/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
308929	Non-Physician Medical Practitioner	None	1922588151	0	0	ERICKSON, NATASHA C PA	8/5/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
308944	Non-Physician Medical Practitioner	None	1558361733	0	0	ESPINOZA, DEBORAH A	1/24/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	343 SOQUEL AVE	STE 164	SANTA CRUZ	CA	95062	2355	00	06000	36.97442198	-122.019445	Santa Cruz County
308984	Non-Physician Medical Practitioner	None	1376797803	0	0	EVANS, NANCY GOEBEL	1/28/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3883 AIRWAY DR STE 165	SUITE 3	SANTA ROSA	CA	95403	1675	00	06000	38.483226	-122.739705	Sonoma County
309064	Non-Physician Medical Practitioner	None	1922399609	0	0	EMANUEL, RICH F NP	1/8/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16633 SOLANA LN	None	CANYON CNTRY	CA	91351	1433	00	06000	34.45767039	-118.4265609	Los Angeles County
309177	Non-Physician Medical Practitioner	None	1881752392	0	0	EDWARDS, CARLOS PA	10/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	00	06000	33.969141	-118.0489095	Los Angeles County
309216	Non-Physician Medical Practitioner	None	1104410273	0	0	EBBERTT, JENNIFER	7/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	06000	36.180999	-115.3174815	Clark County
309326	Non-Physician Medical Practitioner	None	1497838924	0	0	ENUNWA, RITA O	1/26/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2210 E ILLINOIS AVE	406	FRESNO	CA	93701	2125	00	06000	36.74500687	-119.7846885	Fresno County
309408	Non-Physician Medical Practitioner	None	1902130842	0	0	ESANI, TIARA CHRISTINE	11/30/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	277 RANCHEROS DRIVE, SUI	None	SAN MARCOS	CA	92069	0000	00	06000	33.13859391	-117.1604009	San Diego County
309443	Non-Physician Medical Practitioner	None	1477576502	0	0	ESPICHA, PATRICIA A NP	12/31/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3716 ROXBURY LANE	None	HAYWARD	CA	94542	1735	00	06000	37.66136754	-122.0359095	Alameda County
309463	Non-Physician Medical Practitioner	None	1487330999	0	0	ELSIR, YOUSRA PA	7/25/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
309561	Non-Physician Medical Practitioner	None	1972839462	0	0	ELLSTROM, JENNIFER A NP	10/4/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	00	06000	33.94354395	-117.394926	Riverside County
309605	Non-Physician Medical Practitioner	None	1013328566	0	0	ENTSMINGER, NICHOLAS N	7/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	33694 STATE HIGHWAY 36	None	BRIDGEVILLE	CA	95526	9528	00	06000	40.450779	-123.6970755	Humboldt County
309698	Non-Physician Medical Practitioner	None	1386169415	0	0	EUREK, HATIFA Y PA-C	9/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
309756	Non-Physician Medical Practitioner	None	1952950263	0	0	EVANS, JENNIFER A NP	1/17/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2890 LA LOMA DR	None	RANCHO CORDOVA	CA	95670	3308	00	06000	38.584512	-121.3140375	Sacramento County
309911	Non-Physician Medical Practitioner	None	1235190299	0	0	ESTRADA, EDWARD PAUL	5/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2205 W. BEVERLY BOULEVAR	None	MONTEBELLO	CA	90640	0000	00	06000	34.02075854	-118.1232344	Los Angeles County
309956	Non-Physician Medical Practitioner	None	1467064436	0	0	ESTERON, JOMELYN F NP	1/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	729 SUNRISE AVE	SUITE 602	ROSEVILLE	CA	95661	4542	00	06000	38.73444822	-121.2720033	Placer County
310032	Non-Physician Medical Practitioner	None	1225110836	0	0	EDMONDS, WILLIAM H.	4/17/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
310213	Non-Physician Medical Practitioner	None	1316148885	0	0	ESPINOSA DE LOS MONTEROS, RENALDO L	7/27/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11725 GARVEY AVE	SUITE 5B	EL MONTE	CA	91732	4534	00	06000	34.06287148	-118.02222	Los Angeles County
310270	Non-Physician Medical Practitioner	None	1417235706	0	0	ESPINOSA, SANDRA L NP	10/12/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6119 SOUTHWIND DRIVE	None	WHITTIER	CA	90601	3838	00	06000	33.98737613	-118.0206222	Los Angeles County
310285	Non-Physician Medical Practitioner	None	1073981783	0	0	EL DORADO COUNTY COMMUNITY HEALTH CENTER	1/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3100 PONTE MORINO DR	SUITE 120	CAMERON PARK	CA	95682	7432	00	06000	38.66252014	-120.9672091	El Dorado County
310317	Non-Physician Medical Practitioner	None	1841625712	0	0	ESCALANTE-ALVIZ, JOANN E	2/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7411 EDINGER AVE	APT 416	HUNTINGTON BEACH	CA	92647	7839	00	06000	33.73021177	-117.9999219	Orange County
310343	Non-Physician Medical Practitioner	None	1902570351	0	0	ESQUER, KAITLYN	5/28/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10590 TOWN CENTER DR	170	RANCHO CUCAMONGA	CA	91730	0360	00	06000	34.11101693	-117.5740616	San Bernardino County
310357	Non-Physician Medical Practitioner	None	1780915678	0	0	ELMESEWDY, DINAH	5/10/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	00	06000	38.12188356	-121.285872	San Joaquin County
310422	Non-Physician Medical Practitioner	None	1033734900	0	0	ELLIOTT, KIMBERLY A NP	7/8/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1662 DOMINICAN WAY	None	SANTA CRUZ	CA	95065	1816	00	06000	36.99033079	-121.9816507	Santa Cruz County
310435	Non-Physician Medical Practitioner	None	1861851396	0	0	EDMONSON, AMANDA A	5/17/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	141 MOUNTAIN VALLEY ST	None	OAKLAND	CA	94605	4615	00	06000	37.76931219	-122.1307712	Alameda County
310503	Non-Physician Medical Practitioner	None	1073809893	0	0	ESCOBAR, PEDRO ARCENIO	7/25/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	555 6TH ST	None	ORANGE COVE	CA	93646	2136	00	06000	36.62528929	-119.3124175	Fresno County
310543	Non-Physician Medical Practitioner	None	1851643399	0	0	EYSTER, MEAGAN A NP	2/8/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	00	06000	39.33573744	-120.180872	Nevada County
310701	Non-Physician Medical Practitioner	None	1679587307	0	0	ENGLER, CONSTANCE MARIE	10/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	515 MAPLE AVE	None	SAN BRUNO	CA	94066	4147	00	06000	37.61972972	-122.4213235	San Mateo County
310705	Non-Physician Medical Practitioner	None	1104276732	0	0	ELISE, NICOLE NP	11/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9888 GENESEE	None	LA JOLLA	CA	92037	1205	00	06000	32.8865608	-117.2250386	San Diego County
310716	Non-Physician Medical Practitioner	None	1447763867	0	0	ELY, RACHEL E CNM	4/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	270 AUDUBON CIR	None	SACRAMENTO	CA	95831	2972	00	06000	38.498886	-121.5560835	Sacramento County
310830	Non-Physician Medical Practitioner	None	1578325023	0	0	ELLIOTT, CHRISTIAN PA	4/2/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	47111 MONROE ST	None	INDIO	CA	92201	6739	00	06000	33.70620698	-116.2339008	Riverside County
310843	Non-Physician Medical Practitioner	None	1841061470	0	0	ESTRADA, ROMELDA C NP	2/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3660 PARK SIERRA DR	208	RIVERSIDE	CA	92501	1768	00	06000	33.90330693	-117.4707039	Riverside County
310845	Non-Physician Medical Practitioner	None	1720632847	0	0	EMPENO, KIMBERLY NP	10/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1908 SWEETWATER RD	None	NATIONAL CITY	CA	91950	7628	00	06000	32.66119079	-117.0786584	San Diego County
310912	Non-Physician Medical Practitioner	None	1669534970	0	0	EBBECKE, PATRICIA J NP	9/10/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14185 HOPI RD	None	APPLE VALLEY	CA	92307	5716	00	06000	34.50933443	-117.206951	San Bernardino County
310975	Non-Physician Medical Practitioner	None	1427825769	0	0	EARLY, LYNNE M NP	2/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	540 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4230	00	06000	34.42739162	-119.7253175	Santa Barbara County
310977	Non-Physician Medical Practitioner	None	1568871143	0	0	EL PROYECTO DEL BARRIO,INC	12/21/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9140 VAN NUYS BLVD	SUITE 207	PANORAMA CITY	CA	91402	6727	00	06000	34.236603	-118.4502215	Los Angeles County
310985	Non-Physician Medical Practitioner	None	1396485561	0	0	ESTRADA, ROCIO PA	10/31/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
310991	Non-Physician Medical Practitioner	None	1326194333	0	0	EVANS-CLAASSEN, DESIREE M	3/17/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	818 VIVA CT	None	SOLANA BEACH	CA	92075	2465	00	06000	32.98439928	-117.257837	San Diego County
311032	Non-Physician Medical Practitioner	None	1689087892	0	0	EJAZ, EHSAN PA	9/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	130 LA CASA VIA	3-111	WALNUT CREEK	CA	94598	3045	00	06000	37.91175467	-122.0414101	Contra Costa County
311064	Non-Physician Medical Practitioner	None	1306246772	0	0	ECKERT, KIRSTEN E CNM	12/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1118 NORTH ST	None	SANTA ROSA	CA	95404	3551	00	06000	38.449656	-122.7077415	Sonoma County
311110	Non-Physician Medical Practitioner	None	1114074374	0	0	EMERY, JANET EVANS	1/10/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	800 N STATE COLLEGE BLVD	None	FULLERTON	CA	92831	3547	00	06000	33.879987	-117.886086	Orange County
311175	Non-Physician Medical Practitioner	None	1962666990	0	0	ELIZABETH, DELGADILLO M	3/3/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2801 L ST	None	SACRAMENTO	CA	95816	5615	00	06000	38.57202	-121.4692695	Sacramento County
311223	Non-Physician Medical Practitioner	None	1891252334	0	0	EVERETT, ERICA PA	4/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	00	06000	34.13998921	-118.7070142	Los Angeles County
311313	Non-Physician Medical Practitioner	None	1295243863	0	0	EWELL, ZACHARY T PA-C	12/11/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 OLD RIVER ROAD	None	BAKERSFIELD	CA	93311	9781	00	06000	35.351487	-119.1143025	Kern County
311342	Non-Physician Medical Practitioner	None	1225548886	0	0	ESCOBEDO, NACHELL T	6/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
311505	Non-Physician Medical Practitioner	None	1548425853	0	0	ELICA HEALTH CENTERS	2/25/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	155 15TH ST	SUITE A	WEST SACRAMENTO	CA	95691	3737	00	06000	38.57104661	-121.5260133	Yolo County
311524	Non-Physician Medical Practitioner	None	1104251065	0	0	ECHEVERRIA, LETTY S	11/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5010 W WAGNER AVE	None	VISALIA	CA	93277	5611	00	06000	36.311013	-119.346372	Tulare County
311594	Non-Physician Medical Practitioner	None	1710609706	0	0	EVANS, JESSICA M NP	1/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	00	06000	36.74333844	-119.7831874	Fresno County
311606	Non-Physician Medical Practitioner	None	1356541031	0	0	ELIZONDO, ARACELI M	1/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1850 DEL PASO AVE	None	LOS ANGELES	CA	90032	3836	00	06000	34.06461519	-118.183037	Los Angeles County
311665	Non-Physician Medical Practitioner	None	1144766890	0	0	EDWARDS, BRIANNA V NP	7/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1208 W WHISPERING PINES	None	VISALIA	CA	93277	4676	00	06000	36.318024	-119.30436	Tulare County
311805	Non-Physician Medical Practitioner	None	1295441624	0	0	EMERUEH, ESTHER NP	2/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	191 E ALESSANDRO BLVD	9A	RIVERSIDE	CA	92508	5095	00	06000	33.91628074	-117.3284633	Riverside County
311842	Non-Physician Medical Practitioner	None	1285016394	0	0	EDDY, WYATT R	7/24/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	861 S DESERT CANYON WAY	None	KINGMAN	AZ	86401	4385	00	06000	35.173215	-113.9807925	Mohave County
311900	Non-Physician Medical Practitioner	None	1427469386	0	0	EL DORADO COMMUNITY SERVICE CENTER	11/21/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21619 NORWALK BLVD	None	HAWAIIAN GARDENS	CA	90716	1123	00	06000	33.83264348	-118.0720753	Los Angeles County
311967	Non-Physician Medical Practitioner	None	1336489814	0	0	ESPOSO, WILFRENGERARD P	4/29/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4501 X ST	2ND FLOOR	SACRAMENTO	CA	95817	2229	00	06000	38.553822	-121.452822	Sacramento County
311990	Non-Physician Medical Practitioner	None	1023277589	0	0	EVANS, ANNA C NP	5/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	615 CANYON DRIVE	None	GLENDALE	CA	91206	2611	00	06000	34.15470077	-118.2341086	Los Angeles County
312006	Non-Physician Medical Practitioner	None	1154706562	0	0	EZE, IJEOMA S NP	12/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1823 EAST DENWELL DRIVE	None	CARSON	CA	90746	2935	00	06000	33.84731067	-118.2373236	Los Angeles County
312060	Non-Physician Medical Practitioner	None	1922432954	0	0	ELARMO, ROSALYN M R NP	5/12/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5660 DANVILLE COURT	None	CHINO HILLS	CA	91709	8790	00	06000	33.96406153	-117.6820692	San Bernardino County
312110	Non-Physician Medical Practitioner	None	1235647298	0	0	ESPOSO, ALICIA-JAY NP	5/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12 CAMINO ENCINAS	None	ORINDA	CA	94563	3304	00	06000	37.87679015	-122.1800856	Contra Costa County
312144	Non-Physician Medical Practitioner	None	1831389477	0	0	ESNAASHARI, NASRIN	10/19/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	SUITE 3000	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
312158	Non-Physician Medical Practitioner	None	1659678712	0	0	ESQUIVEL-ACOSTA, JAVIER	7/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1066 S WHITE RD	SUITE 170	SAN JOSE	CA	95127	3812	00	06000	37.35676387	-121.8196933	Santa Clara County
312160	Non-Physician Medical Practitioner	None	1487792164	0	0	EARLY, SONDRA ELAINE	4/28/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	875 BLAKE WILBUR DR	ROOM CC 2200A	PALO ALTO	CA	94304	2205	00	06000	37.43562782	-122.1766097	Santa Clara County
312186	Non-Physician Medical Practitioner	None	1255859906	0	0	ESGUERRA, SAMANTHA F NP	7/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9375 SAN FERNANDO RD	None	SUN VALLEY	CA	91352	1418	00	06000	34.2395322	-118.3939944	Los Angeles County
312206	Non-Physician Medical Practitioner	None	1992322168	0	0	EBERHART, TESSIE L NP	12/16/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	00	06000	33.67831005	-117.852138	Orange County
312287	Non-Physician Medical Practitioner	None	1801175070	0	0	ERDAHL, GINA R	6/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6422 LAKE BADIN AVENUE	None	SAN DIEGO	CA	92119	3123	00	06000	32.79825045	-117.0221772	San Diego County
312291	Non-Physician Medical Practitioner	None	1306331988	0	0	EILMES, JUDITH L	7/14/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	700 W 19TH ST	None	COSTA MESA	CA	92627	3517	00	06000	33.64342564	-117.9280911	Orange County
312352	Non-Physician Medical Practitioner	None	1609287564	0	0	EL DORADO COMMUNITY SERVICE CENTER	11/14/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14611 HAWTHORNE BLVD	None	LAWNDALE	CA	90260	1522	00	06000	33.898932	-118.3527785	Los Angeles County
312358	Non-Physician Medical Practitioner	None	1215440136	0	0	EGBUNA, NNENNA J PA	1/12/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24329 CRENSHAW BLVD	STE. A	TORRANCE	CA	90505	5334	00	06000	33.804612	-118.327997	Los Angeles County
312415	Non-Physician Medical Practitioner	None	1245388974	0	0	ELDRIDGE, CAROLYN J CNM	9/26/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2505 LUCAS STREET	SUITE B	EUREKA	CA	95501	4436	00	06000	40.79130448	-124.139304	Humboldt County
312512	Non-Physician Medical Practitioner	None	1457787681	0	0	EL DORADO COMMUNITY SERVICE CENTER	6/4/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3130 S HILL ST	None	LOS ANGELES	CA	90007	3817	00	06000	34.0213143	-118.2737961	Los Angeles County
312521	Non-Physician Medical Practitioner	None	1083040216	0	0	EL DORADO COMMUNITY SERVICE CENTER	6/4/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	540 S SAN PEDRO ST	None	LOS ANGELES	CA	90013	2102	00	06000	34.04316943	-118.2445676	Los Angeles County
312544	Non-Physician Medical Practitioner	None	1528336146	0	0	ELLIS, RYAN M	7/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26754 TRAFALGAR WAY	None	MURRIETA	CA	92563	4360	00	06000	33.54426844	-117.1576041	Riverside County
312622	Non-Physician Medical Practitioner	None	1821536137	0	0	EISCHEID, ASHLEY K NP	3/7/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	829 MOLA VISTA WAY	None	SOLANO BEACH	CA	92075	2056	00	06000	32.99060287	-117.2578601	San Diego County
312746	Non-Physician Medical Practitioner	None	1154930212	0	0	EILAND, STEPHANIE M NP	4/16/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	415 W ROUTE 66	SUITE 202	GLENDORA	CA	91740	4335	00	06000	34.12883848	-117.869958	Los Angeles County
312926	Non-Physician Medical Practitioner	None	1639492390	0	0	EFFORT,INC	2/11/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3234 MARYSVILLE BLVD	None	SACRAMENTO	CA	95815	0000	00	06000	38.626371	-121.4322615	Sacramento County
313001	Non-Physician Medical Practitioner	None	1487982526	0	0	ECK, RACHEL J NP	6/3/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	270 LASSEN DRIVE	None	SAN BRUNO	CA	94066	2518	00	06000	37.62336662	-122.4509961	San Mateo County
313052	Non-Physician Medical Practitioner	None	1538608856	0	0	ESPARZA, NOEMI D NP	8/18/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 CAHUILLA DRIVE	None	IMPERIAL	CA	92551	8610	00	06000	32.86519682	-115.5662698	Imperial County
313147	Non-Physician Medical Practitioner	None	1598071193	0	0	EFFINGER, DEBORAH J NP	1/30/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25285 MADISON AVE	STE 101	TEMECULA	CA	92562	8955	00	06000	33.55369902	-117.1965543	Riverside County
313156	Non-Physician Medical Practitioner	None	1225064983	0	0	ETHRIDGE, APRIL S PA-C	4/2/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
313194	Non-Physician Medical Practitioner	None	1902521164	0	0	ESPINOZA, JUAN PA-C	2/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	00	06000	33.93112671	-118.2035532	Los Angeles County
313217	Non-Physician Medical Practitioner	None	1861436230	0	0	ENCINAS, JANEL RAE	4/7/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	00	06000	34.13489987	-118.0424069	Los Angeles County
313321	Non-Physician Medical Practitioner	None	1174015192	0	0	ENWIA, EDWIN PA	10/7/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1050 LINDEN AVE	None	LONG BEACH	CA	90813	3393	00	06000	33.78003775	-118.1866604	Los Angeles County
313398	Non-Physician Medical Practitioner	None	1689150716	0	0	EJIGU, DESALEGN A NP	12/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	124 WALNUT ST	None	WOODLAND	CA	95695	3137	00	06000	38.68160056	-121.7781391	Yolo County
313417	Non-Physician Medical Practitioner	None	1467605725	0	0	EBERSOHL, TIFFANY A	1/22/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4537 GLOVER WAY	None	CARMICHAEL	CA	95608	1207	00	06000	38.647215	-121.3350705	Sacramento County
313438	Non-Physician Medical Practitioner	None	1124229612	0	0	EVERHART, KATHLENE M	10/31/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4726 LAUREL RIDGE DR	None	RIVERSIDE	CA	92509	5453	00	06000	34.00240722	-117.4424634	Riverside County
313449	Non-Physician Medical Practitioner	None	1639892722	0	0	EAVES, YABRIYAH A PA	3/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	847 W CHILDS AVE	None	MERCED	CA	95341	6805	00	06000	37.28825369	-120.4963159	Merced County
313522	Non-Physician Medical Practitioner	None	1205959921	0	0	ELDRIDGE, KERRY E CNM	7/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14629 BLACKBERRY RD	None	FOREST RANCH	CA	95942	9773	00	06000	39.84058229	-121.6913923	Butte County
313687	Non-Physician Medical Practitioner	None	1437394368	0	0	ENNIS, ANDREA M NP	3/6/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4817 OCEAN FRONT WALK	None	MARINA DEL REY	CA	90292	6711	00	06000	33.96976702	-118.4592792	Los Angeles County
313693	Non-Physician Medical Practitioner	None	1255579207	0	0	ESCOBAR, MARLENE P.	4/15/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2033 W 7TH ST STE 16	None	LOS ANGELES	CA	90057	4080	00	06000	34.05635107	-118.2764653	Los Angeles County
313695	Non-Physician Medical Practitioner	None	1134980923	0	0	ESTRERA, MIGUEL RODRIGO C NP	11/21/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 MEDICAL PLAZA	565	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
313710	Non-Physician Medical Practitioner	None	1174182265	0	0	ESPINOZA, JESUS PA-C	3/30/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	33494 OAK GLEN RD	None	YUCAIPA	CA	92399	2057	00	06000	34.03255442	-117.0737219	San Bernardino County
313727	Non-Physician Medical Practitioner	None	1750318275	0	0	ESKES, CHRISTY L	7/12/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	488 S K ST	None	SAN BERNARDINO	CA	92410	2641	00	06000	34.09242003	-117.3077072	San Bernardino County
313812	Non-Physician Medical Practitioner	None	1073275467	0	0	EMMETT, ERIC P PA-C	12/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1235 W VINE ST	None	LODI	CA	95240	5144	00	06000	38.12279179	-121.2879362	San Joaquin County
313864	Non-Physician Medical Practitioner	None	1447696356	0	0	ELKADY, DINA G	7/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	46722 CRAWFORD STREET	None	FREMONT	CA	94539	7169	00	06000	37.49256621	-121.9238191	Alameda County
313869	Non-Physician Medical Practitioner	None	1275704587	0	0	EVANGELISTA, JOSEPHINE A NP	3/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2020 SANTA MONICA BLVD	600	SANTA MONICA	CA	90404	2000	00	06000	34.02901811	-118.4795396	Los Angeles County
314063	Non-Physician Medical Practitioner	None	1184272759	0	0	EVANGELISTA, EDIL NP	11/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	425 DIAMOND DRIVE	SUITE 104-105	LAKE ELSINORE	CA	92530	4495	00	06000	33.65802263	-117.3002985	Riverside County
314115	Non-Physician Medical Practitioner	None	1639647019	0	0	EJIOGU, KENNETH	7/15/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2350 W WHITENDALE AVE	None	VISALIA	CA	93277	6136	00	06000	36.307377	-119.316285	Tulare County
314174	Non-Physician Medical Practitioner	None	1023596095	0	0	EISENBERG, EMILY PA	10/31/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
314235	Non-Physician Medical Practitioner	None	1992338016	0	0	EVANS, MATTHEW	9/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
314289	Non-Physician Medical Practitioner	None	1073175873	0	0	ESTRONICK, LORRAINE M NP	10/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	00	06000	34.12811155	-118.2577764	Los Angeles County
314293	Non-Physician Medical Practitioner	None	1063922771	0	0	ELLIS, ANTHONY C NP	12/26/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1230 BEETHOVEN COMMON	None	FREMONT	CA	94538	2534	00	06000	37.55678909	-121.9674044	Alameda County
314306	Non-Physician Medical Practitioner	None	1891017125	0	0	ELLIOT DEMARS, HEATHER M	12/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1467 PORTOLA MEADOWS RD	None	LIVERMORE	CA	94551	3982	00	06000	37.69491008	-121.777075	Alameda County
314312	Non-Physician Medical Practitioner	None	1225795610	0	0	EDRY, JOELLE PA-C	11/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	530 E WASHINGTON BLVD	None	LOS ANGELES	CA	90015	3723	00	06000	34.02866849	-118.2597481	Los Angeles County
314317	Non-Physician Medical Practitioner	None	1356162804	0	0	EDWARDS, ERICA N NP	4/14/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10621 CHURCH ST	STE 120	RANCHO CUCAMONGA	CA	91730	6862	00	06000	34.11289206	-117.5715772	San Bernardino County
314403	Non-Physician Medical Practitioner	None	1952555732	0	0	ESCOBEDO, TINA J NP	1/15/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1854 OAKRIDGE DR	None	CORONA	CA	92882	2305	00	06000	33.86861409	-117.6414976	Riverside County
314512	Non-Physician Medical Practitioner	None	1689854044	0	0	ESPINO, JEREMY J	1/14/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1349 COUNTRY HILL RD	None	SANTA MARIA	CA	93455	4082	00	06000	34.87897416	-120.4122057	Santa Barbara County
314543	Non-Physician Medical Practitioner	None	1093352791	0	0	EVANS, REBECCA PA	2/26/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1742 OREGON STREET	None	REDDING	CA	96001	1717	00	06000	40.5808265	-122.3932989	Shasta County
314544	Non-Physician Medical Practitioner	None	1679292015	0	0	ERNST, CARMEN R NP	5/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	00	06000	37.36797679	-122.0297112	Santa Clara County
314548	Non-Physician Medical Practitioner	None	1497221196	0	0	EL-FAHMAWI, HASAN S NP	1/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
314627	Non-Physician Medical Practitioner	None	1952037400	0	0	ERBEZNIK, MIA A NP	1/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	00	06000	37.43920432	-122.162109	Santa Clara County
314635	Non-Physician Medical Practitioner	None	1811372618	0	0	ENG, WINNIE W P	7/3/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1802 N ALVARADO STREET	APT 2	LOS ANGELES	CA	90026	1746	00	06000	34.08699975	-118.257646	Los Angeles County
314637	Non-Physician Medical Practitioner	None	1285945576	0	0	ESGUERRA, JETHRO J NP	12/20/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	250 W OCEAN BLVD #1909	None	LONG BEACH	CA	90802	7950	00	06000	33.76705411	-118.1945757	Los Angeles County
314647	Non-Physician Medical Practitioner	None	1508955634	0	0	ESMAEILI, AKRAM PA	12/21/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1981 N BROADWAY	STE 190	WALNUT CREEK	CA	94596	3671	00	06000	37.90582392	-122.0613697	Contra Costa County
314699	Non-Physician Medical Practitioner	None	1083949689	0	0	ESPARZA, LYNN ANN	10/21/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
314893	Non-Physician Medical Practitioner	None	1235598749	0	0	ESTRADA, MARINA N	2/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2941 OSTROM AVENUE	None	LONG BEACH	CA	90815	1608	00	06000	33.80968725	-118.1011004	Los Angeles County
314936	Non-Physician Medical Practitioner	None	1144831322	0	0	EZELL, CATHERINE E NP	11/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18564 US HWY 18	104	APPLE VALLEY	CA	92307	2321	00	06000	34.53926652	-117.2592564	San Bernardino County
314938	Non-Physician Medical Practitioner	None	1073588646	0	0	ESCONDIDO CA ENDOSCOPY ASC LP	12/1/1999	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	488 E VALLEY PKWY	SUITE 110	ESCONDIDO	CA	92025	3363	00	06000	33.12523814	-117.0769715	San Diego County
315001	Non-Physician Medical Practitioner	None	1194239707	0	0	ESTUAR, CARRIE J NP	12/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
315022	Non-Physician Medical Practitioner	None	1407489560	0	0	EDWARDS, TAYLOR S	3/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6306	00	06000	33.98160766	-118.4400667	Los Angeles County
315144	Non-Physician Medical Practitioner	None	1447496906	0	0	ELLISON, CARIE	12/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	00	06000	33.746805	-117.834147	Orange County
315152	Non-Physician Medical Practitioner	None	1891855516	0	0	ELSHIRE, JACQUELINE ASUNCION	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	00	06000	37.43378232	-121.8920598	Santa Clara County
315170	Non-Physician Medical Practitioner	None	1497244792	0	0	ELLIOTT, MATTHEW J PA-C	10/15/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1330 N INDIAN CANYON DR	STE F	PALM SPRINGS	CA	92262	4880	00	06000	33.84144	-116.5455715	Riverside County
315221	Non-Physician Medical Practitioner	None	1619482718	0	0	ESTEVA, AGNES A NP	7/8/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22110 ROSCOE BLVD	STE 201	CANOGA PARK	CA	91304	3861	00	06000	34.21957849	-118.6082685	Los Angeles County
315246	Non-Physician Medical Practitioner	None	1760787030	0	0	EDEM, MARY NP	7/22/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3350 TACT CT	None	CHINO HILLS	CA	91709	1833	00	06000	33.98925592	-117.7314444	San Bernardino County
315247	Non-Physician Medical Practitioner	None	1316354400	0	0	ETHRIDGE, NATHAN J	9/30/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3710 E PAGE AVENUE	None	GILBERT	AZ	85234	4300	00	06000	33.356061	-111.7105155	Maricopa County
315253	Non-Physician Medical Practitioner	None	1538598156	0	0	EGHBALI, SARAH	5/18/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	232 S WETHERLY DR	None	BEVERLY HILLS	CA	90211	2516	00	06000	34.06373159	-118.3886481	Los Angeles County
315341	Non-Physician Medical Practitioner	None	1003207812	0	0	ELLER, ALICIA N PA	11/15/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25495 MEDICAL CENTER DR	STE 102	MURRIETA	CA	92562	4903	00	06000	33.55804188	-117.1834064	Riverside County
315356	Non-Physician Medical Practitioner	None	1740391051	0	0	ELDER, TORRA Y PA-C	6/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	00	06000	38.443806	-122.701374	Sonoma County
315397	Non-Physician Medical Practitioner	None	1396835120	0	0	ELMQUIST, STEPHANIE M	8/31/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3325 RESEARCH WAY	None	CARSON CITY	NV	89706	7913	00	06000	39.189159	-119.749842	Consolidated Municipality of Carson City
315422	Non-Physician Medical Practitioner	None	1376534008	0	0	ELEMEN, BEVERLY J	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	276 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	0000	00	06000	37.2402111	-121.8021684	Santa Clara County
315484	Non-Physician Medical Practitioner	None	1255351417	0	0	EARLEY, JAMISON LEIGH	5/16/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	213 SOARING HAWK PL	None	LINCOLN	CA	95648	8257	00	06000	38.84359905	-121.2764259	Placer County
315522	Non-Physician Medical Practitioner	None	1053650416	0	0	ESCALANTE, JUVY A	1/24/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2140 RAMADA DR	None	OCEANSIDE	CA	92056	6333	00	06000	33.19539643	-117.306954	San Diego County
315568	Non-Physician Medical Practitioner	None	1639543994	0	0	EUSEBIO, ESPERANZA N NP	4/21/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
315802	Non-Physician Medical Practitioner	None	1396257382	0	0	EZEMONYE, IJEOMA H NP	1/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8534 ROSECRANS AVE	None	PARAMOUNT	CA	90723	3644	00	06000	33.9036267	-118.1503206	Los Angeles County
315804	Non-Physician Medical Practitioner	None	1407918733	0	0	ELGUEZABAL, RAUL	2/17/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	563 ISLE DR	None	SAN DIEGO	CA	92154	8510	00	06000	32.58519045	-117.029569	San Diego County
315868	Non-Physician Medical Practitioner	None	1922432640	0	0	EMENIKE, CHRISTINE N NP	1/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3220 S BETHANY PASEO	None	ONTARIO	CA	91761	2674	00	06000	34.014663	-117.563787	San Bernardino County
315886	Non-Physician Medical Practitioner	None	1710138524	0	0	ENNIS, NICOLE L	8/19/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1944 WEBSTER STREET	STE 3	SAN FRANCISCO	CA	94115	2897	00	06000	37.78881133	-122.4321014	San Francisco County
315999	Non-Physician Medical Practitioner	None	1639729833	0	0	ESTRADA, RYAN E PA	10/30/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	00	06000	34.062852	-117.9446658	Los Angeles County
316019	Non-Physician Medical Practitioner	None	1578921425	0	0	ELDEEB, NISSMA PA-C	1/7/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7500 HOSPITAL DRIVE	None	SACRAMENTO	CA	95823	5403	00	06000	38.463381	-121.416183	Sacramento County
316045	Non-Physician Medical Practitioner	None	1093136269	0	0	EDGINTON, MELISSA C NP	4/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2210 E ILLINOIS AVE	SUITE 408	FRESNO	CA	93701	2168	00	06000	36.74500687	-119.7846885	Fresno County
316197	Ordering, Referring, Prescribing	N/A	1003249525	0	0	EHLERS, JESSICA LCSW	6/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88677	N/A	N/A	N/A	N/A	N/A	50 BRANSCOMB RD	None	LAYTONVILLE	CA	95454	0870	00	06000	39.68781544	-123.4842982	Mendocino County
316221	Ordering, Referring, Prescribing	N/A	1003279118	0	0	EZEOKOYE, CALISTA NP	10/20/2017	Taxonomy not applicable	NA	n/a	000	Unknown	NP95003322	N/A	N/A	N/A	N/A	N/A	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	00	06000	33.94274917	-118.2461916	Los Angeles County
316423	Ordering, Referring, Prescribing	N/A	1003834367	0	0	ECHEVERRIA, MELINDA J LCSW	1/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23319	N/A	N/A	N/A	N/A	N/A	1855 W KATELLA AVE	150	ORANGE	CA	92867	3451	00	06000	33.8061655	-117.872442	Orange County
316513	Ordering, Referring, Prescribing	N/A	1013055441	0	0	ENTZ, JAMES B LMFT	3/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT31323	N/A	N/A	N/A	N/A	N/A	850 E. FOOTHILL BLVD.	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
316522	Ordering, Referring, Prescribing	N/A	1013059237	0	0	EDHERE, LINDA E MD	2/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A90391	N/A	N/A	N/A	N/A	N/A	1830 S CENTRAL ST	None	VISALIA	CA	93277	4418	00	06000	36.314271	-119.311362	Tulare County
316525	Ordering, Referring, Prescribing	N/A	1013078625	0	0	EHRLICH, NEIL P	5/18/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G23599	N/A	N/A	N/A	N/A	N/A	16390 MAIN ST	None	GUERNEVILLE	CA	95446	9677	00	06000	38.5020015	-123.0000255	Sonoma County
316610	Ordering, Referring, Prescribing	N/A	1013225374	0	0	ELEY, KAREN M LCSW	3/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	69434	N/A	N/A	N/A	N/A	N/A	260 COHASSET RD	120	CHICO	CA	95926	2282	00	06000	39.754035	-121.851117	Butte County
316631	Ordering, Referring, Prescribing	N/A	1013271337	0	0	EFROS, KEVIN MD	10/17/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A129011	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
316669	Ordering, Referring, Prescribing	N/A	1013331768	0	0	ESKANDAR, RAMY E PHARMD	8/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH69639	N/A	N/A	N/A	N/A	N/A	41169 GOODWIN WAY	110	MADERA	CA	93636	8766	00	06000	36.88577349	-119.800021	Madera County
316680	Ordering, Referring, Prescribing	N/A	1013349588	0	0	EARHART, MARIA LCSW	2/20/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	111703	N/A	N/A	N/A	N/A	N/A	6001 E WASHINGTON BLVD	None	COMMERCE	CA	90040	2414	00	06000	33.99703164	-118.1499826	Los Angeles County
316711	Ordering, Referring, Prescribing	N/A	1013386630	0	0	ENNIS, BRIANNA K MD	3/29/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL802	N/A	N/A	N/A	N/A	N/A	747 52ND STREET	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
316751	Ordering, Referring, Prescribing	N/A	1013448281	0	0	EVANS, NICOLE S MD	9/10/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158765	N/A	N/A	N/A	N/A	N/A	2425 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78272203	-122.4433297	San Francisco County
316755	Ordering, Referring, Prescribing	N/A	1013460245	0	0	EVANS, ROSALIE LCSW	12/20/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106244	N/A	N/A	N/A	N/A	N/A	9057 SOQUEL DR BLDG C	A	APTOS	CA	95003	4053	00	06000	36.9757005	-121.890042	Santa Cruz County
316757	Ordering, Referring, Prescribing	N/A	1013461003	0	0	EHYA, NEDA LMFT	6/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118685	N/A	N/A	N/A	N/A	N/A	1265 DAINTY AVE	None	BRENTWOOD	CA	94513	1211	00	06000	37.93267349	-121.710564	Contra Costa County
316925	Ordering, Referring, Prescribing	N/A	1023170032	0	0	EDWARDS, TERRI L LMFT	12/1/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT43070	N/A	N/A	N/A	N/A	N/A	108 W. VICTORIA STREET	None	GARDENA	CA	90248	3523	00	06000	33.86509452	-118.2762279	Los Angeles County
316934	Ordering, Referring, Prescribing	N/A	1023196417	0	0	ERVING, ASHLEIGH LCSW	10/2/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26468	N/A	N/A	N/A	N/A	N/A	1236 CHAPALA ST	None	SANTA BARBARA	CA	93101	3116	00	06000	34.42310529	-119.7066629	Santa Barbara County
317043	Ordering, Referring, Prescribing	N/A	1023417375	0	0	EUBANKS, JAMES D LMFT	10/20/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124393	N/A	N/A	N/A	N/A	N/A	444 N. WASHINGTON ST	None	CLOVERDALE	CA	95425	3237	00	06000	38.80942502	-123.0230979	Sonoma County
317045	Ordering, Referring, Prescribing	N/A	1023417383	0	0	EFEVBERHA, CATHERINE LMFT	2/22/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124480	N/A	N/A	N/A	N/A	N/A	695 S. VERMONT AVE	None	LOS ANGELES	CA	90005	1101	00	06000	34.06078495	-118.2916863	Los Angeles County
317122	Ordering, Referring, Prescribing	N/A	1023535515	0	0	ENAMORADO, MARTHA E NP	4/27/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008768	N/A	N/A	N/A	N/A	N/A	8902 WOODMAN AVE	None	ARLETA	CA	91331	6401	00	06000	34.23141203	-118.4374526	Los Angeles County
317145	Ordering, Referring, Prescribing	N/A	1023566213	0	0	ERAZO, LISA LMFT	5/3/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109322	N/A	N/A	N/A	N/A	N/A	1370 S. STATE STREET	A	SAN JACINTO	CA	92583	4933	00	06000	33.773796	-116.9719185	Riverside County
317187	Ordering, Referring, Prescribing	N/A	1023661121	0	0	ESKINNORMAN, GIGI LCSW	11/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	16648	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
317201	Ordering, Referring, Prescribing	N/A	1023683141	0	0	ETUKUDOH, MFON-OBONG N NP	6/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95014933	N/A	N/A	N/A	N/A	N/A	12900 FREDRICK ST	STE C	MORENO VALLEY	CA	92553	5266	00	06000	33.932655	-117.261383	Riverside County
317223	Ordering, Referring, Prescribing	N/A	1023772910	0	0	ESCOBEDO, OMAR MD	7/1/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	197305	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
317291	Ordering, Referring, Prescribing	N/A	1033241401	0	0	ESCUDERO-ANDERSON, MARGOT	6/14/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW20181	N/A	N/A	N/A	N/A	N/A	1530 S. OLIVE STREET	None	LOS ANGELES	CA	90015	0000	00	06000	34.03542552	-118.2652073	Los Angeles County
317301	Ordering, Referring, Prescribing	N/A	1033258132	0	0	ENDRES, ABBIGAIL J LMFT	4/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	43308	N/A	N/A	N/A	N/A	N/A	3972 24TH STREET	None	SAN FRANCISCO	CA	94114	3704	00	06000	37.75149819	-122.4312468	San Francisco County
317320	Ordering, Referring, Prescribing	N/A	1033297577	0	0	EISEN, JEANNETTE	6/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT44324	N/A	N/A	N/A	N/A	N/A	45 FRANKLIN STREET	214	SAN FRANCISCO	CA	94102	6021	00	06000	37.77497018	-122.4209309	San Francisco County
317362	Ordering, Referring, Prescribing	N/A	1033373477	0	0	EGHENIAN, CHRISTINE	10/3/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38510	N/A	N/A	N/A	N/A	N/A	4405 WEST RIVERSIDE DRIV	SUITE 207	BURBANK	CA	91505	4050	00	06000	34.15222929	-118.3480509	Los Angeles County
317383	Ordering, Referring, Prescribing	N/A	1033407747	0	0	ENSMAN, KELLI E LCSW	3/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87562	N/A	N/A	N/A	N/A	N/A	850 EAST FOOTHILL	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
317387	Ordering, Referring, Prescribing	N/A	1033426366	0	0	EVANS, WENDY T LCSW	4/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	71271	N/A	N/A	N/A	N/A	N/A	2085 RUSTIN AVE	None	RIVERSIDE	CA	92507	2498	00	06000	33.99323085	-117.3355363	Riverside County
317391	Ordering, Referring, Prescribing	N/A	1033428420	0	0	EMAM, SUZANNE H LCSW	5/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW70669	N/A	N/A	N/A	N/A	N/A	215 W BEAMER ST	None	WOODLAND	CA	95695	2510	00	06000	38.68483629	-121.7937301	Yolo County
317419	Ordering, Referring, Prescribing	N/A	1033462726	0	0	ESPARZA, NANCY E LCSW	9/27/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	83690	N/A	N/A	N/A	N/A	N/A	439 W 97TH ST	None	LOS ANGELES	CA	90003	3968	00	06000	33.94831439	-118.282325	Los Angeles County
317431	Ordering, Referring, Prescribing	N/A	1033477484	0	0	ELIASNIK, RODINA CCC-SLP	12/2/2020	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	20729	N/A	N/A	N/A	N/A	N/A	5595 HUNTINGTON DR N	None	LOS ANGELES	CA	90032	1362	00	06000	34.09524795	-118.1582641	Los Angeles County
317455	Ordering, Referring, Prescribing	N/A	1033501960	0	0	EWALT, NATALIA	11/8/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138912	N/A	N/A	N/A	N/A	N/A	15315 MAGNOLIA BLVD	400	SHERMAN OAKS	CA	91403	1175	00	06000	34.16488161	-118.4666419	Los Angeles County
317522	Ordering, Referring, Prescribing	N/A	1033596556	0	0	EVANS, AUSTIN G DO	11/9/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15229	N/A	N/A	N/A	N/A	N/A	9449 IMPERIAL HWY	226	DOWNEY	CA	90242	2451	00	06000	33.91714048	-118.1262915	Los Angeles County
317576	Ordering, Referring, Prescribing	N/A	1033683388	0	0	EL YOUSFI, HAYAT PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80157	N/A	N/A	N/A	N/A	N/A	1801 E MARCH LANE	B270	STOCKTON	CA	95210	6675	00	06000	38.00315652	-121.2868715	San Joaquin County
317585	Ordering, Referring, Prescribing	N/A	1033692736	0	0	ESCOBAR, ROSA H LMFT	11/13/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT142804	N/A	N/A	N/A	N/A	N/A	840 N AVENUE 66	None	LOS ANGELES	CA	90042	1508	00	06000	34.12110842	-118.1725545	Los Angeles County
317708	Ordering, Referring, Prescribing	N/A	1043353485	0	0	ESPARZA, COLETTE C LMFT	6/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT42538	N/A	N/A	N/A	N/A	N/A	4025 W 226TH STREET	None	TORRANCE	CA	90505	2340	00	06000	33.82360754	-118.3560922	Los Angeles County
317831	Ordering, Referring, Prescribing	N/A	1043604440	0	0	ENGLISH, CARTER W MD MPH	5/5/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A144224	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	0000	00	06000	38.555181	-121.4566785	Sacramento County
317863	Ordering, Referring, Prescribing	N/A	1043641277	0	0	EHRMANN-SUBIA, ELIZABETH C LMFT	5/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	80086	N/A	N/A	N/A	N/A	N/A	2227 CHALLENGER WAY	SUITE 207	SANTA ROSA	CA	95407	5478	00	06000	38.4250533	-122.7524648	Sonoma County
317865	Ordering, Referring, Prescribing	N/A	1043643513	0	0	EZZY, ZAHRA H	9/16/2013	Taxonomy not applicable	NA	n/a	099	DENTIST	D62757	N/A	N/A	N/A	N/A	N/A	1807 BAY RD	None	EAST PALO ALTO	CA	94303	1312	00	06000	37.47199121	-122.1344629	San Mateo County
317884	Ordering, Referring, Prescribing	N/A	1043685183	0	0	EMORY, CHRISTOPHER L LMFT	9/23/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128299	N/A	N/A	N/A	N/A	N/A	7986 DAGGET ST	None	SAN DIEGO	CA	92111	2321	00	06000	32.82363345	-117.1512855	San Diego County
317970	Ordering, Referring, Prescribing	N/A	1043795651	0	0	ESTRADA, VIOLETA Y LMFT	9/26/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	134911	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HWY	100	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
318063	Ordering, Referring, Prescribing	N/A	1053078295	0	0	ELMS, RUSSELL M	6/5/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95019159	N/A	N/A	N/A	N/A	N/A	441 E YOSEMITE AVE	None	CLOVIS	CA	93638	3604	00	06000	36.96460804	-120.055598	Madera County
318128	Ordering, Referring, Prescribing	N/A	1053447714	0	0	ELLIS, EBONY LCSW	5/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW90578	N/A	N/A	N/A	N/A	N/A	2607 MYRTLE ST	None	OAKLAND	CA	94607	3415	00	06000	37.81786317	-122.2786329	Alameda County
318236	Ordering, Referring, Prescribing	N/A	1053640789	0	0	ESPINOZA, LUIS D LCSW	6/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW74802	N/A	N/A	N/A	N/A	N/A	4618 FOUNTAIN AVE	None	LOS ANGELES	CA	90029	1830	00	06000	34.095582	-118.290195	Los Angeles County
318246	Ordering, Referring, Prescribing	N/A	1053663476	0	0	EMBRADOR, ROSSANA A	1/31/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0793802	N/A	N/A	N/A	N/A	N/A	7655 GREENLEAF AVE	None	WHITTIER	CA	90602	1626	00	06000	33.9719973	-118.0374206	Los Angeles County
318249	Ordering, Referring, Prescribing	N/A	1053664912	0	0	EPPS, TIFFANY L	2/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0656393	N/A	N/A	N/A	N/A	N/A	916 W BURBANK BLVD	# M	BURBANK	CA	91506	1450	00	06000	34.18397121	-118.3225966	Los Angeles County
318307	Ordering, Referring, Prescribing	N/A	1053737429	0	0	ERWIN, KARISSA LMFT	3/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110849	N/A	N/A	N/A	N/A	N/A	24275 JEFFERSON AVE.	None	MURRIETA	CA	92562	7285	00	06000	33.5676365	-117.2174559	Riverside County
318399	Ordering, Referring, Prescribing	N/A	1053855585	0	0	EADARA, CHANDRASEKHAR PHARMD	9/15/2020	Taxonomy not applicable	NA	n/a	000	Unknown	65221	N/A	N/A	N/A	N/A	N/A	3838 SHERMAN DR	STE 1	RIVERSIDE	CA	92503	4560	00	06000	33.92678822	-117.4368632	Riverside County
318400	Ordering, Referring, Prescribing	N/A	1053858779	0	0	ENTSUAH, AMETHYST NP	1/25/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024030	N/A	N/A	N/A	N/A	N/A	15403 PARK AVE E	None	VICTORVILLE	CA	92392	2482	00	06000	34.50640129	-117.3250645	San Bernardino County
318427	Ordering, Referring, Prescribing	N/A	1053905901	0	0	EMEAHU, MITCHELL C NP	3/19/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016989	N/A	N/A	N/A	N/A	N/A	4600 PANAMA LN	SUITE 102B	BAKERSFIELD	CA	93313	3509	00	06000	35.29596129	-119.0543102	Kern County
318560	Ordering, Referring, Prescribing	N/A	1063515047	0	0	ESPINAS, LANI LMFT	5/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFC34011	N/A	N/A	N/A	N/A	N/A	801 E CHAPMAN AVE	203	FULLERTON	CA	92831	3839	00	06000	33.87407517	-117.9110814	Orange County
318619	Ordering, Referring, Prescribing	N/A	1063590693	0	0	ESPANA, LIZETTE MD	8/4/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A81616	N/A	N/A	N/A	N/A	N/A	240 SHOTWELL ST	None	SAN FRANCISCO	CA	94110	1323	00	06000	37.76460716	-122.416335	San Francisco County
318686	Ordering, Referring, Prescribing	N/A	1063726818	0	0	ESSLING, FLORENCE LCSW	1/12/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	19847	N/A	N/A	N/A	N/A	N/A	43537 RIDGE PARK DR	None	TEMECULA	CA	92590	3615	00	06000	33.49569085	-117.159969	Riverside County
318837	Ordering, Referring, Prescribing	N/A	1063934305	0	0	ESPINOZA, ELISABETH LCSW	7/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	95782	N/A	N/A	N/A	N/A	N/A	905 E. 8TH STREET	None	LOS ANGELES	CA	90021	1805	00	06000	34.03639545	-118.2465917	Los Angeles County
318842	Ordering, Referring, Prescribing	N/A	1063938165	0	0	ELSALMAN, SAMER O PHARMD	7/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75083	N/A	N/A	N/A	N/A	N/A	7576 SKYWAY	None	PARADISE	CA	95969	3233	00	06000	39.7699842	-121.6124155	Butte County
318849	Ordering, Referring, Prescribing	N/A	1063943629	0	0	EVEREST, AMARPREET DO	3/14/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A18555	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL ROAD	SUITE #A	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
318852	Ordering, Referring, Prescribing	N/A	1063955011	0	0	EMERSON, KATHLEEN D CNM	8/14/2017	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	95048259	N/A	N/A	N/A	N/A	N/A	1032 A STREET	None	HAYWARD	CA	94541	4106	00	06000	37.67439519	-122.0831733	Alameda County
318877	Ordering, Referring, Prescribing	N/A	1073000691	0	0	EMANUEL, ANNA I MD	3/11/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176896	N/A	N/A	N/A	N/A	N/A	3255 WILSHIRE BLVD	STE 100	LOS ANGELES	CA	90010	1405	00	06000	34.0618166	-118.2932612	Los Angeles County
318955	Ordering, Referring, Prescribing	N/A	1073130951	0	0	ESCOBEDO POL, EVELYN MD	4/10/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A185168	N/A	N/A	N/A	N/A	N/A	6801 COLDWATER CANYON AV	None	NORTH HOLLYWOOD	CA	91605	5162	00	06000	34.194447	-118.4138285	Los Angeles County
319010	Ordering, Referring, Prescribing	N/A	1073369963	0	0	ESPINOSA, IVETTE	1/12/2024	Taxonomy not applicable	NA	n/a	013	HEARING AID DISPENSERS	8937	N/A	N/A	N/A	N/A	N/A	9901 PARAMOUNT BLVD	STE. 236	DOWNEY	CA	90240	3843	00	06000	33.95539219	-118.128812	Los Angeles County
319035	Ordering, Referring, Prescribing	N/A	1073615308	0	0	ELDRIDGE, CHRISTOPHER LMFT	7/31/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT43016	N/A	N/A	N/A	N/A	N/A	9601 KIEFER BLVD	None	SACRAMENTO	CA	95827	3818	00	06000	38.54628	-121.3397415	Sacramento County
319040	Ordering, Referring, Prescribing	N/A	1073630687	0	0	ESTRADA, RACHEL LCSW	2/19/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW20302	N/A	N/A	N/A	N/A	N/A	4870 LUTHER ST	None	RIVERSIDE	CA	92504	2245	00	06000	33.9486194	-117.4092463	Riverside County
319090	Ordering, Referring, Prescribing	N/A	1073740254	0	0	ESHRAGHI, SAEED MD	6/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A118501	N/A	N/A	N/A	N/A	N/A	41002 COUNTY CENTER DR.	320	TEMECULA	CA	92591	6027	00	06000	33.52762603	-117.1615428	Riverside County
319098	Ordering, Referring, Prescribing	N/A	1073768149	0	0	ESPINDOLA, BELLA A LCSW	6/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	91226	N/A	N/A	N/A	N/A	N/A	951 BLANCO CIR	None	SALINAS	CA	93901	4451	00	06000	36.65589725	-121.6366313	Monterey County
319168	Ordering, Referring, Prescribing	N/A	1073914255	0	0	ESTRADA, ORSINI LCSW	12/31/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW93628	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
319235	Ordering, Referring, Prescribing	N/A	1083014906	0	0	EQUITE-RODAS, SANDY C PSYD	10/7/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY32114	N/A	N/A	N/A	N/A	N/A	19231 VICTORY BLVD	110	RESEDA	CA	91335	6321	00	06000	34.18659852	-118.552221	Los Angeles County
319338	Ordering, Referring, Prescribing	N/A	1083158463	0	0	EDMUNDS, ANDREW LPCC	4/4/2022	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC9369	N/A	N/A	N/A	N/A	N/A	7986 DAGGET ST	None	SAN DIEGO	CA	92111	2321	00	06000	32.82363345	-117.1512855	San Diego County
319406	Ordering, Referring, Prescribing	N/A	1083278220	0	0	ELIZONDO, AMANDA LMFT	4/15/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132304	N/A	N/A	N/A	N/A	N/A	6244 EL CAJON BLVD	SUITE 14	SAN DIEGO	CA	92115	3918	00	06000	32.76342577	-117.0636924	San Diego County
319535	Ordering, Referring, Prescribing	N/A	1083845556	0	0	ERICKSON, ROSANNA O NP	6/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	4744	N/A	N/A	N/A	N/A	N/A	22801 ACACIA CT	None	SANTA CLARITA	CA	91390	4142	00	06000	34.47283263	-118.5335085	Los Angeles County
319588	Ordering, Referring, Prescribing	N/A	1083948137	0	0	EURIPIDES, AVIVA LMFT	11/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	37090	N/A	N/A	N/A	N/A	N/A	3061 FILLMORE ST	None	SAN FRANCISCO	CA	94123	4009	00	06000	37.79787328	-122.4356778	San Francisco County
319624	Ordering, Referring, Prescribing	N/A	1083998454	0	0	ESCOBEDO JARQUE, FEDERICO LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98269	N/A	N/A	N/A	N/A	N/A	1907 BOYS REPUBLIC DR	None	CHINO HILLS	CA	91709	5447	00	06000	33.993846	-117.725661	San Bernardino County
319800	Ordering, Referring, Prescribing	N/A	1093271892	0	0	ELBILLEH, MYS S PHARMD	7/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH80261	N/A	N/A	N/A	N/A	N/A	7929 N LOWER SACRAMENTO	None	STOCKTON	CA	95210	3723	00	06000	38.021913	-121.3230885	San Joaquin County
319816	Ordering, Referring, Prescribing	N/A	1093294753	0	0	ENCISO, STEPHANIE LCSW	6/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	123318	N/A	N/A	N/A	N/A	N/A	5050 SAN BERNARDINO ST	None	MONTCLAIR	CA	91763	2326	00	06000	34.0776775	-117.694521	San Bernardino County
319835	Ordering, Referring, Prescribing	N/A	1093343105	0	0	EMPIE, KRISTEN MD	6/4/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A186707	N/A	N/A	N/A	N/A	N/A	8881 FLETCHER PARKWAY	SUITE 205	LA MESA	CA	91942	3135	00	06000	32.78442148	-117.0073814	San Diego County
319880	Ordering, Referring, Prescribing	N/A	1093539462	0	0	ERAN, RICKY S	1/2/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95025889	N/A	N/A	N/A	N/A	N/A	1205 MELVILLE SQUARE	103	RICHMOND	CA	94804	0001	00	06000	37.91491473	-122.3484244	Contra Costa County
319899	Ordering, Referring, Prescribing	N/A	1093744260	0	0	EVE, GAIL LMFT	7/30/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT24889	N/A	N/A	N/A	N/A	N/A	2180 HARVARD	SUITE 210	SACRAMENTO	CA	95815	3314	00	06000	38.60568	-121.4345385	Sacramento County
319943	Ordering, Referring, Prescribing	N/A	1093869554	0	0	ELIJAH, MATHEWS M LMFT	12/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	39223	N/A	N/A	N/A	N/A	N/A	1111 TORO STREET	A	SAN LUIS OBISPO	CA	93401	7942	00	06000	35.28269724	-120.6578935	San Luis Obispo County
319946	Ordering, Referring, Prescribing	N/A	1093869661	0	0	EDWALDS, PAULA M MD	3/11/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G76799	N/A	N/A	N/A	N/A	N/A	720 WOOD STREET	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
319988	Ordering, Referring, Prescribing	N/A	1093921959	0	0	ELDER, REBECCA N LCSW	9/23/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	104260	N/A	N/A	N/A	N/A	N/A	720 WOOD ST.	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
320037	Ordering, Referring, Prescribing	N/A	1104047372	0	0	ESCHMAN, JESSICA R LCSW	3/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29591	N/A	N/A	N/A	N/A	N/A	3165 OLIN AVE	None	SAN JOSE	CA	95117	1635	00	06000	37.3204645	-121.9521375	Santa Clara County
320060	Ordering, Referring, Prescribing	N/A	1104096825	0	0	ENGELSTAD, CHERYL A LMFT	4/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	36007	N/A	N/A	N/A	N/A	N/A	1885 LUNDY AVE	223	SAN JOSE	CA	95131	1887	00	06000	37.39329538	-121.8907367	Santa Clara County
320212	Ordering, Referring, Prescribing	N/A	1104347509	0	0	ESPINOZA, ELIZABETH A LMFT	1/26/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	124143	N/A	N/A	N/A	N/A	N/A	108 W VICTORIA ST	None	GARDENA	CA	90248	3523	00	06000	33.86509452	-118.2762279	Los Angeles County
320356	Ordering, Referring, Prescribing	N/A	1104955384	0	0	ELIZONDO, RAMONA LMFT	6/3/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT93394	N/A	N/A	N/A	N/A	N/A	1015 BAKER STREET	4	BAKERSFIELD	CA	93305	4341	00	06000	35.37958694	-118.9918864	Kern County
320411	Ordering, Referring, Prescribing	N/A	1114052321	0	0	EDWARDS, NEAL S MD	6/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G74786	N/A	N/A	N/A	N/A	N/A	700 ADELINE STREET	None	OAKLAND	CA	94607	2608	00	06000	37.80430011	-122.2879962	Alameda County
320425	Ordering, Referring, Prescribing	N/A	1114063351	0	0	ELKINS, SHERILYN D LMFT	9/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122001	N/A	N/A	N/A	N/A	N/A	109 PARMAC RD	None	CHICO	CA	95926	2294	00	06000	39.75358764	-121.8505893	Butte County
320479	Ordering, Referring, Prescribing	N/A	1114174877	0	0	ELDER, AMANDA B PSYD	7/16/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31928	N/A	N/A	N/A	N/A	N/A	1430 WILLOW PASS RD	100	CONCORD	CA	94520	7928	00	06000	37.97055112	-122.0492933	Contra Costa County
320491	Ordering, Referring, Prescribing	N/A	1114207057	0	0	EVANGELISTA, MICHAEL M	1/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	57606	N/A	N/A	N/A	N/A	N/A	17383 MAIN ST	None	HESPERIA	CA	92345	6111	00	06000	34.41887306	-117.2836865	San Bernardino County
320499	Ordering, Referring, Prescribing	N/A	1114211224	0	0	ESQUIVEL, ERIKA A LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	96738	N/A	N/A	N/A	N/A	N/A	13 TOWER ROAD	None	BELMONT	CA	94002	3001	00	06000	37.51151835	-122.3334253	San Mateo County
320512	Ordering, Referring, Prescribing	N/A	1114246014	0	0	ELFERS, JOHN LMFT	6/3/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	32786	N/A	N/A	N/A	N/A	N/A	676 PISMO ST	None	SAN LUIS OBISPO	CA	93401	3945	00	06000	35.27640631	-120.6628883	San Luis Obispo County
320569	Ordering, Referring, Prescribing	N/A	1114339223	0	0	EDEN, SAVANNAH LMFT	6/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92607	N/A	N/A	N/A	N/A	N/A	5740 RALSTON ST	None	VENTURA	CA	93003	6051	00	06000	34.26070802	-119.213699	Ventura County
320596	Ordering, Referring, Prescribing	N/A	1114379922	0	0	ELALI, SYLVANA LMFT	12/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT123810	N/A	N/A	N/A	N/A	N/A	540 S EREMLAND DR	None	COVINA	CA	91723	3186	00	06000	34.079904	-117.8863235	Los Angeles County
320710	Ordering, Referring, Prescribing	N/A	1114589819	0	0	ESTEBAN, ANAI LCSW	9/5/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	125758	N/A	N/A	N/A	N/A	N/A	530 W BADILLO ST	None	COVINA	CA	91722	3762	00	06000	34.08625283	-117.8999625	Los Angeles County
320716	Ordering, Referring, Prescribing	N/A	1114628138	0	0	ELIOPULOS, MARIBEL RDH	5/2/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RDH12915	N/A	N/A	N/A	N/A	N/A	1043 ELM AVE.	SUITE 302	LONG BEACH	CA	90813	3295	00	06000	33.779655	-118.1880065	Los Angeles County
320752	Ordering, Referring, Prescribing	N/A	1114919263	0	0	ELLIOTT, JEFFREY B PSYD	2/9/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY17917	N/A	N/A	N/A	N/A	N/A	2180 JOHNSON AVENUE	None	SAN LUIS OBISPO	CA	93401	4558	00	06000	35.27488974	-120.6468257	San Luis Obispo County
320833	Ordering, Referring, Prescribing	N/A	1124157144	0	0	EARNEST, KEVIN LMFT	7/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT34123	N/A	N/A	N/A	N/A	N/A	3628 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2153	00	06000	35.35426453	-119.045007	Kern County
320854	Ordering, Referring, Prescribing	N/A	1124202692	0	0	EVERSON, LISA D LMFT	4/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT44486	N/A	N/A	N/A	N/A	N/A	950 N RAMONA BLVD	None	SAN JACINTO	CA	92582	2567	00	06000	33.79559324	-116.9731495	Riverside County
320868	Ordering, Referring, Prescribing	N/A	1124229612	0	0	EVERHART, KATHLENE	10/2/2022	Taxonomy not applicable	NA	n/a	000	Unknown	18713	N/A	N/A	N/A	N/A	N/A	8876 MISSION BLVD	None	RIVERSIDE	CA	92509	2811	00	06000	34.01176954	-117.476118	Riverside County
321013	Ordering, Referring, Prescribing	N/A	1124479233	0	0	ERICKSON, KRYSTIN R LMFT	3/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118449	N/A	N/A	N/A	N/A	N/A	1704 CAPE HORN AVE	None	JULIAN	CA	92036	0403	00	06000	33.07703283	-116.5974387	San Diego County
321117	Ordering, Referring, Prescribing	N/A	1124657986	0	0	EVALDEZ, FRANCIS M LMFT	6/8/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133155	N/A	N/A	N/A	N/A	N/A	4000 W. METROPOLITAN DR.	401	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
321155	Ordering, Referring, Prescribing	N/A	1124793849	0	0	EBRAHIMI-NUYKEN, SORAYA MSW LCSW	11/19/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127362	N/A	N/A	N/A	N/A	N/A	8912 VOLUNTEER LANE	None	SACRAMENTO	CA	95826	3221	00	06000	38.55438	-121.3756965	Sacramento County
321248	Ordering, Referring, Prescribing	N/A	1134292634	0	0	EDWARDS, MAUREEN G LCSW	7/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26757	N/A	N/A	N/A	N/A	N/A	755 SOUTH VAN NESS	None	SAN FRANCISCO	CA	94110	1908	00	06000	37.76103073	-122.4170932	San Francisco County
321270	Ordering, Referring, Prescribing	N/A	1134359789	0	0	EHRENREICH, KYLA W PA	3/16/2022	Taxonomy not applicable	NA	n/a	000	Unknown	20387	N/A	N/A	N/A	N/A	N/A	652 PETALUMA AVE	SUITE H	SEBASTOPOL	CA	95472	4256	00	06000	38.39662494	-122.8201368	Sonoma County
321342	Ordering, Referring, Prescribing	N/A	1134502834	0	0	EBERLY, KRISTEN LCSW	5/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82625	N/A	N/A	N/A	N/A	N/A	3020 CHILDRENS WAY	MC 5016	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
321364	Ordering, Referring, Prescribing	N/A	1134536626	0	0	ENG, ELIZABETH B LMFT	4/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT118099	N/A	N/A	N/A	N/A	N/A	760 HARRISON ST	None	SAN FRANCISCO	CA	94107	1235	00	06000	37.78155484	-122.3987081	San Francisco County
321413	Ordering, Referring, Prescribing	N/A	1134613946	0	0	ESCAMILLA, KARLA B LCSW	12/11/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87168	N/A	N/A	N/A	N/A	N/A	950 S EUCLID AVE	None	SAN DIEGO	CA	92114	6201	00	06000	32.696181	-117.085139	San Diego County
321419	Ordering, Referring, Prescribing	N/A	1134622293	0	0	EDWARDS, SHANNON LMFT	11/27/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	151600	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
321451	Ordering, Referring, Prescribing	N/A	1134672280	0	0	EFNER, KLARA N	9/7/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	100367	N/A	N/A	N/A	N/A	N/A	355 CENTRAL AVE	None	FILLMORE	CA	93015	1920	00	06000	34.40028802	-118.9137057	Ventura County
321611	Ordering, Referring, Prescribing	N/A	1144399122	0	0	ERIGUEL-DE JESUS, LIZA M PHARMD	3/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55796	N/A	N/A	N/A	N/A	N/A	12470 WHITTIER BLVD.	None	WHITTIER	CA	90602	1017	00	06000	33.97081587	-118.04422	Los Angeles County
321639	Ordering, Referring, Prescribing	N/A	1144476474	0	0	ESCARENO, ERIK J LCSW	5/10/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108025	N/A	N/A	N/A	N/A	N/A	5901 W OLYMPIC BLVD	STE 500	LOS ANGELES	CA	90036	4664	00	06000	34.05764121	-118.3603115	Los Angeles County
321758	Ordering, Referring, Prescribing	N/A	1144679184	0	0	EL-LAHAM, MOHAMED S	3/23/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	100270	N/A	N/A	N/A	N/A	N/A	57019 YUCCA TRAIL	STE C	YUCCA VALLEY	CA	92284	7909	00	06000	34.1205273	-116.4202324	San Bernardino County
321774	Ordering, Referring, Prescribing	N/A	1144695495	0	0	ESPINOZA, ANDREA A LMFT	11/17/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115173	N/A	N/A	N/A	N/A	N/A	9723 BURNET AVE	None	NORTH HILLS	CA	91343	5117	00	06000	34.24714228	-118.4631119	Los Angeles County
321970	Ordering, Referring, Prescribing	N/A	1154102010	0	0	ESKINDER, LEAH	6/3/2024	Taxonomy not applicable	NA	n/a	000	Unknown	64564	N/A	N/A	N/A	N/A	N/A	2907 EL CAMINO REAL	None	REDWOOD CITY	CA	94061	4003	00	06000	37.46906354	-122.2114417	San Mateo County
321986	Ordering, Referring, Prescribing	N/A	1154313658	0	0	ENGLISH, IOANA R	12/18/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D53349	N/A	N/A	N/A	N/A	N/A	1179 N MCDOWELL BLVD	None	PETALUMA	CA	94954	6559	00	06000	38.26876442	-122.6598332	Sonoma County
322158	Ordering, Referring, Prescribing	N/A	1154702991	0	0	ERESHEFSKY, SABRINA PHD	10/14/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY33891	N/A	N/A	N/A	N/A	N/A	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1353	00	06000	38.555631	-121.459203	Sacramento County
322160	Ordering, Referring, Prescribing	N/A	1154706562	0	0	EZE, IJEOMA S NP	10/24/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	702203	N/A	N/A	N/A	N/A	N/A	545 SOUTH ALVARADO ST	None	LOS ANGELES	CA	90057	2903	00	06000	34.06009726	-118.2745484	Los Angeles County
322287	Ordering, Referring, Prescribing	N/A	1154911071	0	0	ELMZADEH, AVA	4/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125639	N/A	N/A	N/A	N/A	N/A	2026 W BEACON AVE	None	ANAHEIM	CA	92804	4406	00	06000	33.82030486	-117.9539867	Orange County
322319	Ordering, Referring, Prescribing	N/A	1154968923	0	0	EISENBERG, NATALIE A PA	9/27/2019	Taxonomy not applicable	NA	n/a	000	Unknown	PA57258	N/A	N/A	N/A	N/A	N/A	24910 LAS BRISAS ROAD	SUITE 114	MURRIETA	CA	92562	9998	00	06000	33.57522424	-117.1828078	Riverside County
322331	Ordering, Referring, Prescribing	N/A	1154995611	0	0	EICHLER, ELAINE LMFT	9/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT116757	N/A	N/A	N/A	N/A	N/A	100 MASONIC AVE	None	SAN FRANCISCO	CA	94118	4415	00	06000	37.78055387	-122.4474128	San Francisco County
322401	Ordering, Referring, Prescribing	N/A	1164135489	0	0	EDOGUN, SONYA PHARMD	5/16/2023	Taxonomy not applicable	NA	n/a	000	Unknown	86006	N/A	N/A	N/A	N/A	N/A	315 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	00	06000	34.444881	-119.7793725	Santa Barbara County
322408	Ordering, Referring, Prescribing	N/A	1164192480	0	0	ESKANDER, EMMA C LMFT	11/16/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	142913	N/A	N/A	N/A	N/A	N/A	4760 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
322463	Ordering, Referring, Prescribing	N/A	1164542411	0	0	EBY, JOHN F LMFT	6/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT34808	N/A	N/A	N/A	N/A	N/A	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	00	06000	39.23512508	-121.0306878	Nevada County
322474	Ordering, Referring, Prescribing	N/A	1164560264	0	0	EYONG, PHILOMINA	7/29/2013	Taxonomy not applicable	NA	n/a	000	Unknown	PA13728	N/A	N/A	N/A	N/A	N/A	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	00	06000	33.94274917	-118.2461916	Los Angeles County
322584	Ordering, Referring, Prescribing	N/A	1164763710	0	0	ESTERKIN, ARI N LMFT	12/15/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	91434	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HWY	100	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
322635	Ordering, Referring, Prescribing	N/A	1164853347	0	0	ESQUIVEL, MELISA N LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT98746	N/A	N/A	N/A	N/A	N/A	4333 E VINEYARD AVE	None	OXNARD	CA	93036	1013	00	06000	34.25498155	-119.1558342	Ventura County
322684	Ordering, Referring, Prescribing	N/A	1164940284	0	0	ESPINOZA, DESIREE P CNP	10/17/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007284	N/A	N/A	N/A	N/A	N/A	2201 COURAGE DR	None	FAIRFIELD	CA	94533	6733	00	06000	38.23727106	-122.0692856	Solano County
322728	Ordering, Referring, Prescribing	N/A	1174010888	0	0	EKE, UCHENNA C	9/13/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008715	N/A	N/A	N/A	N/A	N/A	17311 GREENTREE DR	None	RIVERSIDE	CA	92503	6762	00	06000	33.86895068	-117.4509087	Riverside County
322781	Ordering, Referring, Prescribing	N/A	1174106744	0	0	ESCALA PEREZ-REYES, ANDREA Y MD	3/21/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A194924	N/A	N/A	N/A	N/A	N/A	211 EASTMOOR AVE	None	DALY CITY	CA	94015	2036	00	06000	37.6847337	-122.4787562	San Mateo County
322881	Ordering, Referring, Prescribing	N/A	1174569453	0	0	ETTELSON, RICHARD PHD	9/10/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	18953	N/A	N/A	N/A	N/A	N/A	10630 TOWN CENTER DRIVE	SUITE 120	RANCHO CUCAMONGA	CA	91730	6889	00	06000	34.11112305	-117.5729644	San Bernardino County
322890	Ordering, Referring, Prescribing	N/A	1174619985	0	0	ESTRADA, JOSEPH J OD	6/7/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT8713	N/A	N/A	N/A	N/A	N/A	311 PAJARO ST	None	SALINAS	CA	93901	3421	00	06000	36.67356122	-121.6524134	Monterey County
322919	Ordering, Referring, Prescribing	N/A	1174671069	0	0	EHLERS, DONNA L MD	3/29/2020	Taxonomy not applicable	NA	n/a	000	Unknown	A41692	N/A	N/A	N/A	N/A	N/A	9015 MURRAY AVE STE 100	STE 100	GILROY	CA	95020	3675	00	06000	37.03080985	-121.5741639	Santa Clara County
322996	Ordering, Referring, Prescribing	N/A	1174786024	0	0	EBRAHIM, GUL M MD	9/21/2015	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A42994	N/A	N/A	N/A	N/A	N/A	4211 S AVALON BLVD	None	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
323020	Ordering, Referring, Prescribing	N/A	1174865455	0	0	ELLEDGE, BRIAN E DO	6/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A14904	N/A	N/A	N/A	N/A	N/A	1066 S WHITE RD	None	SAN JOSE	CA	95127	3812	00	06000	37.35676387	-121.8196933	Santa Clara County
323089	Ordering, Referring, Prescribing	N/A	1174949580	0	0	ESENARRO, ALISSA K LMFT	2/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	104463	N/A	N/A	N/A	N/A	N/A	5575 CAPISTRANO AVE	None	ATASCADERO	CA	93422	4264	00	06000	35.49223909	-120.663796	San Luis Obispo County
323154	Ordering, Referring, Prescribing	N/A	1184026973	0	0	ECHEVARRIA, DEANNA LCSW	2/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87094	N/A	N/A	N/A	N/A	N/A	233 S QUINTANA DR	None	ANAHEIM	CA	92807	4029	00	06000	33.85230249	-117.7739305	Orange County
323285	Ordering, Referring, Prescribing	N/A	1184233397	0	0	ESPINOZA, JOSE LCSW	5/10/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101459	N/A	N/A	N/A	N/A	N/A	1300 17TH ST	None	BAKERSFIELD	CA	93301	4504	00	06000	35.37476047	-119.016774	Kern County
323306	Ordering, Referring, Prescribing	N/A	1184265845	0	0	EDENS, JONATHAN PA-C	4/16/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA57279	N/A	N/A	N/A	N/A	N/A	9333 TECH CENTER DR	STE 100	SACRAMENTO	CA	95826	2583	00	06000	38.563839	-121.3521435	Sacramento County
323346	Ordering, Referring, Prescribing	N/A	1184375644	0	0	ELSAYED, MONA	3/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78262	N/A	N/A	N/A	N/A	N/A	1807 W KATELLA AVE	206	ANAHEIM, CA	CA	92804	0000	00	06000	33.80322548	-117.946044	Orange County
323356	Ordering, Referring, Prescribing	N/A	1184398372	0	0	ESTELL, CORNELIA NP	11/15/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017864	N/A	N/A	N/A	N/A	N/A	3451 W CENTURY BLVD	None	INGLEWOOD	CA	90303	1227	00	06000	33.948198	-118.3321575	Los Angeles County
323384	Ordering, Referring, Prescribing	N/A	1184665200	0	0	EDWARDS, CHARLES H MD	8/26/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G81670	N/A	N/A	N/A	N/A	N/A	240 SHOTWELL ST	None	SAN FRANCISCO	CA	94110	1323	00	06000	37.76460716	-122.416335	San Francisco County
323445	Ordering, Referring, Prescribing	N/A	1184823304	0	0	ELMAN, STEVEN B	11/30/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D23926	N/A	N/A	N/A	N/A	N/A	55 E JULIAN ST	None	SAN JOSE	CA	95112	4007	00	06000	37.34118198	-121.8925795	Santa Clara County
323507	Ordering, Referring, Prescribing	N/A	1184918088	0	0	ECKER, DANIELLE R LMFT	1/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103565	N/A	N/A	N/A	N/A	N/A	3724 N 1ST ST	STE. B	FRESNO	CA	93726	5601	00	06000	36.785925	-119.7723515	Fresno County
323517	Ordering, Referring, Prescribing	N/A	1184943896	0	0	ENRIQUEZ, JACLYN LMFT	7/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT100206	N/A	N/A	N/A	N/A	N/A	2865 LOGAN AVE	None	SAN DIEGO	CA	92113	2411	00	06000	32.69694991	-117.1324497	San Diego County
323550	Ordering, Referring, Prescribing	N/A	1184995342	0	0	EIDSON, TRACY D	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0599215	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
323563	Ordering, Referring, Prescribing	N/A	1194025122	0	0	EID, NERMINE	8/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	57099	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	MS SEC2-B	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
323614	Ordering, Referring, Prescribing	N/A	1194118927	0	0	ESTRADA, NATALIA LCSW	3/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87230	N/A	N/A	N/A	N/A	N/A	375 89TH ST	None	DALY CITY	CA	94015	1802	00	06000	37.69175212	-122.474006	San Mateo County
323720	Ordering, Referring, Prescribing	N/A	1194287839	0	0	EWING, TANJI J LMFT	12/19/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	136595	N/A	N/A	N/A	N/A	N/A	400 W CIVIC CENTER DR	4TH FLOOR	SANTA ANA	CA	92701	4539	00	06000	33.7514907	-117.8707379	Orange County
323749	Ordering, Referring, Prescribing	N/A	1194381756	0	0	EBEL, KATHERINE N PHARMD	4/5/2019	Taxonomy not applicable	NA	n/a	000	Unknown	CA80403	N/A	N/A	N/A	N/A	N/A	1520 BRUNDAGE LN	None	BAKERSFIELD	CA	93304	2949	00	06000	35.355456	-119.0196225	Kern County
323931	Ordering, Referring, Prescribing	N/A	1205045598	0	0	ELLIS, ARNOLD MD	9/4/2017	Taxonomy not applicable	NA	n/a	000	Unknown	A31480	N/A	N/A	N/A	N/A	N/A	3631 CRENSHAW BLVD	STE 109	LOS ANGELES	CA	90016	4869	00	06000	34.023177	-118.3351475	Los Angeles County
324039	Ordering, Referring, Prescribing	N/A	1205251493	0	0	EASTMAN, KUMI LMFT	2/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106200	N/A	N/A	N/A	N/A	N/A	4444 CALLE REAL	None	SANTA BARBARA	CA	93110	1002	00	06000	34.44240122	-119.7765542	Santa Barbara County
324073	Ordering, Referring, Prescribing	N/A	1205310794	0	0	ELDERKIN, NORA	5/11/2020	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236117	N/A	N/A	N/A	N/A	N/A	650 N. FULTON STREET	None	FRESNO	CA	93728	3404	00	06000	36.75213	-119.800333	Fresno County
324083	Ordering, Referring, Prescribing	N/A	1205314721	0	0	EVNIN, AIMEE R LMFT	5/26/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121983	N/A	N/A	N/A	N/A	N/A	226 W OJAI AVE	101-180	OJAI	CA	93023	3277	00	06000	34.44760276	-119.2488095	Ventura County
324097	Ordering, Referring, Prescribing	N/A	1205332863	0	0	EARLE, SUZANNE LMFT	8/21/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT141029	N/A	N/A	N/A	N/A	N/A	1503 GRANT ROAD	SUITE 110	MOUNTAIN VIEW	CA	94040	3270	00	06000	37.37672165	-122.0757295	Santa Clara County
324198	Ordering, Referring, Prescribing	N/A	1205572708	0	0	EVANS, MICHELE LP	5/5/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	4236	N/A	N/A	N/A	N/A	N/A	7216 PALM AVE	C	HIGHLAND	CA	92346	3280	00	06000	34.12296953	-117.208792	San Bernardino County
324312	Ordering, Referring, Prescribing	N/A	1215067038	0	0	ELIS, RACHEL LCSW	6/29/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29403	N/A	N/A	N/A	N/A	N/A	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	00	06000	36.696987	-121.633164	Monterey County
324327	Ordering, Referring, Prescribing	N/A	1215070008	0	0	ECHEVERRIA, JANIE LCSW	5/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW26570	N/A	N/A	N/A	N/A	N/A	202 N 8TH ST	None	EL CENTRO	CA	92243	2302	00	06000	32.794335	-115.5614775	Imperial County
324364	Ordering, Referring, Prescribing	N/A	1215185293	0	0	EYESTONE, ANTHONY J LMFT	1/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	86520	N/A	N/A	N/A	N/A	N/A	2640 BRESLAUER WAY	None	REDDING	CA	96001	4246	00	06000	40.5496754	-122.3791396	Shasta County
324403	Ordering, Referring, Prescribing	N/A	1215233465	0	0	ERCIA, JESSICA D M NP	4/28/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	635867	N/A	N/A	N/A	N/A	N/A	243 GEORGIA ST	STE B	VALLEJO	CA	94590	5905	00	06000	38.10111026	-122.2588175	Solano County
324459	Ordering, Referring, Prescribing	N/A	1215319983	0	0	ELEMUREN, TAIWO A NP	6/30/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	797360	N/A	N/A	N/A	N/A	N/A	400 W 30TH ST	None	LOS ANGELES	CA	90007	3200	00	06000	34.0239409	-118.2755606	Los Angeles County
324491	Ordering, Referring, Prescribing	N/A	1215366570	0	0	ESQUIVEL, MARIO	3/12/2018	Taxonomy not applicable	NA	n/a	000	Unknown	51223	N/A	N/A	N/A	N/A	N/A	1454 E 2ND ST	None	SAN BERNARDINO	CA	92408	0118	00	06000	34.1035953	-117.2563723	San Bernardino County
324683	Ordering, Referring, Prescribing	N/A	1225085731	0	0	ERRICO, JOSEPH R MD	6/30/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C129921	N/A	N/A	N/A	N/A	N/A	31760 CASINO DR	100	LAKE ELSINORE	CA	92530	2313	00	06000	33.65752351	-117.2961478	Riverside County
324712	Ordering, Referring, Prescribing	N/A	1225156599	0	0	ELIZALDI, GABRIELA G LCSW	6/8/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW75445	N/A	N/A	N/A	N/A	N/A	2922 TRANSWORLD DR	None	STOCKTON	CA	95206	3952	00	06000	37.90687986	-121.2291511	San Joaquin County
324768	Ordering, Referring, Prescribing	N/A	1225238694	0	0	EALEY, SHALBE	5/16/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29331	N/A	N/A	N/A	N/A	N/A	15206 PARTHENIA ST	None	NORTH HILLS	CA	91343	5305	00	06000	34.22817313	-118.4636497	Los Angeles County
324829	Ordering, Referring, Prescribing	N/A	1225375132	0	0	ERAZO, ELSA LCSW	8/23/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW92904	N/A	N/A	N/A	N/A	N/A	160 E VIRGINIA ST	None	SAN JOSE	CA	95112	5857	00	06000	37.32582868	-121.8777868	Santa Clara County
324843	Ordering, Referring, Prescribing	N/A	1225401953	0	0	ELIZONDO, ADRIAN LMFT	5/23/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116616	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY	210	SANTA ROSA	CA	95407	5478	00	06000	38.425266	-122.749875	Sonoma County
324851	Ordering, Referring, Prescribing	N/A	1225412836	0	0	ESCOTO, STEPHANIE LCSW	12/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99115	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	STE.210	OXNARD	CA	93036	2612	00	06000	34.219566	-119.1539365	Ventura County
324863	Ordering, Referring, Prescribing	N/A	1225431448	0	0	ESGUERRA, CAROLINE C MD	2/13/2015	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132724	N/A	N/A	N/A	N/A	N/A	7601 HOSPITAL DR	STE 103	SACRAMENTO	CA	95823	5408	00	06000	38.464794	-121.415571	Sacramento County
324943	Ordering, Referring, Prescribing	N/A	1225534746	0	0	EICHELBERG, VALERIE M LMFT	9/13/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128071	N/A	N/A	N/A	N/A	N/A	265 SAN JACINTO RIVER RD	STE. 107	LAKE ELSINORE	CA	92530	4419	00	06000	33.66201142	-117.3001906	Riverside County
325036	Ordering, Referring, Prescribing	N/A	1225751274	0	0	EGUASA, VALERIE O NP	7/27/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95022033	N/A	N/A	N/A	N/A	N/A	16147 E WHITTIER BLVD	None	WHITTIER	CA	90603	2560	00	06000	33.94157588	-117.9859969	Los Angeles County
325061	Ordering, Referring, Prescribing	N/A	1235164047	0	0	ELDER, CHRISTINE A	12/10/2019	Taxonomy not applicable	NA	n/a	000	Unknown	12187	N/A	N/A	N/A	N/A	N/A	18144 SECO ST	None	JAMESTOWN	CA	95327	9498	00	06000	37.95208073	-120.4216785	Tuolumne County
325091	Ordering, Referring, Prescribing	N/A	1235258005	0	0	EMMER, DANA L LCSW	11/21/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26113	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
325094	Ordering, Referring, Prescribing	N/A	1235243007	0	0	EDDY, STEVEN NP	9/6/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027074	N/A	N/A	N/A	N/A	N/A	554-850 MEDICAL CENTER D	None	BIEBER	CA	96009	0277	00	06000	0	0	None
325095	Ordering, Referring, Prescribing	N/A	1235264474	0	0	ESCUDERO, JENNIFER C LCSW	12/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	65808	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
325271	Ordering, Referring, Prescribing	N/A	1235565524	0	0	EVANS, CARRIE N NP	3/18/2016	Taxonomy not applicable	NA	n/a	000	Unknown	824689	N/A	N/A	N/A	N/A	N/A	1682 7TH ST	None	OAKLAND	CA	94607	1351	00	06000	37.80663765	-122.3002667	Alameda County
325380	Ordering, Referring, Prescribing	N/A	1235748336	0	0	ELIA, FADI E	3/16/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	105073	N/A	N/A	N/A	N/A	N/A	165 S 1ST ST	None	EL CAJON	CA	92019	4795	00	06000	32.794002	-116.944563	San Diego County
325388	Ordering, Referring, Prescribing	N/A	1235789918	0	0	EYZAGUIRRE, RHONDA J PHD	9/16/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	2940	N/A	N/A	N/A	N/A	N/A	1111 W CENTURY BLVD	None	LODI	CA	95240	6605	00	06000	38.10825345	-121.2850035	San Joaquin County
325410	Ordering, Referring, Prescribing	N/A	1235876905	0	0	ESQUIVEL, VENUS MD	7/5/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A197515	N/A	N/A	N/A	N/A	N/A	26600 CACTUS AVE	SUITE #300	MORENO VALLEY	CA	92555	3901	00	06000	33.91013953	-117.193383	Riverside County
325505	Ordering, Referring, Prescribing	N/A	1245388974	0	0	ELDRIDGE, CAROLYN J CNM	6/22/2017	Taxonomy not applicable	NA	n/a	018	NURSE ANESTHETISTS	748192	N/A	N/A	N/A	N/A	N/A	101 WEST COAST RD	None	REDWAY	CA	95560	0769	00	06000	40.11704433	-123.8133408	Humboldt County
325516	Ordering, Referring, Prescribing	N/A	1245417997	0	0	ESCOBEDO, LILIA B LMFT	10/2/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	91936	N/A	N/A	N/A	N/A	N/A	47923 OASIS ST	None	INDIO	CA	92201	9203	00	06000	33.70080223	-116.2209518	Riverside County
325529	Ordering, Referring, Prescribing	N/A	1245434877	0	0	EVANS, LORI LMFT	9/20/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51067	N/A	N/A	N/A	N/A	N/A	1400 EMELINE AVE	None	SANTA CRUZ	CA	95060	1976	00	06000	36.99276804	-122.0178271	Santa Cruz County
325567	Ordering, Referring, Prescribing	N/A	1245506732	0	0	ELIZONDO, PAUL M DO	9/13/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A13023	N/A	N/A	N/A	N/A	N/A	3230 KERNER BLVD	None	SAN RAFAEL	CA	94901	4840	00	06000	37.96037915	-122.5019455	Marin County
325811	Ordering, Referring, Prescribing	N/A	1245892272	0	0	ELLANTI, NAGA P MD	2/23/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176510	N/A	N/A	N/A	N/A	N/A	65 N HOCKETT ST	None	PORTERVILLE	CA	93257	0000	00	06000	36.0663928	-119.01714	Tulare County
325981	Ordering, Referring, Prescribing	N/A	1255565982	0	0	ECHEVERRIA, SALVADOR MD	3/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A107114	N/A	N/A	N/A	N/A	N/A	149 PASADENA AVE.	FIRST FLOOR	SOUTH PASADENA	CA	91030	2947	00	06000	34.11188281	-118.1734374	Los Angeles County
326018	Ordering, Referring, Prescribing	N/A	1255636130	0	0	ESCORCIA, CLAUDIA E LMFT	3/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	93633	N/A	N/A	N/A	N/A	N/A	6809 INDIANA AVE	131	RIVERSIDE	CA	92506	4221	00	06000	33.94312844	-117.3918196	Riverside County
326112	Ordering, Referring, Prescribing	N/A	1255786646	0	0	EWUDO, IZUNNA V	5/24/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95004185	N/A	N/A	N/A	N/A	N/A	325 E 7TH ST	None	LOS ANGELES	CA	90014	2209	00	06000	34.04209386	-118.2486813	Los Angeles County
326125	Ordering, Referring, Prescribing	N/A	1255818688	0	0	EMERSON, SIONA M PHARMD	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77254	N/A	N/A	N/A	N/A	N/A	3800 DALE RD	None	MODESTO	CA	95356	8627	00	06000	37.69395556	-121.0499498	Stanislaus County
326174	Ordering, Referring, Prescribing	N/A	1255886537	0	0	ESQUIVEL, MONICA LMFT	12/9/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	136321	N/A	N/A	N/A	N/A	N/A	5350 MACHADO LN	None	CULVER CITY	CA	90230	8800	00	06000	33.99772397	-118.3961412	Los Angeles County
326265	Ordering, Referring, Prescribing	N/A	1265068878	0	0	EGWIM, VITALIS NP	2/20/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95014012	N/A	N/A	N/A	N/A	N/A	43322 GINGHAM AVE	None	LANCASTER	CA	93535	4577	00	06000	34.67013731	-118.1222748	Los Angeles County
326276	Ordering, Referring, Prescribing	N/A	1265096101	0	0	ELTAGUNDE, CARLOS F NP	2/27/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011295	N/A	N/A	N/A	N/A	N/A	3940 SANDPIPER AVE	None	MERCED	CA	95340	8372	00	06000	37.33841229	-120.466546	Merced County
326280	Ordering, Referring, Prescribing	N/A	1265096861	0	0	EDQUIST, JENNIFER RN PHN	1/17/2019	Taxonomy not applicable	NA	n/a	000	Unknown	811621	N/A	N/A	N/A	N/A	N/A	545 CHANEY ST	None	LAKE ELSINORE	CA	92530	2712	00	06000	33.68277396	-117.3359408	Riverside County
326354	Ordering, Referring, Prescribing	N/A	1265520761	0	0	ESCOBAR-WOOD, EVELYN E PSYD	3/18/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY15917	N/A	N/A	N/A	N/A	N/A	800 N ECKHOFF ST	None	ORANGE	CA	92868	1008	00	06000	33.79960624	-117.8741126	Orange County
326359	Ordering, Referring, Prescribing	N/A	1265549588	0	0	ENSOM, ROBERT T MD	5/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G45247	N/A	N/A	N/A	N/A	N/A	40 E MINARETS AVE	None	PINEDALE	CA	93650	1239	00	06000	36.84269447	-119.7897525	Fresno County
326378	Ordering, Referring, Prescribing	N/A	1265568323	0	0	ESTRELLA, CARMELY LCSW	10/18/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW7054	N/A	N/A	N/A	N/A	N/A	12940 BONAPARTE AVE	None	LOS ANGELES	CA	90066	6528	00	06000	33.98543172	-118.4304611	Los Angeles County
326383	Ordering, Referring, Prescribing	N/A	1265582779	0	0	ELIE, NEDA N PHARMD	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57707	N/A	N/A	N/A	N/A	N/A	5601 DESOTO AVE	None	WOODLAND HILLS	CA	91367	6701	00	06000	34.17030266	-118.5881699	Los Angeles County
326543	Ordering, Referring, Prescribing	N/A	1265863096	0	0	ECKLOR, TIFFANY L LMFT	3/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	107009	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD	None	HESPERIA	CA	92395	7720	00	06000	34.48058899	-117.2907353	San Bernardino County
326545	Ordering, Referring, Prescribing	N/A	1265867261	0	0	ENRIQUEZ, ALEJANDRA LCSW	2/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82317	N/A	N/A	N/A	N/A	N/A	1420 MILLIKEN AVE.	508	ONTARIO	CA	91761	2337	00	06000	34.047684	-117.55872	San Bernardino County
326567	Ordering, Referring, Prescribing	N/A	1265889588	0	0	ELDRIDGE, CARIN MD MPH	3/12/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	58403	N/A	N/A	N/A	N/A	N/A	10956 DONNER PASS RD FL	None	TRUCKEE	CA	96161	4861	00	06000	39.32625521	-120.2012059	Nevada County
326779	Ordering, Referring, Prescribing	N/A	1275600579	0	0	ESTRADA, BERENICE LMFT	6/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90277	N/A	N/A	N/A	N/A	N/A	951 B BLANCO CIRCLE	None	SALINAS	CA	93901	4451	00	06000	36.65589725	-121.6366313	Monterey County
326816	Ordering, Referring, Prescribing	N/A	1275665820	0	0	EKIZIAN, GASSIA LMFT	11/3/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	40428	N/A	N/A	N/A	N/A	N/A	2500 E FOOTHILL BLVD	None	PASADENA	CA	91107	3464	00	06000	34.14979547	-118.097982	Los Angeles County
326923	Ordering, Referring, Prescribing	N/A	1275885253	0	0	EVANS, MARY ANN PHD	12/7/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY11935	N/A	N/A	N/A	N/A	N/A	28 W ARRELLAGA ST	None	SANTA BARBARA	CA	93101	6514	00	06000	34.42634973	-119.7103983	Santa Barbara County
326932	Ordering, Referring, Prescribing	N/A	1275895641	0	0	ELDRINGHOFF, DAVID M	9/10/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A155404	N/A	N/A	N/A	N/A	N/A	741 S ORANGE AVE	SUITE 200	WEST COVINA	CA	97190	2662	00	06000	34.07079634	-117.9445034	Los Angeles County
326995	Ordering, Referring, Prescribing	N/A	1275983991	0	0	ESPANO, JOSHUA B LCSW	11/30/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	92594	N/A	N/A	N/A	N/A	N/A	520 S LA FAYETTE PARK PL	None	LOS ANGELES	CA	90057	1607	00	06000	34.06392003	-118.2826062	Los Angeles County
327000	Ordering, Referring, Prescribing	N/A	1275986127	0	0	EAPEN, RENE P MD	1/26/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A162269	N/A	N/A	N/A	N/A	N/A	808 W 58TH ST	None	LOS ANGELES	CA	90037	3632	00	06000	33.98965917	-118.287673	Los Angeles County
327183	Ordering, Referring, Prescribing	N/A	1285261107	0	0	ETZEL, MICHAEL S MD	2/19/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A179204	N/A	N/A	N/A	N/A	N/A	5860 UPLANDER WAY	None	CULVER CITY	CA	90230	6608	00	06000	33.98480921	-118.3871859	Los Angeles County
327226	Ordering, Referring, Prescribing	N/A	1285396804	0	0	ELDRIDGE, MATTHEW L NP	10/13/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	823434	N/A	N/A	N/A	N/A	N/A	1250 16TH STREET	None	SANTA MONICA	CA	90404	1249	00	06000	34.02749142	-118.486063	Los Angeles County
327356	Ordering, Referring, Prescribing	N/A	1285903203	0	0	ENGELDRUM MAGANA, AMANDA L LCSW	9/30/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW110773	N/A	N/A	N/A	N/A	N/A	411 E LAKE AVE	None	WATSONVILLE	CA	95076	4424	00	06000	36.91720138	-121.7507888	Santa Cruz County
327434	Ordering, Referring, Prescribing	N/A	1295035905	0	0	EVANS, JENNIFER A LMFT	11/3/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT81067	N/A	N/A	N/A	N/A	N/A	520 W PALMDALE BLVD	D	PALMDALE	CA	93551	4229	00	06000	34.58407117	-118.1400842	Los Angeles County
327471	Ordering, Referring, Prescribing	N/A	1295111292	0	0	ESPINOZA, ARAYALITH LCSW	11/13/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93818	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
327472	Ordering, Referring, Prescribing	N/A	1295098283	0	0	EDSHTEYN, INGRID DO	3/19/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15899	N/A	N/A	N/A	N/A	N/A	200 MED PLAZA	365, 420, 120	LOS ANGELES	CA	90024	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
327492	Ordering, Referring, Prescribing	N/A	1295149359	0	0	ESTRADA MARROQUIN, ERICA LCSW	4/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76420	N/A	N/A	N/A	N/A	N/A	695 S VERMONT AVE	FLOOR 8	LOS ANGELES	CA	90005	1349	00	06000	34.06078495	-118.2916863	Los Angeles County
327507	Ordering, Referring, Prescribing	N/A	1295186112	0	0	ELSAMRA, AMR PHARMD	1/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83943	N/A	N/A	N/A	N/A	N/A	2955 ALPINE BLVD	None	ALPINE	CA	91901	2392	00	06000	32.83443413	-116.7499452	San Diego County
327634	Ordering, Referring, Prescribing	N/A	1295452597	0	0	ESPINOZA SAAVEDRA, VICTOR NP	10/26/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023123	N/A	N/A	N/A	N/A	N/A	1101 N CHERRY ST	None	TULARE	CA	93274	2231	00	06000	36.22333808	-119.337575	Tulare County
327663	Ordering, Referring, Prescribing	N/A	1295720548	0	0	EASLEY, ANN C NP	12/27/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	6904	N/A	N/A	N/A	N/A	N/A	5901 W OLYMPIC BLVD	None	LOS ANGELES	CA	90036	4667	00	06000	34.05764121	-118.3603115	Los Angeles County
327700	Ordering, Referring, Prescribing	N/A	1295814648	0	0	ELAHIYOUN, ELHAM DDS	3/1/2023	Taxonomy not applicable	NA	n/a	000	Unknown	DDS53701	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	100	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
327704	Ordering, Referring, Prescribing	N/A	1295852408	0	0	ESPINOZA, HILDA M LMFT	1/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	88805	N/A	N/A	N/A	N/A	N/A	209 E 7TH ST	None	MADERA	CA	93638	3780	00	06000	36.96069768	-120.0559841	Madera County
327707	Ordering, Referring, Prescribing	N/A	1295859247	0	0	ESCAMILLA, ADRIANA G LMFT	7/12/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51066	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	3050	00	06000	34.41078438	-118.510775	Los Angeles County
327819	Ordering, Referring, Prescribing	N/A	1306108063	0	0	ESQUIVEL, SYLVIA I LMFT	2/14/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT145050	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD	None	VICTORVILLE	CA	92395	7720	00	06000	34.48058899	-117.2907353	San Bernardino County
327853	Ordering, Referring, Prescribing	N/A	1306153671	0	0	ELSON, SHERRILL A LCSW	3/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	78718	N/A	N/A	N/A	N/A	N/A	820 34TH ST	None	BAKERSFIELD	CA	93301	2283	00	06000	35.39053308	-119.0117133	Kern County
327867	Ordering, Referring, Prescribing	N/A	1306170212	0	0	EGGERS, KATHERINE S LMFT	3/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103245	N/A	N/A	N/A	N/A	N/A	350 90TH ST	None	DALY CITY	CA	94015	1879	00	06000	37.69111548	-122.473143	San Mateo County
327900	Ordering, Referring, Prescribing	N/A	1306224803	0	0	ESCALANTE, FABIOLA V PHARMD	4/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72018	N/A	N/A	N/A	N/A	N/A	13652 CANTARA STREET	None	PANORAMA	CA	91402	0000	00	06000	34.21980849	-118.4301135	Los Angeles County
328008	Ordering, Referring, Prescribing	N/A	1306420286	0	0	ESCOBEDO, EVA G PHARMD	1/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH82809	N/A	N/A	N/A	N/A	N/A	202 W WILLOW AVE	#502	VISALIA	CA	93291	6238	00	06000	36.328536	-119.293569	Tulare County
328025	Ordering, Referring, Prescribing	N/A	1306475033	0	0	EDDY, YOOJEONG K NP	11/18/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011826	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
328140	Ordering, Referring, Prescribing	N/A	1306976782	0	0	EXELL, ELIZABETH LCSW	6/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76960	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	150	OXNARD	CA	93036	2612	00	06000	34.219566	-119.1539365	Ventura County
328154	Ordering, Referring, Prescribing	N/A	1306992953	0	0	ESPINOZA, DANIELLE M LMFT	4/11/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	81025	N/A	N/A	N/A	N/A	N/A	16700 VALLEY VIEW AVE.	STE. 300	LA MIRADA	CA	90638	5841	00	06000	33.87993557	-118.028767	Los Angeles County
328211	Ordering, Referring, Prescribing	N/A	1316092794	0	0	ESPINOSA, ARLENE M LMFT	12/29/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT85952	N/A	N/A	N/A	N/A	N/A	21840 S NORMANDIE AVE	500	TORRANCE	CA	90509	0000	00	06000	33.82982744	-118.2991395	Los Angeles County
328258	Ordering, Referring, Prescribing	N/A	1316221377	0	0	EZE, MERCY NP	6/15/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	733235	N/A	N/A	N/A	N/A	N/A	45104 10TH STREET WEST	None	LANCASTER	CA	93534	2310	00	06000	34.702929	-118.1480935	Los Angeles County
328262	Ordering, Referring, Prescribing	N/A	1316229586	0	0	EVERITT, MELISSA B PHARMD	11/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54618	N/A	N/A	N/A	N/A	N/A	477 W NAPA ST	None	SONOMA	CA	95476	6551	00	06000	38.29284433	-122.4675535	Sonoma County
328275	Ordering, Referring, Prescribing	N/A	1316239775	0	0	EAKIN, JOHN MD	4/23/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A185784	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
328341	Ordering, Referring, Prescribing	N/A	1316351711	0	0	EARL, ALYX LCSW	2/6/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87315	N/A	N/A	N/A	N/A	N/A	995 GATEWAY CENTER WAY	SUITE	SAN DIEGO	CA	92102	4500	00	06000	32.71405516	-117.1158459	San Diego County
328468	Ordering, Referring, Prescribing	N/A	1316540206	0	0	EGBUNA, LINDA A	2/1/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024120	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
328639	Ordering, Referring, Prescribing	N/A	1326179417	0	0	ENRIQUEZ, MICHAEL M	4/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49125	N/A	N/A	N/A	N/A	N/A	14624 SHERMAN WAY, SUITE	508	VAN NUYS	CA	91405	1001	00	06000	34.20078354	-118.450843	Los Angeles County
328651	Ordering, Referring, Prescribing	N/A	1326208299	0	0	EVANS, DANIELLE LCSW	12/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27595	N/A	N/A	N/A	N/A	N/A	2828 FORD ST	None	OAKLAND	CA	94601	2114	00	06000	37.77357837	-122.2352589	Alameda County
328666	Ordering, Referring, Prescribing	N/A	1326249244	0	0	ECHEBESTE-SILVA, YOLANDA LMFT	7/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52574	N/A	N/A	N/A	N/A	N/A	310 N IRWIN ST	SUITE #21	HANFORD	CA	93230	4479	00	06000	36.32789942	-119.6476719	Kings County
328717	Ordering, Referring, Prescribing	N/A	1326321944	0	0	ENGELBRECHT, JAN C	12/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	46187	N/A	N/A	N/A	N/A	N/A	72800 DINAH SHORE DR	None	PALM DESERT	CA	92211	0814	00	06000	33.80472802	-116.3902768	Riverside County
328759	Ordering, Referring, Prescribing	N/A	1326371105	0	0	EPSTEIN, MARCY W NP	1/22/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	8963	N/A	N/A	N/A	N/A	N/A	150 W 7TH ST	None	SAN PEDRO	CA	90731	3320	00	06000	33.73786341	-118.2810362	Los Angeles County
328800	Ordering, Referring, Prescribing	N/A	1326443482	0	0	ERLER, CIARA S LMFT	10/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT103818	N/A	N/A	N/A	N/A	N/A	8139 SUNSET AVE #224	None	FAIR OAKS	CA	95628	5131	00	06000	38.653335	-121.263165	Sacramento County
328846	Ordering, Referring, Prescribing	N/A	1326514886	0	0	EARLS, KELLY A RN	2/6/2018	Taxonomy not applicable	NA	n/a	000	Unknown	517268	N/A	N/A	N/A	N/A	N/A	1300 BAKER STREET	None	BAKERSFIELD	CA	93305	4326	00	06000	35.38256022	-118.990868	Kern County
328953	Ordering, Referring, Prescribing	N/A	1326698754	0	0	ESTRADA, ELISA LPCC	4/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC11462	N/A	N/A	N/A	N/A	N/A	160 S 7TH ST	None	LA PUENTE	CA	91746	3211	00	06000	34.0335863	-117.9760093	Los Angeles County
329089	Ordering, Referring, Prescribing	N/A	1336384163	0	0	EBANKS-BUTLER, SHANA L LMFT	4/13/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102284	N/A	N/A	N/A	N/A	N/A	2900 ADAMS ST.	STE C170	RIVERSIDE	CA	92504	4335	00	06000	33.9214315	-117.4148549	Riverside County
329099	Ordering, Referring, Prescribing	N/A	1336408004	0	0	EVANS, JENNIFER LMFT	7/6/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT107515	N/A	N/A	N/A	N/A	N/A	321 NORTH IOWA ST.	None	FALLBROOK	CA	92028	2108	00	06000	33.3841598	-117.2480667	San Diego County
329112	Ordering, Referring, Prescribing	N/A	1336424753	0	0	ELIZALDE, MARIA P LMFT	12/9/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	94572	N/A	N/A	N/A	N/A	N/A	300 EAST 15TH STREET	SUITE B	MERCED	CA	95341	6217	00	06000	37.29443362	-120.4719616	Merced County
329116	Ordering, Referring, Prescribing	N/A	1336432277	0	0	ENGLEBRECHT, KAROL LCSW	5/3/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	122330	N/A	N/A	N/A	N/A	N/A	2125 CITRACADO PKWY	STE 200	ESCONDIDO	CA	92029	4159	00	06000	33.11901958	-117.1202863	San Diego County
329223	Ordering, Referring, Prescribing	N/A	1336589290	0	0	ELLIS, DESTI A LCSW	3/14/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW80994	N/A	N/A	N/A	N/A	N/A	190 E HACKETT RD	None	MODESTO	CA	95350	0000	00	06000	37.58759858	-120.9911422	Stanislaus County
329251	Ordering, Referring, Prescribing	N/A	1336634559	0	0	EVERLY, DANIELLE LMFT	3/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116445	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
329374	Ordering, Referring, Prescribing	N/A	1346014081	0	0	ELLIS-FALIK, ELIZABETH	11/20/2024	Taxonomy not applicable	NA	n/a	000	Unknown	65464	N/A	N/A	N/A	N/A	N/A	3030 EXPLORER DR	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
329434	Ordering, Referring, Prescribing	N/A	1346366010	0	0	ESPAILLAT, JOSE MD	5/5/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A101837	N/A	N/A	N/A	N/A	N/A	359 GABILAN DR	None	SOLEDAD	CA	93960	3550	00	06000	36.43614633	-121.3277604	Monterey County
329492	Ordering, Referring, Prescribing	N/A	1346463163	0	0	EVANS, PAULA A LMFT	6/16/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	23384	N/A	N/A	N/A	N/A	N/A	2522 GRAND CANAL BLVD	SUITE 1	STOCKTON	CA	95207	8150	00	06000	37.98353982	-121.3388944	San Joaquin County
329539	Ordering, Referring, Prescribing	N/A	1346546173	0	0	EPSTEIN, BERT H PSYD	12/20/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY21404	N/A	N/A	N/A	N/A	N/A	1501 MENDOCINO AVE	None	SANTA ROSA	CA	95401	4332	00	06000	38.455038	-122.718771	Sonoma County
329552	Ordering, Referring, Prescribing	N/A	1346565777	0	0	EMBRY, TREVOR L LMFT	10/2/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51104	N/A	N/A	N/A	N/A	N/A	6061 EAST AVE.	None	ETIWANDA	CA	91739	2218	00	06000	34.14421719	-117.514554	San Bernardino County
329561	Ordering, Referring, Prescribing	N/A	1346591591	0	0	EVANS, CHRISTINE MD	4/28/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A124644	N/A	N/A	N/A	N/A	N/A	524 W VISTA WAY	None	VISTA	CA	92083	5704	00	06000	33.19635191	-117.2517899	San Diego County
329566	Ordering, Referring, Prescribing	N/A	1346596392	0	0	ENG, CORY A PHARMD	11/21/2019	Taxonomy not applicable	NA	n/a	000	Unknown	48770	N/A	N/A	N/A	N/A	N/A	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
329671	Ordering, Referring, Prescribing	N/A	1346744356	0	0	EGURE, CORDELIA A PHARMD	11/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78179	N/A	N/A	N/A	N/A	N/A	1596 STATE HIGHWAY 99	None	GRIDLEY	CA	95948	3121	00	06000	39.362355	-121.687884	Butte County
329690	Ordering, Referring, Prescribing	N/A	1346778446	0	0	ECKERT, ZACHARY R LCSW	9/15/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW110504	N/A	N/A	N/A	N/A	N/A	1330 E COOLEY DR	None	COLTON	CA	92324	3905	00	06000	34.0544745	-117.305721	San Bernardino County
329782	Ordering, Referring, Prescribing	N/A	1356026082	0	0	EDMOND, EMMA PA-C	6/30/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA62844	N/A	N/A	N/A	N/A	N/A	20601 WEST PAOLI LANE	None	WEIMAR	CA	95736	0518	00	06000	39.03521526	-120.9755343	Placer County
329808	Ordering, Referring, Prescribing	N/A	1356140172	0	0	EHRENBERG, MILO NP	3/3/2025	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95034211	N/A	N/A	N/A	N/A	N/A	29 BAYWOOD AVE	None	SAN MATEO	CA	94402	1516	00	06000	37.56478204	-122.3289243	San Mateo County
329823	Ordering, Referring, Prescribing	N/A	1356361885	0	0	ETHERIDGE, ARI U MD	3/4/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A80762	N/A	N/A	N/A	N/A	N/A	982 MISSION ST	None	SAN FRANCISCO	CA	94103	1111	00	06000	37.7813638	-122.4082438	San Francisco County
329858	Ordering, Referring, Prescribing	N/A	1356468847	0	0	EDWARCZYK, WOJCIECH J LMFT	12/30/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50093	N/A	N/A	N/A	N/A	N/A	3680 E. IMPERIAL HWY	#220	LYNWOOD	CA	90262	2663	00	06000	33.93211641	-118.2011728	Los Angeles County
329876	Ordering, Referring, Prescribing	N/A	1356473920	0	0	ESPINOSA, VANESSA LCSW	8/10/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	65043	N/A	N/A	N/A	N/A	N/A	3303 N BROADWAY AVE	4TH FLOOR	LOS ANGELES	CA	90031	2803	00	06000	34.07380397	-118.20586	Los Angeles County
329910	Ordering, Referring, Prescribing	N/A	1356591531	0	0	EARHART, JAMES A PHD	9/5/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	25055	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
330003	Ordering, Referring, Prescribing	N/A	1356726756	0	0	ELLENWOOD, NORMA LMFT	12/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT123602	N/A	N/A	N/A	N/A	N/A	855 CANYON RD	None	REDDING	CA	96001	5544	00	06000	40.48978049	-122.3926387	Shasta County
330132	Ordering, Referring, Prescribing	N/A	1356953970	0	0	EAR, JENNY K PHARMD	3/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82806	N/A	N/A	N/A	N/A	N/A	270 INTERNATIONAL CIR	BUILDING 3	SAN JOSE	CA	95119	1130	00	06000	37.24047903	-121.7998157	Santa Clara County
330157	Ordering, Referring, Prescribing	N/A	1366002933	0	0	ELKHAZIN, MOHAMED M	4/21/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	104641	N/A	N/A	N/A	N/A	N/A	650 S ZEDIKER AVE	BLDG 3	PARLIER	CA	93648	2667	00	06000	36.60500164	-119.5210273	Fresno County
330247	Ordering, Referring, Prescribing	N/A	1366402976	0	0	ESSAIAN, INESSA MD	12/11/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A72848	N/A	N/A	N/A	N/A	N/A	1540 E COLORADO ST	None	GLENDALE	CA	91205	1514	00	06000	34.1427285	-118.230039	Los Angeles County
330437	Ordering, Referring, Prescribing	N/A	1366859878	0	0	EBRAHIMI, ANNI LCSW	2/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW91027	N/A	N/A	N/A	N/A	N/A	237 N. CENTRAL AVE.	None	GLENDALE	CA	91203	3526	00	06000	34.14943423	-118.2579487	Los Angeles County
330522	Ordering, Referring, Prescribing	N/A	1366997801	0	0	ELLIOTT, FIELDING T	1/8/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95004624	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
330664	Ordering, Referring, Prescribing	N/A	1376544197	0	0	EINHORN, ELISSA J	11/6/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	5308	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
330690	Ordering, Referring, Prescribing	N/A	1376636308	0	0	EVANS, CHARLIE	7/29/2013	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT0008121	N/A	N/A	N/A	N/A	N/A	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	00	06000	33.94274917	-118.2461916	Los Angeles County
330739	Ordering, Referring, Prescribing	N/A	1376732669	0	0	ERICKSON, ALYSSA LPCC	5/10/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC3590	N/A	N/A	N/A	N/A	N/A	855 THIRD AVE	STE 1110	CHULA VISTA	CA	91911	1354	00	06000	32.62197574	-117.0723222	San Diego County
330814	Ordering, Referring, Prescribing	N/A	1376882431	0	0	ERICKSON, JEAN M LMFT	7/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52616	N/A	N/A	N/A	N/A	N/A	1750 S.LEWIS. ROAD	None	CAMARILLO	CA	93010	1056	00	06000	34.186607	-119.0369561	Ventura County
330880	Ordering, Referring, Prescribing	N/A	1376979328	0	0	EARLEY, BRIGHTON PSYD	6/4/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	31230	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS ROAD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
331033	Ordering, Referring, Prescribing	N/A	1386193316	0	0	ERICKSON, JODI LMFT	4/14/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114651	N/A	N/A	N/A	N/A	N/A	120 W HAWTHORNE ST	None	FALLBROOK	CA	92028	2053	00	06000	33.38278338	-117.2520395	San Diego County
331107	Ordering, Referring, Prescribing	N/A	1386388858	0	0	EWING, EMILY E NP	7/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95021655	N/A	N/A	N/A	N/A	N/A	27141 HIDAWAY AVE	200	CANYON COUNTRY	CA	91351	4144	00	06000	34.41483	-118.469039	Los Angeles County
331236	Ordering, Referring, Prescribing	N/A	1386839538	0	0	EBRAHIMI, NADEREH DDS	6/26/2023	Taxonomy not applicable	NA	n/a	000	Unknown	DDS56293	N/A	N/A	N/A	N/A	N/A	1685 E HOME AVE	None	FRESNO	CA	93728	2027	00	06000	36.76325049	-119.7908582	Fresno County
331399	Ordering, Referring, Prescribing	N/A	1396161048	0	0	ENRIGHT, SIRENA LMFT	4/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	107005	N/A	N/A	N/A	N/A	N/A	14140 BEACH BLVD	223	WESTMINSTER	CA	92683	4453	00	06000	33.756966	-117.9894915	Orange County
331511	Ordering, Referring, Prescribing	N/A	1396327326	0	0	ESPITIA, BRENDA PA	1/3/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA63880	N/A	N/A	N/A	N/A	N/A	22481 ASPAN ST	A	LAKE FOREST	CA	92630	1651	00	06000	33.63584653	-117.7125462	Orange County
331596	Ordering, Referring, Prescribing	N/A	1396720710	0	0	ELHAKIM, SAMER MD	8/17/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A64024	N/A	N/A	N/A	N/A	N/A	2400 WIBLE RD	SUITE 14	BAKERSFIELD	CA	93304	4700	00	06000	35.3328934	-119.0389535	Kern County
331808	Ordering, Referring, Prescribing	N/A	1407199912	0	0	EKSTROM, ANNA V DO	5/6/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	14076	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3314	00	06000	38.62729851	-122.8637785	Sonoma County
331941	Ordering, Referring, Prescribing	N/A	1407403959	0	0	ESLAVA, JOANNA C B PHARMD	11/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80470	N/A	N/A	N/A	N/A	N/A	1115 VINE ST	None	HEALDSBURG	CA	95448	4831	00	06000	38.60978207	-122.8723756	Sonoma County
331988	Ordering, Referring, Prescribing	N/A	1407547953	0	0	EDOUARD, LAMARRE LPCC	1/22/2025	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC18493	N/A	N/A	N/A	N/A	N/A	5472 EL CAJON BLVD	#101	SAN DIEGO	CA	92115	3627	00	06000	32.75822774	-117.0768721	San Diego County
332020	Ordering, Referring, Prescribing	N/A	1407842933	0	0	ESTABROOK, BRIAN M PA	9/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	16825	N/A	N/A	N/A	N/A	N/A	198 COHASSET RD	None	CHICO	CA	95926	2202	00	06000	39.75140931	-121.8541188	Butte County
332030	Ordering, Referring, Prescribing	N/A	1407873102	0	0	EGEKEZE, CAROLINE O MD	5/13/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A86266	N/A	N/A	N/A	N/A	N/A	15206 PARTHENIA ST	None	NORTH HILLS	CA	91343	5305	00	06000	34.22817313	-118.4636497	Los Angeles County
332041	Ordering, Referring, Prescribing	N/A	1407924863	0	0	ESTRADA, JASMIN A LPCC	10/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC5154	N/A	N/A	N/A	N/A	N/A	160 E VIRGINIA ST	280	SAN JOSE	CA	95112	5857	00	06000	37.32582868	-121.8777868	Santa Clara County
332133	Ordering, Referring, Prescribing	N/A	1417090648	0	0	EKLUND, STEVE A MD	2/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A72281	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD	None	VICTORVILLE	CA	92395	7720	00	06000	34.48058899	-117.2907353	San Bernardino County
332160	Ordering, Referring, Prescribing	N/A	1417144767	0	0	ELLIS, ELIAS LCSW	7/2/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	85301	N/A	N/A	N/A	N/A	N/A	5000 W SUNSET BLVD	600	LOS ANGELES	CA	90027	5861	00	06000	34.0981066	-118.2986382	Los Angeles County
332218	Ordering, Referring, Prescribing	N/A	1417264755	0	0	EJIMADU, THEDORIA D	12/23/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114499	N/A	N/A	N/A	N/A	N/A	275 BECK AVE	None	FAIRFIELD	CA	94533	6804	00	06000	38.23532718	-122.0663968	Solano County
332232	Ordering, Referring, Prescribing	N/A	1417295734	0	0	ESTRADA, ROXANNA LMFT	9/9/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126242	N/A	N/A	N/A	N/A	N/A	901 WEST VICTORIA STREET	SUITE F&G	COMPTON	CA	90220	5825	00	06000	33.86784006	-118.2368928	Los Angeles County
332246	Ordering, Referring, Prescribing	N/A	1417322066	0	0	EAGLIN, CATRINA A LMFT	4/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT41120	N/A	N/A	N/A	N/A	N/A	4164 BROCKTON AVE	None	RIVERSIDE	CA	92501	3400	00	06000	33.98077024	-117.3813862	Riverside County
332299	Ordering, Referring, Prescribing	N/A	1417392812	0	0	ELSEROAD, STANTON G MD	9/11/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	53053	N/A	N/A	N/A	N/A	N/A	10820 PARKSIDE DR	None	KNOXVILLE	TN	37934	1956	00	06000	35.90003918	-84.14416556	Knox County
332369	Ordering, Referring, Prescribing	N/A	1417508920	0	0	ESQUIVEL, SANDRY Z LMFT	6/28/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126693	N/A	N/A	N/A	N/A	N/A	5628 SLAUSON AVE	None	COMMERCE	CA	90040	0000	00	06000	33.98593459	-118.163681	Los Angeles County
332448	Ordering, Referring, Prescribing	N/A	1417679903	0	0	EKSTROM, SONYA LMFT	1/18/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152739	N/A	N/A	N/A	N/A	N/A	700 FREDERICK ST	#103	SANTA CRUZ	CA	95062	2239	00	06000	36.98031434	-122.004438	Santa Cruz County
332490	Ordering, Referring, Prescribing	N/A	1427098441	0	0	ELLIS, DEBORAH NP	6/29/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	13079	N/A	N/A	N/A	N/A	N/A	474 W VERMONT AVE	None	ESCONDIDO	CA	92025	6584	00	06000	33.10046604	-117.0729623	San Diego County
332505	Ordering, Referring, Prescribing	N/A	1427119973	0	0	ESTILL, FLORE DJANG	11/19/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0592072	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
332526	Ordering, Referring, Prescribing	N/A	1427165232	0	0	ELIAS, ALLICIA G PA	9/4/2018	Taxonomy not applicable	NA	n/a	000	Unknown	22237	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
332563	Ordering, Referring, Prescribing	N/A	1427240191	0	0	EWEN, LYNLEY R LMFT	6/22/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT96975	N/A	N/A	N/A	N/A	N/A	354 S HALCYON RD	None	ARROYO GRANDE	CA	93420	3876	00	06000	35.1136354	-120.5916435	San Luis Obispo County
332569	Ordering, Referring, Prescribing	N/A	1427249150	0	0	EGAN, TARRAH E LMFT	5/1/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52036	N/A	N/A	N/A	N/A	N/A	2145 5TH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
332602	Ordering, Referring, Prescribing	N/A	1427329374	0	0	ESPINOZA, MELISSA L LCSW	4/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82922	N/A	N/A	N/A	N/A	N/A	831 E ARROW HWY	None	POMONA	CA	91767	2535	00	06000	34.09030767	-117.7353578	Los Angeles County
332615	Ordering, Referring, Prescribing	N/A	1427348952	0	0	EAKER, SYDNEY LMFT	7/8/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	27779	N/A	N/A	N/A	N/A	N/A	676 PISMO ST	None	SAN LUIS OBISPO	CA	93401	3945	00	06000	35.27640631	-120.6628883	San Luis Obispo County
332669	Ordering, Referring, Prescribing	N/A	1427443621	0	0	EOM, ELIZABETH MD	1/12/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A162165	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD	MS#54	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
332756	Ordering, Referring, Prescribing	N/A	1427577642	0	0	EDWARDS, MICHELLE PA-C	2/27/2024	Taxonomy not applicable	NA	n/a	000	Unknown	64163	N/A	N/A	N/A	N/A	N/A	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	00	06000	37.54845774	-121.9773463	Alameda County
332780	Ordering, Referring, Prescribing	N/A	1427610443	0	0	ENDOW, EMILIE OD	9/14/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34327	N/A	N/A	N/A	N/A	N/A	810 N AVALON BLVD	None	WILMINGTON	CA	90744	4502	00	06000	33.78041576	-118.2624535	Los Angeles County
332801	Ordering, Referring, Prescribing	N/A	1427650852	0	0	ESTOQUE, LIGAYA	2/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59211	N/A	N/A	N/A	N/A	N/A	1682 7TH STREET	None	OAKLAND	CA	94607	1351	00	06000	37.80663765	-122.3002667	Alameda County
332855	Ordering, Referring, Prescribing	N/A	1437129939	0	0	EASTMAN, WILFRED MD	7/8/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G39623	N/A	N/A	N/A	N/A	N/A	475 BRUCE STREET	SUITE 900	YREKA	CA	96097	3484	00	06000	41.71860037	-122.6467317	Siskiyou County
332862	Ordering, Referring, Prescribing	N/A	1437169224	0	0	ENGLISH, JOHN MD	3/11/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A63984	N/A	N/A	N/A	N/A	N/A	12691 BENTLEY STREET	None	WATERFORD	CA	95386	9011	00	06000	37.64119734	-120.7605517	Stanislaus County
332899	Ordering, Referring, Prescribing	N/A	1437267846	0	0	ERICKSON, KENDRA M	10/10/2002	Taxonomy not applicable	NA	n/a	099	DENTIST	D43001	N/A	N/A	N/A	N/A	N/A	637 MERCED ST	None	NEWMAN	CA	95360	1070	00	06000	37.31481158	-121.0162228	Stanislaus County
332948	Ordering, Referring, Prescribing	N/A	1437343837	0	0	EGEA, RAYANA LMFT	4/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84725	N/A	N/A	N/A	N/A	N/A	1950 ALAMEDA DE LAS PULG	None	BELMONT	CA	94403	1222	00	06000	37.545779	-122.3213093	San Mateo County
332980	Ordering, Referring, Prescribing	N/A	1437404639	0	0	EWING, REGINA A PA-C	8/9/2020	Taxonomy not applicable	NA	n/a	000	Unknown	52247	N/A	N/A	N/A	N/A	N/A	401 E CYPRESS AVE	2ND FLOOR	LOMPOC	CA	93436	6806	00	06000	34.63730451	-120.453777	Santa Barbara County
333073	Ordering, Referring, Prescribing	N/A	1437535457	0	0	ESTRADA, ANA L LCSW	12/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW98906	N/A	N/A	N/A	N/A	N/A	1720 E 120TH ST	None	LOS ANGELES	CA	90059	3052	00	06000	33.92455929	-118.2423557	Los Angeles County
333109	Ordering, Referring, Prescribing	N/A	1437591740	0	0	ENSAFI, SHABNAM PHARMD	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67868	N/A	N/A	N/A	N/A	N/A	1932 WILSHIRE BLVD	None	SANTA MONICA	CA	90403	5606	00	06000	34.03121204	-118.4833937	Los Angeles County
333128	Ordering, Referring, Prescribing	N/A	1437617982	0	0	EDWARDS, BRITTANY CNM	8/9/2019	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236023	N/A	N/A	N/A	N/A	N/A	500B JEFFERSON BLVD	180	WEST SACRAMENTO	CA	95605	2394	00	06000	38.58811316	-121.5270471	Yolo County
333197	Ordering, Referring, Prescribing	N/A	1437714821	0	0	ETEREA, KRIS LCSW	2/3/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106741	N/A	N/A	N/A	N/A	N/A	4760 SEPULVEDA BLVD	None	LOS ANGELES	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
333199	Ordering, Referring, Prescribing	N/A	1437709854	0	0	EGNER, TINA M CNM	4/8/2020	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	95219630	N/A	N/A	N/A	N/A	N/A	700 S TUSTIN ST	None	ORANGE	CA	92866	3425	00	06000	33.77685748	-117.8357804	Orange County
333224	Ordering, Referring, Prescribing	N/A	1437773090	0	0	ESPARZA, JOCELYN DO	4/21/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A20937	N/A	N/A	N/A	N/A	N/A	5427 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4101	00	06000	34.01966132	-118.1536008	Los Angeles County
333344	Ordering, Referring, Prescribing	N/A	1447366026	0	0	EICH, JENNIFER F LCSW	5/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24943	N/A	N/A	N/A	N/A	N/A	131 W MIDWAY DR	None	ANAHEIM	CA	92805	6507	00	06000	33.81259746	-117.910782	Orange County
333377	Ordering, Referring, Prescribing	N/A	1447439005	0	0	EDISON, AREASE LMFT	3/25/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	96020	N/A	N/A	N/A	N/A	N/A	3281 E GUASTI RD	450	ONTARIO	CA	91761	7622	00	06000	34.065063	-117.5799015	San Bernardino County
333399	Ordering, Referring, Prescribing	N/A	1447496906	0	0	ELLISON, CARIE B PA-C	4/12/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60990	N/A	N/A	N/A	N/A	N/A	1971 E 4TH ST	200	SANTA ANA	CA	92705	3917	00	06000	33.7482685	-117.83934	Orange County
333432	Ordering, Referring, Prescribing	N/A	1447548235	0	0	ERWIN, PEGGY MSW LCSW	11/6/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101832	N/A	N/A	N/A	N/A	N/A	850 E FOOTHILL BLVD	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
333533	Ordering, Referring, Prescribing	N/A	1447718689	0	0	ESCUTIA, DESIREY N LMFT	3/28/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131983	N/A	N/A	N/A	N/A	N/A	851 N OAKLAND AVE	None	PASADENA	CA	91104	4343	00	06000	34.16031813	-118.1403347	Los Angeles County
333791	Ordering, Referring, Prescribing	N/A	1457604837	0	0	EVARO, JEANETTE N LMFT	4/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111162	N/A	N/A	N/A	N/A	N/A	201 N COURT ST	None	VISALIA	CA	93291	4918	00	06000	36.331218	-119.292561	Tulare County
333883	Ordering, Referring, Prescribing	N/A	1457768566	0	0	EIDELSON, JOEL MD	5/30/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	FE6726333	N/A	N/A	N/A	N/A	N/A	844 OLD TUNNEL RD	None	GRASS VALLEY	CA	95945	8524	00	06000	39.23512508	-121.0306878	Nevada County
333979	Ordering, Referring, Prescribing	N/A	1457884793	0	0	EZENWA, NKOLI G NP	4/5/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006377	N/A	N/A	N/A	N/A	N/A	2151 E PALMDALE BLVD	None	PALMDALE	CA	93550	4037	00	06000	34.58013142	-118.0898273	Los Angeles County
333984	Ordering, Referring, Prescribing	N/A	1457889974	0	0	EMPRANTHIRI, MAYA	4/10/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH50332	N/A	N/A	N/A	N/A	N/A	1601 COLEMAN AVE	None	SANTA CLARA	CA	95050	5530	00	06000	37.35814451	-121.93908	Santa Clara County
334059	Ordering, Referring, Prescribing	N/A	1467049387	0	0	ENGLISH, ALISON L PA-C	8/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59414	N/A	N/A	N/A	N/A	N/A	400 WEST PUEBLO	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
334256	Ordering, Referring, Prescribing	N/A	1467737890	0	0	ENG, AMY PHARMD	7/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50969	N/A	N/A	N/A	N/A	N/A	3601 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1701	00	06000	37.78635452	-122.4535829	San Francisco County
334461	Ordering, Referring, Prescribing	N/A	1477044519	0	0	ESTRADA, LETICIA M LMFT	8/6/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133098	N/A	N/A	N/A	N/A	N/A	17800 HIGHWAY 18	None	APPLE VALLEY	CA	92307	1221	00	06000	34.54007429	-117.2744761	San Bernardino County
334691	Ordering, Referring, Prescribing	N/A	1477780674	0	0	ELG, CRAIG PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54834	N/A	N/A	N/A	N/A	N/A	75036 GERALD FORD DR	None	PALM DESERT	CA	92211	2080	00	06000	33.78158473	-116.353994	Riverside County
334701	Ordering, Referring, Prescribing	N/A	1477803880	0	0	EKBERG, REBEKAH LMFT	5/5/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT91248	N/A	N/A	N/A	N/A	N/A	2434 MILVIA STREET	OFFICE B	BERKELEY	CA	94704	1918	00	06000	37.86415096	-122.2699204	Alameda County
334787	Ordering, Referring, Prescribing	N/A	1477936680	0	0	ESCALERA, JEANNETTE LCSW	12/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	90770	N/A	N/A	N/A	N/A	N/A	1301 PINE AVENUE	None	LONG BEACH	CA	90813	3124	00	06000	33.782913	-118.192417	Los Angeles County
335110	Ordering, Referring, Prescribing	N/A	1487731238	0	0	EISEN, SUSANA LMFT	6/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47246	N/A	N/A	N/A	N/A	N/A	45 FRANKLIN ST.	#215	SAN FRANCISCO	CA	94102	6017	00	06000	37.77497018	-122.4209309	San Francisco County
335325	Ordering, Referring, Prescribing	N/A	1497133409	0	0	EARLY, MEGAN I MD	2/26/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178795	N/A	N/A	N/A	N/A	N/A	6801 COLDWATER CANYON AV	1D	NORTH HOLLYWOOD	CA	91605	5162	00	06000	34.194447	-118.4138285	Los Angeles County
335377	Ordering, Referring, Prescribing	N/A	1497200430	0	0	EUBANK, MORGAN L LMFT	1/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT115752	N/A	N/A	N/A	N/A	N/A	720 WOOD ST	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
335390	Ordering, Referring, Prescribing	N/A	1497232052	0	0	EDWARDS, MELISSA LCSW	10/2/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW114031	N/A	N/A	N/A	N/A	N/A	700 FREDERICK STREET	103	SANTA CRUZ	CA	95062	2239	00	06000	36.98031434	-122.004438	Santa Cruz County
335443	Ordering, Referring, Prescribing	N/A	1497318695	0	0	EZEAKACHA, ANITA CNP	10/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027561	N/A	N/A	N/A	N/A	N/A	1707 EYE ST	100	BAKERSFIELD	CA	93301	5208	00	06000	35.37461686	-119.020062	Kern County
335665	Ordering, Referring, Prescribing	N/A	1508112855	0	0	ENMAN, NAMJAS MD	4/9/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A167037	N/A	N/A	N/A	N/A	N/A	1400 EMELINE AVE	None	SANTA CRUZ	CA	95060	1976	00	06000	36.99276804	-122.0178271	Santa Cruz County
335756	Ordering, Referring, Prescribing	N/A	1508245903	0	0	ESCOBAR, FREDIE LCSW	6/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW93989	N/A	N/A	N/A	N/A	N/A	2600 REDONDO AVE	6TH FLOOR	LONG BEACH	CA	90806	2325	00	06000	33.806097	-118.151378	Los Angeles County
335823	Ordering, Referring, Prescribing	N/A	1508348582	0	0	ELIZARRARAZ, ROSA N LCSW	6/13/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108477	N/A	N/A	N/A	N/A	N/A	593 W 6TH ST	None	SAN PEDRO	CA	90731	2521	00	06000	33.73875253	-118.2899475	Los Angeles County
335933	Ordering, Referring, Prescribing	N/A	1508627589	0	0	ELLIOTT, ELISABETH A PA-C	11/19/2024	Taxonomy not applicable	NA	n/a	000	Unknown	64457	N/A	N/A	N/A	N/A	N/A	5333 HOLLISTER AVE	#105	SANTA BARBARA	CA	93111	3309	00	06000	34.43491982	-119.8105484	Santa Barbara County
335989	Ordering, Referring, Prescribing	N/A	1508942053	0	0	ESTAFAN, MAGED MD	4/2/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C52942	N/A	N/A	N/A	N/A	N/A	1688 N PERRIS BLVD	None	PERRIS	CA	92571	4709	00	06000	33.802488	-117.2262385	Riverside County
336018	Ordering, Referring, Prescribing	N/A	1518009380	0	0	ESPINOZA, EVELYN E PSYD	7/14/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY25971	N/A	N/A	N/A	N/A	N/A	17707 STUDEBAKER RD	SUITE 208	CERRITOS	CA	90703	2640	00	06000	33.87008991	-118.0991298	Los Angeles County
336238	Ordering, Referring, Prescribing	N/A	1518407055	0	0	EKSTROM, JESSICA NP	9/17/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006009	N/A	N/A	N/A	N/A	N/A	16147 E WHITTIER BLVD	None	WHITTIER	CA	90603	2560	00	06000	33.94157588	-117.9859969	Los Angeles County
336313	Ordering, Referring, Prescribing	N/A	1518549443	0	0	ESCOBAR, DULCE H PA-C	8/16/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61509	N/A	N/A	N/A	N/A	N/A	204 E BEACH ST	None	WATSONVILLE	CA	95076	4809	00	06000	36.91224802	-121.7541363	Santa Cruz County
336337	Ordering, Referring, Prescribing	N/A	1518646850	0	0	EHIGIEGBA, OSAS S NP	7/29/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031331	N/A	N/A	N/A	N/A	N/A	1340 ARNOLD DRIVE	110	MARTINEZ	CA	94553	4189	00	06000	37.99250264	-122.0983907	Contra Costa County
336348	Ordering, Referring, Prescribing	N/A	1518674605	0	0	EXCONDE-MERCADO, CATHLEEN VANESSA G NP	11/30/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023464	N/A	N/A	N/A	N/A	N/A	25815 BARTON RD	STE 101	LOMA LINDA	CA	92354	3894	00	06000	34.04825519	-117.2408344	San Bernardino County
336355	Ordering, Referring, Prescribing	N/A	1518687748	0	0	ECLARINO, GALELEO NP	8/25/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022380	N/A	N/A	N/A	N/A	N/A	9995 CARMEL MOUNTAIN RD	B10-11	SAN DIEGO	CA	92129	2889	00	06000	32.96073738	-117.1119913	San Diego County
336425	Ordering, Referring, Prescribing	N/A	1528184264	0	0	ELSON, MELINDA D LCSW	11/17/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	19699	N/A	N/A	N/A	N/A	N/A	2933 N. EL NIDO AVE	None	ALTADENA	CA	91001	0000	00	06000	34.19549106	-118.1655134	Los Angeles County
336440	Ordering, Referring, Prescribing	N/A	1528212461	0	0	ELICEGUI, ADRIAN G LCSW	2/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87914	N/A	N/A	N/A	N/A	N/A	1126 N GRAND AVE	None	COVINA	CA	91724	1551	00	06000	34.100082	-117.8724825	Los Angeles County
336643	Ordering, Referring, Prescribing	N/A	1528551082	0	0	ENALEN, TRACY S LMFT	5/8/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT105314	N/A	N/A	N/A	N/A	N/A	41593 WINCHESTER RD	200	TEMECULA	CA	92590	4860	00	06000	33.52030169	-117.1659061	Riverside County
336689	Ordering, Referring, Prescribing	N/A	1528643954	0	0	EASTMAN, KIRA N PHARMD	3/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84203	N/A	N/A	N/A	N/A	N/A	1855 W KATELLA AVE	150	ORANGE	CA	92867	3451	00	06000	33.8061655	-117.872442	Orange County
336692	Ordering, Referring, Prescribing	N/A	1528647724	0	0	ESTAFANOUS, ABRAM N DO	9/13/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A20585	N/A	N/A	N/A	N/A	N/A	2130 NATIONAL AVENUE	None	SAN DIEGO	CA	92113	2209	00	06000	32.69800063	-117.1411927	San Diego County
336694	Ordering, Referring, Prescribing	N/A	1528645827	0	0	EASLER, LAURA E LCSW	8/31/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99625	N/A	N/A	N/A	N/A	N/A	4309 3RD AVE	None	SAN DIEGO	CA	92103	1407	00	06000	32.75638577	-117.162084	San Diego County
336747	Ordering, Referring, Prescribing	N/A	1528792546	0	0	EGWIM, CHIMA E NP	7/13/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025983	N/A	N/A	N/A	N/A	N/A	2145 5TH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
336824	Ordering, Referring, Prescribing	N/A	1538286109	0	0	EGAN, DINERY LMFT	5/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53718	N/A	N/A	N/A	N/A	N/A	3125 MYERS ST	None	RIVERSIDE	CA	92503	5527	00	06000	33.90932558	-117.4428095	Riverside County
336978	Ordering, Referring, Prescribing	N/A	1538545702	0	0	ESPINOSA, ARIAM M LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT114131	N/A	N/A	N/A	N/A	N/A	200 BROADWAY ST	200	KING CITY	CA	93930	0000	00	06000	36.2133658	-121.1256124	Monterey County
337292	Ordering, Referring, Prescribing	N/A	1548517436	0	0	ELIZARRARAZ, MONICA	7/6/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116691	N/A	N/A	N/A	N/A	N/A	11800 CENTRAL AVE	225	CHINO	CA	91710	7200	00	06000	34.0388092	-117.689654	San Bernardino County
337305	Ordering, Referring, Prescribing	N/A	1548553233	0	0	EDWARDS, CAROLYN R LMFT	3/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112521	N/A	N/A	N/A	N/A	N/A	1255 E HIGHLAND AVE	105B	SAN BERNARDINO	CA	92404	6804	00	06000	34.13584648	-117.259875	San Bernardino County
337369	Ordering, Referring, Prescribing	N/A	1548678220	0	0	EWING, ELIZABETH C NP	8/13/2014	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN763632	N/A	N/A	N/A	N/A	N/A	3779 PIEDMONT AVE	None	OAKLAND	CA	94611	5347	00	06000	37.82384659	-122.2558913	Alameda County
337446	Ordering, Referring, Prescribing	N/A	1548795966	0	0	EITOKU, JANE C PHARMD	4/4/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH39910	N/A	N/A	N/A	N/A	N/A	1212 FOREST AVE	None	PACIFIC GROVE	CA	93950	5123	00	06000	36.60510796	-121.9208349	Monterey County
337520	Ordering, Referring, Prescribing	N/A	1558050377	0	0	ELKESS, MARINA E DDS	6/12/2024	Taxonomy not applicable	NA	n/a	000	Unknown	DDS110157	N/A	N/A	N/A	N/A	N/A	1127 WILSHIRE BLVD.	SUITE 1504	LOS ANGELES	CA	90017	4006	00	06000	34.05270508	-118.2641005	Los Angeles County
337555	Ordering, Referring, Prescribing	N/A	1558335851	0	0	EGGLESTON, CHRISTOPHER F MD	2/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A81231	N/A	N/A	N/A	N/A	N/A	9343 TECH CENTER DRIVE	None	SACRAMENTO	CA	95826	2592	00	06000	38.564091	-121.3509285	Sacramento County
337562	Ordering, Referring, Prescribing	N/A	1558183004	0	0	ESTES, BREIAH	9/27/2024	Taxonomy not applicable	NA	n/a	000	Unknown	65123	N/A	N/A	N/A	N/A	N/A	5700 WATT AVE	None	NORTH HIGHLANDS	CA	95660	4752	00	06000	38.670723	-121.3823745	Sacramento County
337584	Ordering, Referring, Prescribing	N/A	1558454892	0	0	ESPINOZA, ESTRELLA LMFT	6/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51514	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY	211	SANTA ROSA	CA	95407	9122	00	06000	38.425266	-122.749875	Sonoma County
337592	Ordering, Referring, Prescribing	N/A	1558474270	0	0	ELIASER, GERALD E MD	5/31/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G40198	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3314	00	06000	38.62729851	-122.8637785	Sonoma County
337653	Ordering, Referring, Prescribing	N/A	1558611376	0	0	EHLERS, ALISON A LMFT	8/24/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	100356	N/A	N/A	N/A	N/A	N/A	768 PLEASANT VALLEY RD	SUITE 201	DIAMOND SPRINGS	CA	95619	9260	00	06000	38.69498433	-120.8070771	El Dorado County
337682	Ordering, Referring, Prescribing	N/A	1558670984	0	0	ELKADDOUM, RITA LMFT	2/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	104895	N/A	N/A	N/A	N/A	N/A	2750 E WASHINGTON BLVD	230	PASADENA	CA	91107	1448	00	06000	34.1680038	-118.0943955	Los Angeles County
337744	Ordering, Referring, Prescribing	N/A	1558782029	0	0	ELENES HIGUERA, EDITH PA-C	1/28/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA51283	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	00	06000	32.750523	-117.100927	San Diego County
337756	Ordering, Referring, Prescribing	N/A	1558797324	0	0	ESCOBAR, NORA M LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84553	N/A	N/A	N/A	N/A	N/A	14320 PALM DRIVER	None	DESERT HOT SPRING	CA	92240	0001	00	06000	33.94460044	-116.5012511	Riverside County
337799	Ordering, Referring, Prescribing	N/A	1558864363	0	0	EKEH, BARBARA MD	1/6/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178068	N/A	N/A	N/A	N/A	N/A	202 N 8TH ST	None	EL CENTRO	CA	92243	2302	00	06000	32.794335	-115.5614775	Imperial County
337836	Ordering, Referring, Prescribing	N/A	1558939272	0	0	EGELI, BUGRA H MD	7/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL6121	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
337871	Ordering, Referring, Prescribing	N/A	1568020592	0	0	ENDO, ZAYN MD	7/23/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A181933	N/A	N/A	N/A	N/A	N/A	40910 FREMONT BLVD	None	FREMONT	CA	94538	4375	00	06000	37.53384106	-121.9607241	Alameda County
337901	Ordering, Referring, Prescribing	N/A	1568074458	0	0	ESKANDER, GEORGE PHARMD	9/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	80486	N/A	N/A	N/A	N/A	N/A	8891 ATLANTA AVE	None	HUNTINGTON BEACH	CA	92646	7119	00	06000	33.65774883	-117.973145	Orange County
337907	Ordering, Referring, Prescribing	N/A	1568090595	0	0	ERSKIN, EMILY LMFT	2/23/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131292	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	3050	00	06000	34.41078438	-118.510775	Los Angeles County
337961	Ordering, Referring, Prescribing	N/A	1568454387	0	0	EVENHOUSE, GENEVIEVE	2/26/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0604815	N/A	N/A	N/A	N/A	N/A	1833 FILLMORE ST	FL 3	SAN FRANCISCO	CA	94115	3181	00	06000	37.78652252	-122.4333821	San Francisco County
337991	Ordering, Referring, Prescribing	N/A	1568530004	0	0	ELIAS, ANA L LCSW	5/27/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61754	N/A	N/A	N/A	N/A	N/A	160 E VIRGINIA ST	STE 100	SAN JOSE	CA	95112	5865	00	06000	37.32582868	-121.8777868	Santa Clara County
338041	Ordering, Referring, Prescribing	N/A	1568655728	0	0	ESFAHANI, MARIAM E LMFT	8/22/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49070	N/A	N/A	N/A	N/A	N/A	801 S GRAND AVE	STE 475	LOS ANGELES	CA	90017	0449	00	06000	34.04532806	-118.258462	Los Angeles County
338057	Ordering, Referring, Prescribing	N/A	1568700680	0	0	EVERS, MARI K LCSW	4/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS29111	N/A	N/A	N/A	N/A	N/A	31 TOWER ROAD	None	SAN MATEO	CA	94402	0000	00	06000	37.51232162	-122.3333429	San Mateo County
338065	Ordering, Referring, Prescribing	N/A	1568713659	0	0	ELLIS, ASHLEY E LMFT	6/9/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT96720	N/A	N/A	N/A	N/A	N/A	1035 PLACER STREET	None	REDDING	CA	96001	4245	00	06000	40.58349378	-122.3853903	Shasta County
338196	Ordering, Referring, Prescribing	N/A	1568881860	0	0	ELITZAK, LAUREN M OT	2/22/2022	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	14249	N/A	N/A	N/A	N/A	N/A	10431 COMMERCE STREET	A	REDLANDS	CA	92374	0110	00	06000	34.06427678	-117.2416506	San Bernardino County
338293	Ordering, Referring, Prescribing	N/A	1578045316	0	0	ESPINOZA, SARAH LCSW	8/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW94593	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE	STE 210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
338307	Ordering, Referring, Prescribing	N/A	1578064929	0	0	ESQUIVEL, LUCILA LMFT	10/18/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	135373	N/A	N/A	N/A	N/A	N/A	755 E GILBERT ST	None	SAN BERNARDINO	CA	92404	5413	00	06000	34.1267535	-117.27081	San Bernardino County
338489	Ordering, Referring, Prescribing	N/A	1578698247	0	0	EDDY, CAROLYN LCSW	12/27/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108370	N/A	N/A	N/A	N/A	N/A	1900 BRULE ST	None	SOUTH LAKE TAHOE	CA	96150	5841	00	06000	38.89104359	-119.9837845	El Dorado County
338508	Ordering, Referring, Prescribing	N/A	1578728556	0	0	ELBGAL, MUHAMMAD N LCSW	3/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81839	N/A	N/A	N/A	N/A	N/A	350 90TH ST.	2ND FLOOR	DALY CITY	CA	94015	1880	00	06000	37.69111548	-122.473143	San Mateo County
338525	Ordering, Referring, Prescribing	N/A	1578754479	0	0	ESTRADA, SONIA N LMFT	2/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT114504	N/A	N/A	N/A	N/A	N/A	500 W FOSTER RD	None	SANTA MARIA	CA	93455	3620	00	06000	34.88351329	-120.4428974	Santa Barbara County
338621	Ordering, Referring, Prescribing	N/A	1578905253	0	0	ESCARENO, JEANETTE Y	10/19/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D62604	N/A	N/A	N/A	N/A	N/A	3945 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2440	00	06000	34.02394552	-118.187748	Los Angeles County
338820	Ordering, Referring, Prescribing	N/A	1588159610	0	0	ENAV, EMMA LCSW	6/24/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	123489	N/A	N/A	N/A	N/A	N/A	1727 MLK JR. WAY	UNIT 109	OAKLAND	CA	94612	1358	00	06000	37.80868384	-122.2744362	Alameda County
338844	Ordering, Referring, Prescribing	N/A	1588204440	0	0	ENG, MONICA L PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80691	N/A	N/A	N/A	N/A	N/A	1011 SNEATH LN	None	SAN BRUNO	CA	94066	2311	00	06000	37.63437084	-122.4264474	San Mateo County
338863	Ordering, Referring, Prescribing	N/A	1588229520	0	0	ELIAS, INES M	2/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	536350	N/A	N/A	N/A	N/A	N/A	9333 LOCH LOMOND DR.	None	PICO RIVERA	CA	90660	2913	00	06000	33.99484196	-118.0815839	Los Angeles County
338887	Ordering, Referring, Prescribing	N/A	1588313191	0	0	EHLEY, DESIRAE L MD	7/13/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A187835	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
338907	Ordering, Referring, Prescribing	N/A	1588390629	0	0	EMERUWA, BEN M CNP	7/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021650	N/A	N/A	N/A	N/A	N/A	4137 VERDUGO RD	None	LOS ANGELES	CA	90065	3820	00	06000	34.1261475	-118.2319835	Los Angeles County
338926	Ordering, Referring, Prescribing	N/A	1588629414	0	0	EARWOOD, THOMAS L MD	5/23/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A108693	N/A	N/A	N/A	N/A	N/A	7000 FRANKLIN BLVD	BUILDING 210	SACRAMENTO	CA	95823	1820	00	06000	38.499408	-121.4627715	Sacramento County
338948	Ordering, Referring, Prescribing	N/A	1588709547	0	0	ENRIQUEZ, GWENDELYN D DDS	1/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	DDS47884	N/A	N/A	N/A	N/A	N/A	52 S MAIN STREET	B	ANGELS CAMP	CA	95222	0939	00	06000	38.08181342	-120.5580433	Calaveras County
339009	Ordering, Referring, Prescribing	N/A	1588839468	0	0	ESCOTO, MARYLOU LMFT	3/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112382	N/A	N/A	N/A	N/A	N/A	142 E CALIFORNIA AVE	None	FRESNO	CA	93706	3642	00	06000	36.72133047	-119.810421	Fresno County
339096	Ordering, Referring, Prescribing	N/A	1588986855	0	0	ESLINGER, LILA M LMFT	12/28/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52737	N/A	N/A	N/A	N/A	N/A	480 EAST 13TH STREET	None	MERCED	CA	95341	6214	00	06000	37.29194565	-120.4717887	Merced County
339157	Ordering, Referring, Prescribing	N/A	1598075111	0	0	EDWARDS, JOSEPH LMFT	12/24/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT87660	N/A	N/A	N/A	N/A	N/A	6160 MISSION GORGE RD	SUITE 100	SAN DIEGO	CA	92120	3410	00	06000	32.7868143	-117.0977635	San Diego County
339220	Ordering, Referring, Prescribing	N/A	1598159808	0	0	ESPITIA, ANA E NP	5/1/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	772206	N/A	N/A	N/A	N/A	N/A	1628 BROADWAY ST	None	VALLEJO	CA	94590	2405	00	06000	38.12477216	-122.250021	Solano County
339241	Ordering, Referring, Prescribing	N/A	1598198533	0	0	ESPINOZA, SIDYA Z LMFT	1/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT108613	N/A	N/A	N/A	N/A	N/A	572 N ARROWHEAD AVE	None	SAN BERNARDINO	CA	92401	1251	00	06000	34.109667	-117.289669	San Bernardino County
339437	Ordering, Referring, Prescribing	N/A	1598883845	0	0	EUGENE, DOMINIQUE PHD	5/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	41467	N/A	N/A	N/A	N/A	N/A	1000 S MAIN ST	SUITE 105	SALINAS	CA	93901	2394	00	06000	36.66226091	-121.6578913	Monterey County
339469	Ordering, Referring, Prescribing	N/A	1598956252	0	0	EKERSON, PRISCILLA N CRNA	4/1/2020	Taxonomy not applicable	NA	n/a	018	NURSE ANESTHETISTS	95001288	N/A	N/A	N/A	N/A	N/A	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43816059	-120.6279677	Lassen County
339497	Ordering, Referring, Prescribing	N/A	1609018118	0	0	EDGECOMBE, ALPHONSO R	1/9/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D64205	N/A	N/A	N/A	N/A	N/A	1556 S SULTANA AVE	None	ONTARIO	CA	91761	4238	00	06000	34.045119	-117.6464565	San Bernardino County
339586	Ordering, Referring, Prescribing	N/A	1609195114	0	0	ERICKSON, AUTUMN M LMFT	6/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119306	N/A	N/A	N/A	N/A	N/A	232 E. CANON PERDIDO STR	None	SANTA BARBARA	CA	93101	2242	00	06000	34.42349188	-119.6973758	Santa Barbara County
339599	Ordering, Referring, Prescribing	N/A	1609210186	0	0	ECLARINAL, EULOGIO L MD	2/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A149826	N/A	N/A	N/A	N/A	N/A	3303 N BROADWAY	None	LOS ANGELES	CA	90031	2803	00	06000	34.07380397	-118.20586	Los Angeles County
339661	Ordering, Referring, Prescribing	N/A	1609313535	0	0	EDMONDSON, PATRICK S DC	1/29/2020	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	33767	N/A	N/A	N/A	N/A	N/A	15301 TYLER FOOTE ROAD	None	NEVADA CITY	CA	95959	9318	00	06000	39.36622661	-121.0368658	Nevada County
339675	Ordering, Referring, Prescribing	N/A	1609327717	0	0	EMANUEL, MIRANDA LMFT	10/3/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT115536	N/A	N/A	N/A	N/A	N/A	175 CHAPARRAL DRIVE	None	APTOS	CA	95003	0030	00	06000	37.00086045	-121.855203	Santa Cruz County
339700	Ordering, Referring, Prescribing	N/A	1609372606	0	0	ELLIOTT, THOMAS R MD	6/7/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174780	N/A	N/A	N/A	N/A	N/A	8405 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3401	00	06000	34.07607952	-118.373418	Los Angeles County
339765	Ordering, Referring, Prescribing	N/A	1609508233	0	0	EMAD-VAEZ, SADAF E PHARMD	6/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86174	N/A	N/A	N/A	N/A	N/A	1130 BIRD AVE	None	SAN JOSE	CA	95125	1700	00	06000	37.3105694	-121.8949819	Santa Clara County
339770	Ordering, Referring, Prescribing	N/A	1609525963	0	0	ENRIQUEZ, FAUSTINO NP	3/10/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95020266	N/A	N/A	N/A	N/A	N/A	301 BRUNDAGE LN	None	BAKERSFIELD	CA	93304	3248	00	06000	35.35386839	-119.0055269	Kern County
339805	Ordering, Referring, Prescribing	N/A	1609851674	0	0	EDISON-TON, WETONA S MD	10/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A70407	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	STE 1100	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
339811	Ordering, Referring, Prescribing	N/A	1609883156	0	0	EITOKU, JIMMY K PHARMD	12/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	38620	N/A	N/A	N/A	N/A	N/A	18 4TH ST GONZALES CA	None	GONZALES	CA	93926	0808	00	06000	36.50698522	-121.4443339	Monterey County
339900	Ordering, Referring, Prescribing	N/A	1619055696	0	0	EDMUNDS, KATHLEEN	3/5/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A101151	N/A	N/A	N/A	N/A	N/A	444 BRUCE STREET	None	YREKA	CA	96097	3450	00	06000	41.71863548	-122.6458755	Siskiyou County
339976	Ordering, Referring, Prescribing	N/A	1619198785	0	0	EBEID, RAMY H	1/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH57049	N/A	N/A	N/A	N/A	N/A	3400 CALLOWAY DR.	SUITE 302	BAKESFIELD	CA	93312	2513	00	06000	35.39110123	-119.1097878	Kern County
339996	Ordering, Referring, Prescribing	N/A	1619245743	0	0	EMMONS, LISA M	7/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52376	N/A	N/A	N/A	N/A	N/A	28460 HASKELL CANYON RD	None	SANTA CLARITA	CA	91390	5203	00	06000	34.46016626	-118.5117022	Los Angeles County
340000	Ordering, Referring, Prescribing	N/A	1619250230	0	0	EBORA, JENNYROSE	7/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55779	N/A	N/A	N/A	N/A	N/A	2840 W AVENUE L	None	LANCASTER	CA	93536	4006	00	06000	34.6602533	-118.1827153	Los Angeles County
340087	Ordering, Referring, Prescribing	N/A	1619381779	0	0	ENGLE, MICHELLE MD	12/11/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A139134	N/A	N/A	N/A	N/A	N/A	455 O'CONNOR DRIVE	200	SAN JOSE	CA	95128	0001	00	06000	37.326654	-121.939897	Santa Clara County
340160	Ordering, Referring, Prescribing	N/A	1619510872	0	0	EBORA, KARISMA EDERLYN A NP	9/18/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012836	N/A	N/A	N/A	N/A	N/A	1111 N CHINA LAKE BLVD	190	RIDGECREST	CA	93555	3131	00	06000	35.64171	-117.669847	Kern County
340161	Ordering, Referring, Prescribing	N/A	1619514221	0	0	ESMAEILI-FIRIDOUNI, PARDIS PT	12/12/2022	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	297478	N/A	N/A	N/A	N/A	N/A	1735 MISSION ST	None	SAN FRANCISCO	CA	94103	2417	00	06000	37.76957692	-122.4199811	San Francisco County
340188	Ordering, Referring, Prescribing	N/A	1619551793	0	0	ESSA, MARIAN	8/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71335	N/A	N/A	N/A	N/A	N/A	210 MOUNT HERMON RD	None	SCOTTS VALLEY	CA	95066	4009	00	06000	37.045183	-122.0269209	Santa Cruz County
340206	Ordering, Referring, Prescribing	N/A	1619632718	0	0	ELK EAGLE, MAYUMI LMFT	9/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT128133	N/A	N/A	N/A	N/A	N/A	3120 FREEBOARD DR	None	WEST SACRAMENTO	CA	95691	5039	00	06000	38.5746747	-121.552383	Yolo County
340335	Ordering, Referring, Prescribing	N/A	1629238423	0	0	ELLISON, MONICA LMFT	11/18/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114191	N/A	N/A	N/A	N/A	N/A	5100 S EASTERN AVE	110	COMMERCE	CA	90040	2950	00	06000	33.98882955	-118.1615175	Los Angeles County
340338	Ordering, Referring, Prescribing	N/A	1629247143	0	0	EARGLE, AMY	8/23/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY15890	N/A	N/A	N/A	N/A	N/A	11670 ATWOOD RD	None	AUBURN	CA	95603	9522	00	06000	38.93485327	-121.0988193	Placer County
340374	Ordering, Referring, Prescribing	N/A	1629324611	0	0	EDWARDS, BRIE A LMFT	5/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108747	N/A	N/A	N/A	N/A	N/A	957 BLANCO CIR	A	SALINAS	CA	93901	4447	00	06000	36.65603805	-121.6365549	Monterey County
340427	Ordering, Referring, Prescribing	N/A	1629397989	0	0	ESTRATALAN, SONIA I LMFT	3/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109453	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON AVE	100	LOS ANGELES	CA	90018	0000	00	06000	34.037415	-118.3176815	Los Angeles County
340618	Ordering, Referring, Prescribing	N/A	1629729959	0	0	EVANS, JOANNA R LMFT	2/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84135	N/A	N/A	N/A	N/A	N/A	315 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	00	06000	34.444881	-119.7793725	Santa Barbara County
340629	Ordering, Referring, Prescribing	N/A	1629789888	0	0	EWING, MARCIA P LCSW	3/18/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	94246	N/A	N/A	N/A	N/A	N/A	1950 ALAMEDA DE LAS PULG	None	SAN MATEO	CA	94403	1222	00	06000	37.545779	-122.3213093	San Mateo County
340717	Ordering, Referring, Prescribing	N/A	1639324577	0	0	EQUIHUA, DORATRIZ LCSW	1/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	78876	N/A	N/A	N/A	N/A	N/A	4701 CESAR CHAVEZ AVE.	None	LOS ANGELES	CA	90022	1209	00	06000	34.04062547	-118.1643975	Los Angeles County
340725	Ordering, Referring, Prescribing	N/A	1639367394	0	0	ESPE, CHRISTOPHER	1/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW80031	N/A	N/A	N/A	N/A	N/A	1020 S ARROYO PKWY	None	PASADENA	CA	91105	3911	00	06000	34.128351	-118.1471735	Los Angeles County
340735	Ordering, Referring, Prescribing	N/A	1639394919	0	0	EHREN, AVIVA LMFT	4/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52356	N/A	N/A	N/A	N/A	N/A	429 N SAN ANTONIO RD	None	SANTA BARBARA	CA	93110	1399	00	06000	34.44573228	-119.7804008	Santa Barbara County
340843	Ordering, Referring, Prescribing	N/A	1639549991	0	0	ENRIQUEZ QUEZADA, JOSUE D LCSW	8/18/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW109993	N/A	N/A	N/A	N/A	N/A	17053 E FOOTHILL BLVD	BLD B	FONTANA	CA	92335	9998	00	06000	34.10655148	-117.432828	San Bernardino County
340860	Ordering, Referring, Prescribing	N/A	1639573462	0	0	EZIRIM, RITA N NP	12/27/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010739	N/A	N/A	N/A	N/A	N/A	1704 W MANCHESTER AVE	109	LOS ANGELES	CA	90047	3063	00	06000	33.9599425	-118.307079	Los Angeles County
340864	Ordering, Referring, Prescribing	N/A	1639577109	0	0	ESCOBEDO, SANDRA LCSW	1/6/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99513	N/A	N/A	N/A	N/A	N/A	108 W. VICTORIA ST.	None	GARDENA	CA	90248	3523	00	06000	33.86509452	-118.2762279	Los Angeles County
340867	Ordering, Referring, Prescribing	N/A	1639585326	0	0	EMADI-PARAMKOUHI, NAHALL LCSW	12/28/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW83004	N/A	N/A	N/A	N/A	N/A	12450 VAN NUYS BLVD	SUITE 200	PACOIMA	CA	91331	1391	00	06000	34.27894489	-118.4044363	Los Angeles County
340923	Ordering, Referring, Prescribing	N/A	1639665524	0	0	EDWINSON, DOLORES	8/5/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	148597	N/A	N/A	N/A	N/A	N/A	1260 N DUTTON AVE	230	SANTA ROSA	CA	95401	4659	00	06000	38.449197	-122.7320775	Sonoma County
340932	Ordering, Referring, Prescribing	N/A	1639668510	0	0	ELLIS, RILEY LMFT	1/18/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124044	N/A	N/A	N/A	N/A	N/A	1136 DE LA VINA ST	None	SANTA BARBARA	CA	93101	3114	00	06000	34.42108243	-119.7064185	Santa Barbara County
341037	Ordering, Referring, Prescribing	N/A	1649097973	0	0	EGGERUD, KIM	9/4/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95032032	N/A	N/A	N/A	N/A	N/A	3166 COLLINS DR	None	MERCED	CA	95348	3132	00	06000	37.320318	-120.476542	Merced County
341088	Ordering, Referring, Prescribing	N/A	1649346487	0	0	ESHOO, ERICA V CNP	9/3/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	16278	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
341133	Ordering, Referring, Prescribing	N/A	1649440470	0	0	EBERHARD VEIRA, CAROLINA D LCSW	3/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW73541	N/A	N/A	N/A	N/A	N/A	1120 W LA VETA AVE	SUITE 470	ORANGE	CA	92868	4231	00	06000	33.78029455	-117.864369	Orange County
341167	Ordering, Referring, Prescribing	N/A	1649519380	0	0	ESCOTO, KARLA P LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103676	N/A	N/A	N/A	N/A	N/A	12440 FIRESTONE BLVD	316	NORWALK	CA	90650	4328	00	06000	33.90523023	-118.0681168	Los Angeles County
341200	Ordering, Referring, Prescribing	N/A	1649582909	0	0	ELIZARRARAZ, PATRICIA LCSW	6/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61168	N/A	N/A	N/A	N/A	N/A	265 S ANITA DR	SUITE 102-104	ORANGE	CA	92868	3355	00	06000	33.78499409	-117.8811837	Orange County
341203	Ordering, Referring, Prescribing	N/A	1649590175	0	0	ENRIQUEZ, ROBERT J MD	6/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A126231	N/A	N/A	N/A	N/A	N/A	3132 JEFFERSON ST	None	SAN DIEGO	CA	92110	4421	00	06000	32.75567499	-117.203517	San Diego County
341207	Ordering, Referring, Prescribing	N/A	1649596008	0	0	ELIAS, ISABEL A	1/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57785	N/A	N/A	N/A	N/A	N/A	5700 WATT AVE	None	NORTH HIGHLANDS	CA	95660	0000	00	06000	38.670723	-121.3823745	Sacramento County
341465	Ordering, Referring, Prescribing	N/A	1659193597	0	0	ESER, EMMANUEL	7/31/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031418	N/A	N/A	N/A	N/A	N/A	3030 EXPLORER DR	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
341484	Ordering, Referring, Prescribing	N/A	1659392785	0	0	ELMAGHRABY, ZAKI	3/2/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A77668	N/A	N/A	N/A	N/A	N/A	1200 NORTH STATE STREET	None	LOS ANGELES	CA	90033	1001	00	06000	34.05855992	-118.209755	Los Angeles County
341552	Ordering, Referring, Prescribing	N/A	1659515054	0	0	EASTER-GRIFFIN, TAMEIKA L LMFT	6/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	91246	N/A	N/A	N/A	N/A	N/A	707 14TH STREET	None	MODESTO	CA	95354	2506	00	06000	37.64072107	-120.9933527	Stanislaus County
341621	Ordering, Referring, Prescribing	N/A	1659659761	0	0	EMICK, WILLIAM C PHARMD	11/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	32996	N/A	N/A	N/A	N/A	N/A	21650 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	3990	00	06000	34.50101847	-117.1914367	San Bernardino County
341770	Ordering, Referring, Prescribing	N/A	1659899318	0	0	EDWARDS, JEANA M DC	5/9/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	34010	N/A	N/A	N/A	N/A	N/A	2524 E MAIN ST	None	STOCKTON	CA	95205	6523	00	06000	37.95478956	-121.251428	San Joaquin County
341795	Ordering, Referring, Prescribing	N/A	1659946275	0	0	EBADAT, KIAVASH LMFT	5/31/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125966	N/A	N/A	N/A	N/A	N/A	39485 REGENCY WAY	None	PALM DESERT	CA	92211	9998	00	06000	33.76264114	-116.3239587	Riverside County
341799	Ordering, Referring, Prescribing	N/A	1659966257	0	0	EMIG, OLGA I CNP	4/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95017225	N/A	N/A	N/A	N/A	N/A	802 W COLTON AVE	E	REDLANDS	CA	92374	2905	00	06000	34.06290649	-117.1918845	San Bernardino County
341814	Ordering, Referring, Prescribing	N/A	1669009940	0	0	ESPIRITU, SYDNIE ANN T MD	4/6/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A177479	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
341922	Ordering, Referring, Prescribing	N/A	1669512752	0	0	EDWARDS, DARCIE B	3/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52463	N/A	N/A	N/A	N/A	N/A	850 E. FOOTHILL BLVD	None	RIALTO	CA	92376	0100	00	06000	34.10679449	-117.3542535	San Bernardino County
341948	Ordering, Referring, Prescribing	N/A	1669592739	0	0	ESCOTO, SUSAN A LMFT	12/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT104667	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE	STE.210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
341956	Ordering, Referring, Prescribing	N/A	1669611299	0	0	EATON, AUDREY L	12/5/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0728401	N/A	N/A	N/A	N/A	N/A	2017 FIRST AVE	#301	SAN DIEGO	CA	92101	2033	00	06000	32.72646147	-117.1638767	San Diego County
341984	Ordering, Referring, Prescribing	N/A	1669676094	0	0	ESPINOZA, SARA C LMFT	4/28/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT46096	N/A	N/A	N/A	N/A	N/A	79 JUNEBERRY STREET	None	IRVINE	CA	92606	4503	00	06000	33.69366333	-117.8146428	Orange County
342012	Ordering, Referring, Prescribing	N/A	1669753240	0	0	ELAZIER, STEFAN MD	5/24/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A109345	N/A	N/A	N/A	N/A	N/A	311 WEST I STREET	None	LOS BANOS	CA	93635	3479	00	06000	37.06343055	-120.8570545	Merced County
342106	Ordering, Referring, Prescribing	N/A	1669907275	0	0	ESKANDER, ANDREW N DPM	4/2/2020	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5656	N/A	N/A	N/A	N/A	N/A	18035 BROOKHURST ST	#1100	FOUNTAIN VALLEY	CA	92708	6738	00	06000	33.701184	-117.9544385	Orange County
342172	Ordering, Referring, Prescribing	N/A	1679039663	0	0	ELLIOTT, HANNAH LMFT	7/19/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT140536	N/A	N/A	N/A	N/A	N/A	762 CYPRESS ST	None	SAN DIMAS	CA	91773	3505	00	06000	34.09577399	-117.8223776	Los Angeles County
342261	Ordering, Referring, Prescribing	N/A	1679185144	0	0	EDISON, FELLIX PHARMD	7/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH83729	N/A	N/A	N/A	N/A	N/A	5821 ANTELOPE	None	SACRAMENTO	CA	95842	3902	00	06000	38.704275	-121.3317945	Sacramento County
342274	Ordering, Referring, Prescribing	N/A	1679208557	0	0	EMIL, MICHAEL H	7/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86279	N/A	N/A	N/A	N/A	N/A	12109 APPLE VALLEY RD	None	APPLE VALLEY	CA	92308	6702	00	06000	34.47176263	-117.2423444	San Bernardino County
342284	Ordering, Referring, Prescribing	N/A	1679248199	0	0	ENGSTROM, KATRINA A NP	12/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95017413	N/A	N/A	N/A	N/A	N/A	1325 TRAVIS BLVD	C	FAIRFIELD	CA	94533	4611	00	06000	38.25798926	-122.0518837	Solano County
342285	Ordering, Referring, Prescribing	N/A	1679251714	0	0	ELJECHI, WALEED PA-C	10/10/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA63474	N/A	N/A	N/A	N/A	N/A	6600 COYLE AVE	None	CARMICHAEL	CA	95608	6344	00	06000	38.667807	-121.310748	Sacramento County
342295	Ordering, Referring, Prescribing	N/A	1679298046	0	0	ESCAMILLA-ESCAMILLA, CINTYA Y NP	7/14/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021765	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
342318	Ordering, Referring, Prescribing	N/A	1679604235	0	0	ELSEWAFY, WAGIH A MD	11/25/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A56248	N/A	N/A	N/A	N/A	N/A	4701 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90022	1209	00	06000	34.04062547	-118.1643975	Los Angeles County
342496	Ordering, Referring, Prescribing	N/A	1679957609	0	0	EDWARDS, SHAUN CNP	11/19/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023686	N/A	N/A	N/A	N/A	N/A	550 E WASHINGTON BLVD.	None	CRESCENT CITY	CA	95531	8160	00	06000	41.77274546	-124.19892	Del Norte County
342561	Ordering, Referring, Prescribing	N/A	1689060030	0	0	EMERY, ERIC LCSW	3/5/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	16194	N/A	N/A	N/A	N/A	N/A	333 LAWS AVE	None	UKIAH	CA	95482	6540	00	06000	39.12772164	-123.2111168	Mendocino County
342647	Ordering, Referring, Prescribing	N/A	1689190431	0	0	EDPAO, SANDRA W NP	10/10/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	851113	N/A	N/A	N/A	N/A	N/A	22675 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	8551	00	06000	33.91695337	-117.2672536	Riverside County
342657	Ordering, Referring, Prescribing	N/A	1689206583	0	0	EVANS, LAUREN E LCSW	8/13/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW115855	N/A	N/A	N/A	N/A	N/A	101 CIRBY HILLS DR	None	ROSEVILLE	CA	95678	4360	00	06000	38.7303989	-121.2872592	Placer County
342728	Ordering, Referring, Prescribing	N/A	1689407926	0	0	ELAM-BROWN, TAWANDA NP	8/21/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031812	N/A	N/A	N/A	N/A	N/A	12442 LIMONITE AVE SUITE	None	EASTVALE	CA	91752	2467	00	06000	33.97511454	-117.5531895	Riverside County
342765	Ordering, Referring, Prescribing	N/A	1689710618	0	0	ELLIOTT, CORAZON C MD MPH	6/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A53480	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS STREET,	STE.210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
342773	Ordering, Referring, Prescribing	N/A	1689730236	0	0	ELIAS, LETICIA LCSW	6/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	21250	N/A	N/A	N/A	N/A	N/A	650 CLARK WAY	None	PALO ALTO	CA	94304	2300	00	06000	37.43949537	-122.1784133	Santa Clara County
342902	Ordering, Referring, Prescribing	N/A	1699016212	0	0	EARLE, WENDY C LCSW	7/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW20127	N/A	N/A	N/A	N/A	N/A	3333 M STREET	None	MERCED	CA	95348	2714	00	06000	37.32440393	-120.4783871	Merced County
342927	Ordering, Referring, Prescribing	N/A	1699053744	0	0	ESPINOSA, JAMES R LCSW	6/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82444	N/A	N/A	N/A	N/A	N/A	299 12TH ST	STE A	MARINA	CA	93933	6003	00	06000	36.66784472	-121.8011077	Monterey County
342998	Ordering, Referring, Prescribing	N/A	1699160473	0	0	ETMINAN, MOHAMMAD R PHARMD	11/8/2020	Taxonomy not applicable	NA	n/a	000	Unknown	41937	N/A	N/A	N/A	N/A	N/A	1234 WILSHIRE BLVD	106	LOS ANGELES	CA	90017	1970	00	06000	34.05341911	-118.2658606	Los Angeles County
343008	Ordering, Referring, Prescribing	N/A	1699184838	0	0	ENGLEMAN, MARISSA C LCSW	6/4/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW101866	N/A	N/A	N/A	N/A	N/A	2730 SALVIO ST	None	CONCORD	CA	94519	2599	00	06000	37.98056223	-122.0282614	Contra Costa County
343057	Ordering, Referring, Prescribing	N/A	1699248385	0	0	ESPARZA, NATALIE M LCSW	6/24/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	102166	N/A	N/A	N/A	N/A	N/A	4401 S CRENSHAW BLVD	None	LOS ANGELES	CA	90043	0000	00	06000	34.00339495	-118.3318951	Los Angeles County
343089	Ordering, Referring, Prescribing	N/A	1699331439	0	0	ESQUIVEL, CHRISTINE LMFT	1/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112601	N/A	N/A	N/A	N/A	N/A	902 S MYRTLE AVE	None	MONROVIA	CA	91016	3427	00	06000	34.14233552	-118.0008646	Los Angeles County
343286	Ordering, Referring, Prescribing	N/A	1700030327	0	0	ELLIOTT, AYANA M NP	9/14/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95004511	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
343358	Ordering, Referring, Prescribing	N/A	1700156858	0	0	EVANS, MEREDITH A LMFT	5/16/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51230	N/A	N/A	N/A	N/A	N/A	5730 PACKARD AVE	SUITE 500	MARYSVILLE	CA	95901	7119	00	06000	39.12014523	-121.5659991	Yuba County
343398	Ordering, Referring, Prescribing	N/A	1700206711	0	0	ESPINOZA, GEORGINA LMFT	3/17/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138669	N/A	N/A	N/A	N/A	N/A	1119 E MONTE VISTA AVE	STE. 3800	VACAVILLE	CA	95688	1119	00	06000	38.36024633	-121.9763983	Solano County
343423	Ordering, Referring, Prescribing	N/A	1700238177	0	0	EMPLEO GO, JUNELLE LOUISE PHARMD	7/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	74129	N/A	N/A	N/A	N/A	N/A	2100 WEBSTER STREET	105	SAN FRANCISCO	CA	94115	2373	00	06000	37.7904826	-122.4324477	San Francisco County
343618	Ordering, Referring, Prescribing	N/A	1700669611	0	0	ELLIOTT, LIAM	8/9/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95025942	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY AVE	None	HEALDSBURG	CA	95448	3314	00	06000	38.62757555	-122.8638141	Sonoma County
343656	Ordering, Referring, Prescribing	N/A	1700925724	0	0	EIDE, CARLA E	11/29/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A118060	N/A	N/A	N/A	N/A	N/A	11670 ATWOOD RD	None	AUBURN	CA	95603	9522	00	06000	38.93485327	-121.0988193	Placer County
343732	Ordering, Referring, Prescribing	N/A	1710113808	0	0	EDGAR, CHERE A	6/12/2017	Taxonomy not applicable	NA	n/a	000	Unknown	359	N/A	N/A	N/A	N/A	N/A	1727 CENTRAL AVE	None	MCKINLEYVILLE	CA	95519	3601	00	06000	40.93670432	-124.1008977	Humboldt County
343869	Ordering, Referring, Prescribing	N/A	1710359518	0	0	ESTRADA, SHELLEY N LCSW	1/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	90520	N/A	N/A	N/A	N/A	N/A	2550 E FOOTHILL BLVD	None	PASADENA	CA	91107	3406	00	06000	34.14979153	-118.0979955	Los Angeles County
344015	Ordering, Referring, Prescribing	N/A	1710654546	0	0	EDWARDS, TERRENCE PSYD	2/6/2025	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY35689	N/A	N/A	N/A	N/A	N/A	954 W FOOTHILL BLVD	A	UPLAND	CA	91786	3782	00	06000	34.10675048	-117.6646365	San Bernardino County
344051	Ordering, Referring, Prescribing	N/A	1710982954	0	0	ESTRADA, JENNIFER	9/12/2016	Taxonomy not applicable	NA	n/a	000	Unknown	17936	N/A	N/A	N/A	N/A	N/A	3772 TIBETTS	None	RIVERSIDE	CA	95206	2605	00	06000	33.94720849	-117.399204	Riverside County
344109	Ordering, Referring, Prescribing	N/A	1720161649	0	0	EUBANKS, AUBREY L MD	11/9/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A97276	N/A	N/A	N/A	N/A	N/A	500 CROWN POINT CIRCLE	STE 120	GRASS VALLEY	CA	95945	9561	00	06000	39.22028885	-121.0316663	Nevada County
344259	Ordering, Referring, Prescribing	N/A	1720420854	0	0	EVERTON-LOVELL, STEFANIE LPCC	10/12/2020	Taxonomy not applicable	NA	n/a	000	Unknown	8647	N/A	N/A	N/A	N/A	N/A	1545 HOTEL CIR S	300	SAN DIEGO	CA	92108	3412	00	06000	32.75896365	-117.1774865	San Diego County
344323	Ordering, Referring, Prescribing	N/A	1720498942	0	0	EWING, RACHEL J LMFT	3/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT94702	N/A	N/A	N/A	N/A	N/A	401 S STREET	None	SACRAMENTO	CA	95811	6919	00	06000	38.572677	-121.5050805	Sacramento County
344398	Ordering, Referring, Prescribing	N/A	1720612138	0	0	EVANS, NATALIE L LCSW	10/11/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110980	N/A	N/A	N/A	N/A	N/A	9291 OLD REDWOOD HWY	#500	WINDSOR	CA	95492	8089	00	06000	38.54971089	-122.8138213	Sonoma County
344411	Ordering, Referring, Prescribing	N/A	1720632847	0	0	EMPENO, KIMBERLY	12/11/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012297	N/A	N/A	N/A	N/A	N/A	7986 DAGGET ST	None	SAN DIEGO	CA	92111	2321	00	06000	32.82363345	-117.1512855	San Diego County
344468	Ordering, Referring, Prescribing	N/A	1720766900	0	0	EZEAKA, CHARLES MD	3/6/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL11867	N/A	N/A	N/A	N/A	N/A	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	00	06000	33.89475493	-118.2080292	Los Angeles County
344613	Ordering, Referring, Prescribing	N/A	1730434275	0	0	ELSKY, GREGORY	10/15/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT48133	N/A	N/A	N/A	N/A	N/A	5345 BALBOA BLVD	202	ENCINO	CA	91316	0000	00	06000	34.1685057	-118.5011702	Los Angeles County
344620	Ordering, Referring, Prescribing	N/A	1730447681	0	0	EHLEN, ODALYS LMFT	6/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119517	N/A	N/A	N/A	N/A	N/A	200 W SANTA ANA BLVD	None	SANTA ANA	CA	92701	4134	00	06000	33.74970951	-117.8691975	Orange County
344675	Ordering, Referring, Prescribing	N/A	1730530288	0	0	ECHOLS, JENNIFER LCSW	1/31/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93987	N/A	N/A	N/A	N/A	N/A	3850 CRENSHAW BLVD	None	LOS ANGELES	CA	90008	1821	00	06000	34.01581788	-118.3348506	Los Angeles County
344694	Ordering, Referring, Prescribing	N/A	1730557596	0	0	EDMONDSON, MELINDA S NP	6/22/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95111246	N/A	N/A	N/A	N/A	N/A	1140 MAIN ST	None	LIVINGSTON	CA	95334	1257	00	06000	37.37992056	-120.7234222	Merced County
344760	Ordering, Referring, Prescribing	N/A	1730676040	0	0	ESCALANTE VARELA, JOSE I PA	10/19/2018	Taxonomy not applicable	NA	n/a	000	Unknown	56159	N/A	N/A	N/A	N/A	N/A	263 S WEST ST	None	TULARE	CA	93274	3411	00	06000	36.20460711	-119.3668926	Tulare County
344805	Ordering, Referring, Prescribing	N/A	1730747239	0	0	ELLSWORTH, AZADEH A NP	6/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011907	N/A	N/A	N/A	N/A	N/A	1752 S VICTORIA AVE	SUITE 250	VENTURA	CA	93003	6152	00	06000	34.25916679	-119.2090522	Ventura County
344822	Ordering, Referring, Prescribing	N/A	1730764317	0	0	ENGLAND, JASON PA-C	5/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59502	N/A	N/A	N/A	N/A	N/A	1066 S WHITE R	170	SAN JOSE	CA	95127	3812	00	06000	37.35676387	-121.8196933	Santa Clara County
344837	Ordering, Referring, Prescribing	N/A	1730844101	0	0	EPSTINE, SHELBY NP	10/4/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018695	N/A	N/A	N/A	N/A	N/A	400 W 30TH ST	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
344842	Ordering, Referring, Prescribing	N/A	1730854019	0	0	ESPINOSA, NICOLE A LCSW	3/10/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW65849	N/A	N/A	N/A	N/A	N/A	565 CHANEY ST	None	LAKE ELSINORE	CA	92530	2722	00	06000	33.68339326	-117.3352673	Riverside County
344862	Ordering, Referring, Prescribing	N/A	1730944091	0	0	ESQUEDA, JACQUELINE RN BS	6/28/2023	Taxonomy not applicable	NA	n/a	000	Unknown	95274418	N/A	N/A	N/A	N/A	N/A	150 DISTRICT CENTER DR	None	PALM SPRINGS	CA	92264	3626	00	06000	33.82485354	-116.4955129	Riverside County
344868	Ordering, Referring, Prescribing	N/A	1740011253	0	0	EWEL, EMMA LMFT	8/2/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	148545	N/A	N/A	N/A	N/A	N/A	2827 CONCORD BLVD	None	CONCORD	CA	94519	2608	00	06000	37.97746145	-122.0253615	Contra Costa County
344881	Ordering, Referring, Prescribing	N/A	1740226943	0	0	EUGENIO, MAGNOLIA M NP	9/26/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	15013	N/A	N/A	N/A	N/A	N/A	2051 MARENGO ST.	None	LOS ANGELES	CA	90033	1352	00	06000	34.05627579	-118.2064774	Los Angeles County
344939	Ordering, Referring, Prescribing	N/A	1740376425	0	0	ENGLAND, SHARI L PA-C	4/7/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60980	N/A	N/A	N/A	N/A	N/A	1971 E 4TH ST	200	SANTA ANA	CA	92705	3917	00	06000	33.7482685	-117.83934	Orange County
345008	Ordering, Referring, Prescribing	N/A	1740562107	0	0	EASTMAN-RODRIGUEZ, TIFFANY	5/12/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38909	N/A	N/A	N/A	N/A	N/A	400 W 30TH ST	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
345187	Ordering, Referring, Prescribing	N/A	1740835792	0	0	ESCOBEDO, PAOLA I LCSW	3/27/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	114565	N/A	N/A	N/A	N/A	N/A	200 24TH ST	None	RICHMOND	CA	94804	1804	00	06000	37.93439778	-122.3465322	Contra Costa County
345198	Ordering, Referring, Prescribing	N/A	1740847250	0	0	ELSON, CAROLINE LCSW	5/22/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115408	N/A	N/A	N/A	N/A	N/A	1500 FRANKLIN ST	None	SAN FRANCISCO	CA	94109	4523	00	06000	37.78847503	-122.4235955	San Francisco County
345208	Ordering, Referring, Prescribing	N/A	1740891621	0	0	ESCAJEDA, GABRIELA	12/24/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127871	N/A	N/A	N/A	N/A	N/A	2005 MAIN ST	C	OAKLEY	CA	94561	3301	00	06000	38.00376184	-121.7326716	Contra Costa County
345220	Ordering, Referring, Prescribing	N/A	1740927466	0	0	EVANS, MARI MD	3/8/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A192647	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
345357	Ordering, Referring, Prescribing	N/A	1750512026	0	0	ENDSLEY, DELVIN S MD	1/12/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G130464	N/A	N/A	N/A	N/A	N/A	1550 SUPERIOR AVENUE	None	COSTA MESA	CA	92627	3635	00	06000	33.63305341	-117.9266303	Orange County
345398	Ordering, Referring, Prescribing	N/A	1750634952	0	0	ESQUIVEL BRAVO, SINTHIA Y LCSW	5/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76286	N/A	N/A	N/A	N/A	N/A	225 ACADEMY AVE	None	SANGER	CA	93657	2128	00	06000	36.71298824	-119.5572284	Fresno County
345620	Ordering, Referring, Prescribing	N/A	1760011613	0	0	ESTRADA, JAYE A MD	5/21/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A191519	N/A	N/A	N/A	N/A	N/A	2001 WILSHIRE BLVD	320	SANTA MONICA	CA	90403	5641	00	06000	34.03162362	-118.4829513	Los Angeles County
345633	Ordering, Referring, Prescribing	N/A	1760025886	0	0	ELLIOTT, KIMBERLY K	1/12/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	92580	N/A	N/A	N/A	N/A	N/A	29632 E HIGHWAY 299	None	ROUND MOUNTAIN	CA	96084	8000	00	06000	40.80385331	-121.9397745	Shasta County
345637	Ordering, Referring, Prescribing	N/A	1760035612	0	0	ELKINTON, ROSALIE M	9/20/2019	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236065	N/A	N/A	N/A	N/A	N/A	3131 ALUM ROCK AVE	None	SAN JOSE	CA	95127	2902	00	06000	37.36639819	-121.8272112	Santa Clara County
345806	Ordering, Referring, Prescribing	N/A	1760701023	0	0	EIDE, JACOB A PSYD	8/7/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY27059	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
345867	Ordering, Referring, Prescribing	N/A	1760787030	0	0	EDEM, MARY NP	9/9/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	726847	N/A	N/A	N/A	N/A	N/A	4211 S AVALON BLVD	None	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
345869	Ordering, Referring, Prescribing	N/A	1760805550	0	0	ELLIS, CARLY A LMFT	7/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98148	N/A	N/A	N/A	N/A	N/A	1750 S LEWIS RD	None	CAMARILLO	CA	93012	8520	00	06000	34.186607	-119.0369561	Ventura County
345883	Ordering, Referring, Prescribing	N/A	1760830079	0	0	EUSTANCE, ZACHERY	4/4/2023	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT293232	N/A	N/A	N/A	N/A	N/A	17800 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	1221	00	06000	34.54007429	-117.2744761	San Bernardino County
345907	Ordering, Referring, Prescribing	N/A	1760854616	0	0	ENNY, JESSICA J LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112634	N/A	N/A	N/A	N/A	N/A	1441 CONSTITUTION BLVD	BLDG 400 STE 202	SALINAS	CA	93906	3100	00	06000	36.696987	-121.633164	Monterey County
345932	Ordering, Referring, Prescribing	N/A	1760895296	0	0	EL HABR, ELIE LMFT	3/30/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125262	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON AVE	200	LOS ANGELES	CA	90018	0000	00	06000	34.037415	-118.3176815	Los Angeles County
346031	Ordering, Referring, Prescribing	N/A	1770059750	0	0	ENGLISH, BRITTANY NP	6/12/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010245	N/A	N/A	N/A	N/A	N/A	1300 N DUTTON AVE	None	SANTA ROSA	CA	95401	7108	00	06000	38.449791	-122.733027	Sonoma County
346033	Ordering, Referring, Prescribing	N/A	1770060105	0	0	ESHAGHZADEH, EDWIN Z	11/8/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	102898	N/A	N/A	N/A	N/A	N/A	630 DRAKE AVE	None	SAUSALITO	CA	94965	1107	00	06000	37.87340883	-122.515085	Marin County
346074	Ordering, Referring, Prescribing	N/A	1770144016	0	0	EBRAHIMZADEH, KHASHAYAR MD	2/14/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176374	N/A	N/A	N/A	N/A	N/A	321 HOBSON WAY	SUITE C	BLYTHE	CA	92225	1651	00	06000	33.6105446	-114.5935783	Riverside County
346140	Ordering, Referring, Prescribing	N/A	1770570442	0	0	EMENIKE, EMMANUEL O MD	11/20/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A92212	N/A	N/A	N/A	N/A	N/A	4954 VAN NUYS BLVD	202	SHERMAN OAKS	CA	91403	9999	00	06000	34.16092063	-118.4486697	Los Angeles County
346209	Ordering, Referring, Prescribing	N/A	1770724627	0	0	ELNEMR-ARKZAT, AYDAH LCSW	7/14/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW109146	N/A	N/A	N/A	N/A	N/A	327 S K ST	None	TULARE	CA	93274	5416	00	06000	36.20476387	-119.3454489	Tulare County
346224	Ordering, Referring, Prescribing	N/A	1770765547	0	0	EGHRERINIOVO, MAUREEN N NP	3/1/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020157	N/A	N/A	N/A	N/A	N/A	29364 CASTLEWOOD DRIVE	None	MENIFEE	CA	92584	7585	00	06000	33.69433098	-117.1458516	Riverside County
346265	Ordering, Referring, Prescribing	N/A	1770866592	0	0	ENWEREM, UZOAMAKA C PHARMD	4/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH65957	N/A	N/A	N/A	N/A	N/A	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
346267	Ordering, Referring, Prescribing	N/A	1770864886	0	0	ESFANDIARI, MASOUMEH	6/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58040	N/A	N/A	N/A	N/A	N/A	21230 VENTURA BLVD	None	WOODLAND HILLS	CA	91364	2106	00	06000	34.16740726	-118.5952628	Los Angeles County
346339	Ordering, Referring, Prescribing	N/A	1770970139	0	0	ECHOLS, LAMARR	10/23/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A148156	N/A	N/A	N/A	N/A	N/A	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	00	06000	38.26109552	-122.0470245	Solano County
346446	Ordering, Referring, Prescribing	N/A	1780131003	0	0	EWELL, SHERMON M LMFT	12/3/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	136161	N/A	N/A	N/A	N/A	N/A	1234 EMPIRE ST	None	FAIRFIELD	CA	94533	5711	00	06000	38.25037548	-122.049045	Solano County
346463	Ordering, Referring, Prescribing	N/A	1780157115	0	0	ERICKSEN, TARA R NP	12/3/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010525	N/A	N/A	N/A	N/A	N/A	5925 W LAS POSITAS BLVD	SUITE 100	PLEASANTON	CA	94588	8537	00	06000	37.68360997	-121.8990082	Alameda County
346590	Ordering, Referring, Prescribing	N/A	1780702746	0	0	ESPINOZA COLE, ANA B LCSW	5/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	20886	N/A	N/A	N/A	N/A	N/A	439 W 97TH ST	None	LOS ANGELES	CA	90003	3968	00	06000	33.94831439	-118.282325	Los Angeles County
346680	Ordering, Referring, Prescribing	N/A	1780917989	0	0	EL DEEB, MOKHTAR M MD	5/16/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C156019	N/A	N/A	N/A	N/A	N/A	1041 ROSE AVE	None	SELMA	CA	93662	3240	00	06000	36.56879252	-119.596257	Fresno County
346720	Ordering, Referring, Prescribing	N/A	1780977280	0	0	EVANS, BRANDON LCSW	1/10/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87448	N/A	N/A	N/A	N/A	N/A	31660 HIGHWAY 3	None	WEAVERVILLE	CA	96093	3166	00	06000	40.73956736	-122.9266898	Trinity County
346783	Ordering, Referring, Prescribing	N/A	1790073385	0	0	EHSAN, AMIRPASHA MD	7/20/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A123790	N/A	N/A	N/A	N/A	N/A	5001 COMMERCE DRIVE	SUITE 100	BAKERSFIELD	CA	93309	0648	00	06000	35.36784468	-119.0578744	Kern County
346877	Ordering, Referring, Prescribing	N/A	1790209369	0	0	EDGAL, OPEYEMI LCSW	4/10/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	114705	N/A	N/A	N/A	N/A	N/A	840 N AVENUE 66	None	LOS ANGELES	CA	90042	1508	00	06000	34.12110842	-118.1725545	Los Angeles County
346927	Ordering, Referring, Prescribing	N/A	1790278398	0	0	ESCOBEDO, JACOB A LCSW	1/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	120517	N/A	N/A	N/A	N/A	N/A	3924 RIVERVIEW DR	None	RIVERSIDE	CA	92509	6611	00	06000	33.99857971	-117.4142203	Riverside
346966	Ordering, Referring, Prescribing	N/A	1790347052	0	0	EKEZIE, JOY C MD	1/26/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176124	N/A	N/A	N/A	N/A	N/A	20833 LONGBRANCH DR	None	COTTONWOOD	CA	96022	8701	00	06000	40.39391709	-122.2799142	Shasta County
346998	Ordering, Referring, Prescribing	N/A	1790437051	0	0	ESTRADA, JOSELINNE DDS	1/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	107131	N/A	N/A	N/A	N/A	N/A	522 S SAN PEDRO ST	None	LOS ANGELES	CA	90013	2102	00	06000	34.0436196	-118.2442541	Los Angeles County
347007	Ordering, Referring, Prescribing	N/A	1790463578	0	0	ESGUERRA, KYLE B OT	6/26/2023	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	23316	N/A	N/A	N/A	N/A	N/A	2201 MISSION AVE	None	SAN DIEGO	CA	92116	2839	00	06000	32.76012926	-117.1411896	San Diego County
347037	Ordering, Referring, Prescribing	N/A	1790756070	0	0	ESKANDER, ASHRAF I MD	2/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A48837	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
347060	Ordering, Referring, Prescribing	N/A	1790819472	0	0	ERNST, HEIDEMARIE MD	3/29/2020	Taxonomy not applicable	NA	n/a	000	Unknown	A73163	N/A	N/A	N/A	N/A	N/A	9015 MURRAY AVE STE 100	STE 100	GILROY	CA	95020	3675	00	06000	37.03080985	-121.5741639	Santa Clara County
347096	Ordering, Referring, Prescribing	N/A	1790878585	0	0	ESQUIVIAS, JOSE A LMFT	11/30/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129532	N/A	N/A	N/A	N/A	N/A	2035 E BALL RD	200	ANAHEIM	CA	92806	5159	00	06000	33.81812448	-117.8880075	Orange County
347148	Ordering, Referring, Prescribing	N/A	1801007547	0	0	ESQUEDA-ARTEAGA, JULIA PHD	11/16/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY22803	N/A	N/A	N/A	N/A	N/A	1500 HUGHES WAY	STE C100	LONG BEACH	CA	90810	1870	00	06000	33.82860528	-118.2124528	Los Angeles County
347193	Ordering, Referring, Prescribing	N/A	1801098967	0	0	EPSON, MARTIN F MD	7/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132723	N/A	N/A	N/A	N/A	N/A	3270 KERNER BLVD. STE B	None	SAN RAFAEL, CA	CA	94901	1116	00	06000	37.96108677	-122.5017451	Marin County
347201	Ordering, Referring, Prescribing	N/A	1801108469	0	0	ECKLUND, DAN G LMFT	5/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105061	N/A	N/A	N/A	N/A	N/A	1801 VICENTE ST	None	SAN FRANCISCO	CA	94116	2923	00	06000	37.7388459	-122.4861544	San Francisco County
347244	Ordering, Referring, Prescribing	N/A	1801179353	0	0	EMERUWA, CELEN ONYEBUCHI LMFT	4/8/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118691	N/A	N/A	N/A	N/A	N/A	801 W 70TH ST	None	LOS ANGELES	CA	90044	5218	00	06000	33.97640749	-118.2874275	Los Angeles County
347273	Ordering, Referring, Prescribing	N/A	1801210166	0	0	EDWARDS, SEKAYI LMFT	6/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT118795	N/A	N/A	N/A	N/A	N/A	1155 MARKET ST	None	SAN FRANCISCO	CA	94103	1522	00	06000	37.77947677	-122.4137354	San Francisco County
347318	Ordering, Referring, Prescribing	N/A	1801266226	0	0	ESCAMILLA, ERIKA J LCSW	10/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	97553	N/A	N/A	N/A	N/A	N/A	370 W CRENSHAW BLVD	E-100	LOS ANGELES	CA	90503	1727	00	06000	33.84549	-118.3287415	Los Angeles
347499	Ordering, Referring, Prescribing	N/A	1801923420	0	0	ENTZ, CHRISTINA M LCSW	6/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW16632	N/A	N/A	N/A	N/A	N/A	850 E FOOTHILL BLVD	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
347510	Ordering, Referring, Prescribing	N/A	1801933999	0	0	ESTRADA, DIANE LMFT	5/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117206	N/A	N/A	N/A	N/A	N/A	202 N 8TH ST	None	EL CENTRO	CA	92243	2302	00	06000	32.794335	-115.5614775	Imperial County
347566	Ordering, Referring, Prescribing	N/A	1811057946	0	0	EARLY, TERRENCE S MD	7/21/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G88165	N/A	N/A	N/A	N/A	N/A	5380 OVERPASS RD	UNIT H39	GOLETA	CA	93111	2080	00	06000	34.43999482	-119.8115556	Santa Barbara County
347671	Ordering, Referring, Prescribing	N/A	1811272065	0	0	EVANGELISTA, LEA C PHARMD	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH62579	N/A	N/A	N/A	N/A	N/A	9728 WINTER GARDENS BLVD	None	LAKESIDE	CA	92040	3809	00	06000	32.854545	-116.9311485	San Diego County
347692	Ordering, Referring, Prescribing	N/A	1811313851	0	0	EPSTEIN-GALLIGAN, FALLON M LCSW	2/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88537	N/A	N/A	N/A	N/A	N/A	6651 BALBOA BLVD	None	VAN NUYS	CA	91406	5529	00	06000	34.191468	-118.5011883	Los Angeles County
347724	Ordering, Referring, Prescribing	N/A	1811368285	0	0	EKIZIAN, ANI PHARMD	10/1/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH73480	N/A	N/A	N/A	N/A	N/A	10605 BALBOA BLVD	100	GRANADA HILLS	CA	91344	6342	00	06000	34.263378	-118.5022965	Los Angeles County
347745	Ordering, Referring, Prescribing	N/A	1811393994	0	0	EDWARDS, ALYSON	12/1/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76918	N/A	N/A	N/A	N/A	N/A	1328 W MANCHESTER AVE	None	LOS ANGELES	CA	90044	2240	00	06000	33.95998503	-118.2992802	Los Angeles County
347777	Ordering, Referring, Prescribing	N/A	1811435746	0	0	ERVIN, ANTWON PHARMD	7/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72576	N/A	N/A	N/A	N/A	N/A	1800 W SLAUSON AVE	None	LOS ANGELES	CA	90047	1126	00	06000	33.98910151	-118.3119255	Los Angeles County
347783	Ordering, Referring, Prescribing	N/A	1811446966	0	0	ELSABEE, MINA PHARMD	10/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72089	N/A	N/A	N/A	N/A	N/A	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	00	06000	33.9760587	-117.3800672	Riverside County
347972	Ordering, Referring, Prescribing	N/A	1821150780	0	0	ESTRADA, BRENDA A LMFT	6/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT85174	N/A	N/A	N/A	N/A	N/A	1679 E MAIN ST	STE 102	EL CAJON	CA	92021	5212	00	06000	32.81117533	-116.9193178	San Diego County
348027	Ordering, Referring, Prescribing	N/A	1821280017	0	0	EICKER, ANN C	1/21/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82681	N/A	N/A	N/A	N/A	N/A	108 W VICTORIA ST	None	GARDENA	CA	90248	3523	00	06000	33.86509452	-118.2762279	Los Angeles County
348040	Ordering, Referring, Prescribing	N/A	1821300518	0	0	EVANS, DARCI DO	10/30/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A11889	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
348077	Ordering, Referring, Prescribing	N/A	1821370180	0	0	ESCALONA, EVELYN B	4/11/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	77514	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
348085	Ordering, Referring, Prescribing	N/A	1821375924	0	0	EGERTSON, KAREN M LMFT	5/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT46243	N/A	N/A	N/A	N/A	N/A	5284 ADOLFO RD.	None	CAMARILLO	CA	93012	6787	00	06000	34.21515637	-118.9970881	Ventura County
348097	Ordering, Referring, Prescribing	N/A	1821405515	0	0	ESPARZA, NAOMI I LCSW	8/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW95968	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
348188	Ordering, Referring, Prescribing	N/A	1821534587	0	0	ESPINOZA, ELBA NP	4/19/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	709512	N/A	N/A	N/A	N/A	N/A	1700 E CESAR E CHAVEZ AV	STE 2700	LOS ANGELES	CA	90033	2434	00	06000	34.05101259	-118.217259	Los Angeles County
348194	Ordering, Referring, Prescribing	N/A	1821543455	0	0	ELLIS, SHERRY LCSW	9/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110355	N/A	N/A	N/A	N/A	N/A	11601 S WESTERN AVE	None	LOS ANGELES	CA	90047	5006	00	06000	33.92826552	-118.3092091	Los Angeles County
348202	Ordering, Referring, Prescribing	N/A	1821561622	0	0	ESHOIEE, MIRIAM PA-C	10/12/2018	Taxonomy not applicable	NA	n/a	000	Unknown	56144	N/A	N/A	N/A	N/A	N/A	800 N TUSTIN AVE STE G	SUITE G	SANTA ANA	CA	92705	3605	00	06000	33.752241	-117.8342255	Orange County
348240	Ordering, Referring, Prescribing	N/A	1821632209	0	0	ESPINOZA CONTRERAS, AGUEDA PA-C	8/13/2020	Taxonomy not applicable	NA	n/a	000	Unknown	58431	N/A	N/A	N/A	N/A	N/A	12586 AVE 408	None	OROSI	CA	93647	9454	00	06000	36.53030229	-119.2915122	Tulare County
348297	Ordering, Referring, Prescribing	N/A	1821818121	0	0	ESQUIVIAS, MARIA NP	11/12/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95032930	N/A	N/A	N/A	N/A	N/A	1028 E VERNON AVE	None	LOS ANGELES	CA	90011	3717	00	06000	34.00389853	-118.257615	Los Angeles County
348311	Ordering, Referring, Prescribing	N/A	1831127497	0	0	ELPEDES, BERNARD T DO	8/11/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A6887	N/A	N/A	N/A	N/A	N/A	2362 ALICIA PKWY	None	MISSION VIEJO	CA	92675	0000	00	06000	33.62636663	-117.6389104	Orange County
348383	Ordering, Referring, Prescribing	N/A	1831331958	0	0	EARL, UYEN X LMFT	2/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113392	N/A	N/A	N/A	N/A	N/A	251 LLEWELLYN AVE	None	CAMPBELL	CA	95008	1940	00	06000	37.29173129	-121.9584335	Santa Clara County
348398	Ordering, Referring, Prescribing	N/A	1831356088	0	0	ESPINOZA, LISA LCSW	9/4/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW69686	N/A	N/A	N/A	N/A	N/A	5801 SUNDALE AVE	None	BAKERSFIELD	CA	93309	2924	00	06000	35.34387226	-119.0654328	Kern County
348424	Ordering, Referring, Prescribing	N/A	1831400944	0	0	EREM, MALEK N PHARMD	3/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	41517	N/A	N/A	N/A	N/A	N/A	340 LAKEWOOD CENTER MALL	None	LAKEWOOD	CA	90712	2409	00	06000	33.85044	-118.136997	Los Angeles County
348462	Ordering, Referring, Prescribing	N/A	1831502541	0	0	ELSTER, MARTHA J MD	7/15/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A138423	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL STE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
348469	Ordering, Referring, Prescribing	N/A	1831510098	0	0	ELSAYEH, RACHEL D LPCC	7/29/2020	Taxonomy not applicable	NA	n/a	000	Unknown	661	N/A	N/A	N/A	N/A	N/A	216 W LOS ANGELES DR	None	VISTA	CA	92083	3101	00	06000	33.21246686	-117.247328	San Diego County
348534	Ordering, Referring, Prescribing	N/A	1831608702	0	0	ELIHU, DIANA PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77440	N/A	N/A	N/A	N/A	N/A	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
348550	Ordering, Referring, Prescribing	N/A	1831633544	0	0	ENRIQUEZ, MONIQUE LMFT	11/18/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	135948	N/A	N/A	N/A	N/A	N/A	6051 N FRESNO ST	201	FRESNO	CA	93710	5280	00	06000	36.823905	-119.781436	Fresno County
348604	Ordering, Referring, Prescribing	N/A	1831693803	0	0	ESPARZA, SOPHIA D MD	11/12/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166490	N/A	N/A	N/A	N/A	N/A	1001 E GRAND AVE	None	ESCONDIDO	CA	92025	4604	00	06000	33.12634291	-117.0682058	San Diego County
348615	Ordering, Referring, Prescribing	N/A	1831703503	0	0	EBRAHIMI, ANABEL PHARMD	4/18/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH80484	N/A	N/A	N/A	N/A	N/A	1030 S GLENDALE AVE	101	GLENDALE	CA	91205	2866	00	06000	34.13381535	-118.2519184	Los Angeles County
348703	Ordering, Referring, Prescribing	N/A	1831966746	0	0	ESPIRITU, LANCE T CNP	9/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027065	N/A	N/A	N/A	N/A	N/A	954 W FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	00	06000	34.10675048	-117.6646365	San Bernardino County
348734	Ordering, Referring, Prescribing	N/A	1841238367	0	0	ELSHAFIE, MOHAMED A DDS	8/12/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D32231	N/A	N/A	N/A	N/A	N/A	200 S WELLS ROAD	100	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
348738	Ordering, Referring, Prescribing	N/A	1841290798	0	0	EVANS, BRIAN D MD	7/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A67869	N/A	N/A	N/A	N/A	N/A	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	00	06000	39.23512508	-121.0306878	Nevada County
348753	Ordering, Referring, Prescribing	N/A	1841328143	0	0	ELVIRA, SARAH E LCSW	6/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	123312	N/A	N/A	N/A	N/A	N/A	2621 OSWELL ST	119	BAKERSFIELD	CA	93306	3172	00	06000	35.393283	-118.9496505	Kern County
348775	Ordering, Referring, Prescribing	N/A	1841378072	0	0	ELLIOTT, NISHA L LMFT	6/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48202	N/A	N/A	N/A	N/A	N/A	3125 MYERS ST.	None	RIVERSIDE	CA	92503	5527	00	06000	33.90932558	-117.4428095	Riverside County
348847	Ordering, Referring, Prescribing	N/A	1841512043	0	0	ENTIN, DANIELLE E LMFT	2/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT90854	N/A	N/A	N/A	N/A	N/A	1661 N RAYMOND AVE	200	ANAHEIM	CA	92801	1120	00	06000	33.858234	-117.906788	Orange County
348866	Ordering, Referring, Prescribing	N/A	1841541596	0	0	ESQUEDA, ROCIO LCSW	2/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW79257	N/A	N/A	N/A	N/A	N/A	439 W 97TH ST	None	LOS ANGELES	CA	90003	3968	00	06000	33.94831439	-118.282325	Los Angeles County
348910	Ordering, Referring, Prescribing	N/A	1841583960	0	0	EVANS, KATHY PHD	3/19/2024	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29043	N/A	N/A	N/A	N/A	N/A	900 E GILBERT ST	None	SAN BERNARDINO	CA	92415	0911	00	06000	34.1268333	-117.2670508	San Bernardino County
349092	Ordering, Referring, Prescribing	N/A	1841942190	0	0	EVANS, ALLYSON T NP	9/6/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027087	N/A	N/A	N/A	N/A	N/A	1500 FRANKLIN ST	None	SAN FRANCISCO	CA	94109	4523	00	06000	37.78847503	-122.4235955	San Francisco County
349245	Ordering, Referring, Prescribing	N/A	1851548226	0	0	EATMAN, ALEYNE D PSYD	11/30/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY24671	N/A	N/A	N/A	N/A	N/A	4760 SEPULVEDA BLVD	None	LOS ANGELES	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
349271	Ordering, Referring, Prescribing	N/A	1851592513	0	0	ESTELL, SABRINA A LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	109026	N/A	N/A	N/A	N/A	N/A	1727 MARTIN LUTHER KING	None	OAKLAND	CA	94612	1327	00	06000	37.80868384	-122.2744362	Alameda County
349285	Ordering, Referring, Prescribing	N/A	1851636237	0	0	EASTMAN, TOBY D LCSW	6/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27344	N/A	N/A	N/A	N/A	N/A	5275 CLAREMONT AVE	None	OAKLAND	CA	94618	1032	00	06000	37.8391822	-122.260841	Alameda County
349355	Ordering, Referring, Prescribing	N/A	1851728919	0	0	EPPS, MINDY L LMFT	12/18/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92368	N/A	N/A	N/A	N/A	N/A	9951 HORN BLVD	SUITE B	SACRAMENTO	CA	95827	0000	00	06000	38.577654	-121.3244235	Sacramento County
349403	Ordering, Referring, Prescribing	N/A	1851790513	0	0	ESTEVEZ, GILDA M LMFT	2/12/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108094	N/A	N/A	N/A	N/A	N/A	300 SUNNY HILLS DRIVE	None	SAN ANSELMO	CA	94960	1909	00	06000	37.98269146	-122.5611947	Marin County
349509	Ordering, Referring, Prescribing	N/A	1851987580	0	0	ESPINOZA, ESMERALDA LMFT	3/27/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	154229	N/A	N/A	N/A	N/A	N/A	843 CACTUS CT	None	SALINAS	CA	93905	4604	00	06000	36.69805409	-121.5990479	Monterey County
349591	Ordering, Referring, Prescribing	N/A	1861426702	0	0	EMAN, SHAHROUZ DC	12/21/2021	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	27053	N/A	N/A	N/A	N/A	N/A	150 TEJAS PL	None	NIPOMO	CA	93444	9123	00	06000	35.02661565	-120.4990048	San Luis Obispo County
349642	Ordering, Referring, Prescribing	N/A	1861567976	0	0	EDWARDS, GRIFFIN M PHARMD	3/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55742	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	00	06000	37.23951066	-121.8013511	Santa Clara County
349649	Ordering, Referring, Prescribing	N/A	1861571796	0	0	ELICK, WILEY DDS	10/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	21245	N/A	N/A	N/A	N/A	N/A	329 W 8TH ST	None	HANFORD	CA	93230	4533	00	06000	36.32698307	-119.6503466	Kings County
349701	Ordering, Referring, Prescribing	N/A	1861718579	0	0	ENRIQUEZ, JUAN C LCSW	3/24/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99347	N/A	N/A	N/A	N/A	N/A	3303 N BROADWAY	200	LOS ANGELES	CA	90031	2803	00	06000	34.07380397	-118.20586	Los Angeles County
349706	Ordering, Referring, Prescribing	N/A	1861734006	0	0	EKWUEME, JOY A MD	9/11/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150868	N/A	N/A	N/A	N/A	N/A	3631 CRENSHAW BLVD	STE 109	LOS ANGELES	CA	90016	4869	00	06000	34.023177	-118.3351475	Los Angeles County
349711	Ordering, Referring, Prescribing	N/A	1861738809	0	0	ESPIRITU, ALAN G PHARMD	7/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH48704	N/A	N/A	N/A	N/A	N/A	4940 VAN NUYS BLVD	104	SHERMAN OAKS	CA	91403	1736	00	06000	34.160589	-118.4486715	Los Angeles County
349718	Ordering, Referring, Prescribing	N/A	1861743965	0	0	ESCANAME, CARINA LPCC	4/7/2024	Taxonomy not applicable	NA	n/a	000	Unknown	15584	N/A	N/A	N/A	N/A	N/A	345 5TH ST	18	HOLLISTER	CA	95023	3844	00	06000	36.85144793	-121.4029697	San Benito County
349804	Ordering, Referring, Prescribing	N/A	1861874026	0	0	ESQUEDA, CHRIS M LMFT	12/31/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT117138	N/A	N/A	N/A	N/A	N/A	3645 W SHAW AVE STE 101	None	FRESNO	CA	93711	3206	00	06000	36.805662	-119.858733	Fresno County
349807	Ordering, Referring, Prescribing	N/A	1861873796	0	0	ENGLISH, JODON LCSW	7/3/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82045	N/A	N/A	N/A	N/A	N/A	520 SOUTH LOS ROBLES AVE	3	PASADENA	CA	91101	3806	00	06000	34.13685164	-118.1413103	Los Angeles County
349854	Ordering, Referring, Prescribing	N/A	1861949422	0	0	EKWUEME, PATRICIA O	1/17/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A187779	N/A	N/A	N/A	N/A	N/A	10549 JEFFERSON BLVD	None	CULVER CITY	CA	90232	3513	00	06000	34.00659325	-118.3923586	Los Angeles County
350388	Ordering, Referring, Prescribing	N/A	1881095552	0	0	ESPINOZA, MARIA G LMFT	5/31/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106694	N/A	N/A	N/A	N/A	N/A	160 E. VIRGINIA ST.	SUITE 280	SAN JOSE	CA	95112	0000	00	06000	37.32582868	-121.8777868	Santa Clara County
350506	Ordering, Referring, Prescribing	N/A	1881330934	0	0	EVANS, JENNIFER NP	7/12/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016693	N/A	N/A	N/A	N/A	N/A	2710 W MANCHESTER BLVD	None	INGLEWOOD	CA	90305	2436	00	06000	33.9598587	-118.3237499	Los Angeles County
350629	Ordering, Referring, Prescribing	N/A	1881856227	0	0	ELMORE, PAULLA J LMFT	11/24/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	46569	N/A	N/A	N/A	N/A	N/A	4760 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
350640	Ordering, Referring, Prescribing	N/A	1881863173	0	0	ENGELDINGER, TIFFANY S LMFT	4/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51636	N/A	N/A	N/A	N/A	N/A	5820 STONERIDGE MALL RD	None	PLEASANTON	CA	94588	3274	00	06000	37.69432028	-121.9316867	Alameda County
350859	Ordering, Referring, Prescribing	N/A	1891253100	0	0	ESPARZA, BEATRIZ S LMFT	10/15/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	142106	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	SUITE 220	MISSION VIEJO	CA	92691	6441	00	06000	33.56536541	-117.670334	Orange County
350860	Ordering, Referring, Prescribing	N/A	1891257432	0	0	ERDELYAN, SARAH R MD	11/26/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178146	N/A	N/A	N/A	N/A	N/A	2051 MARENGO ST	None	LOS ANGELES	CA	90033	1352	00	06000	34.05627579	-118.2064774	Los Angeles County
350892	Ordering, Referring, Prescribing	N/A	1891313847	0	0	EIREW, GARY	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH39536	N/A	N/A	N/A	N/A	N/A	1574 E VALLEY PARKWAY	None	ESCONDIDO	CA	92027	2316	00	06000	33.13377959	-117.0599309	San Diego County
350904	Ordering, Referring, Prescribing	N/A	1891348538	0	0	ESPINOLA, ALISON LCSW	7/6/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99579	N/A	N/A	N/A	N/A	N/A	123 W. GUTIERREZ ST	None	SANTA BARBARA	CA	93010	3424	00	06000	34.41387023	-119.6962788	Santa Barbara County
350965	Ordering, Referring, Prescribing	N/A	1891572673	0	0	ESCOBAR, SAUL	10/6/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA63469	N/A	N/A	N/A	N/A	N/A	26357 MCBEAN PKWY	120	VALENCIA	CA	91355	4488	00	06000	34.41257644	-118.5597683	Los Angeles County
350984	Ordering, Referring, Prescribing	N/A	1891810149	0	0	ESTRADA, MICHELLE F LCSW	3/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW63898	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD.	MS#53	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
350989	Ordering, Referring, Prescribing	N/A	1891810438	0	0	ENRIQUEZ, AURELIO PSYD	2/12/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	29785	N/A	N/A	N/A	N/A	N/A	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	00	06000	34.06750236	-117.925203	Los Angeles County
351046	Ordering, Referring, Prescribing	N/A	1891937843	0	0	ELLNER, DAVID L LCSW	2/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29769	N/A	N/A	N/A	N/A	N/A	54 NORTH WILSON AVENUE	None	PASADENA	CA	91106	2306	00	06000	34.14696023	-118.128036	Los Angeles County
351057	Ordering, Referring, Prescribing	N/A	1891948444	0	0	EAGAN, VIRGINIA M LMFT	3/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	29503	N/A	N/A	N/A	N/A	N/A	560 COHASSET RD	175	CHICO	CA	95926	2281	00	06000	39.7519137	-121.8477606	Butte County
351088	Ordering, Referring, Prescribing	N/A	1902019805	0	0	EISENHOFER, KAREN F	2/2/2009	Taxonomy not applicable	NA	n/a	099	DENTIST	D47880	N/A	N/A	N/A	N/A	N/A	15301 S SAN JOSE AVE	None	COMPTON	CA	90221	3131	00	06000	33.8941921	-118.1817657	Los Angeles County
351213	Ordering, Referring, Prescribing	N/A	1902239874	0	0	EDWARDS, BRITTANY A LMFT	12/10/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT94548	N/A	N/A	N/A	N/A	N/A	14545 SHERMAN CIR	None	VAN NUYS	CA	91405	3087	00	06000	34.20064259	-118.450312	Los Angeles County
351306	Ordering, Referring, Prescribing	N/A	1902410632	0	0	EVERETT, LINDSEY L PA	11/6/2020	Taxonomy not applicable	NA	n/a	000	Unknown	58827	N/A	N/A	N/A	N/A	N/A	760 RENZ LANE	None	GILROY	CA	95020	9584	00	06000	37.00466254	-121.5555242	Santa Clara County
351326	Ordering, Referring, Prescribing	N/A	1902458680	0	0	EL-KHOURY, REBECCA DDS	8/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	104717	N/A	N/A	N/A	N/A	N/A	7525 ASHTON CT	None	WEST HILLS	CA	91304	5262	00	06000	34.20921396	-118.6488217	Los Angeles County
351376	Ordering, Referring, Prescribing	N/A	1902860554	0	0	EAKIN, ELIANE F MD	1/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C145488	N/A	N/A	N/A	N/A	N/A	18601 VALLEY BLVD	None	BLOOMINGTON	CA	92316	1831	00	06000	34.07045653	-117.3982455	San Bernardino County
351380	Ordering, Referring, Prescribing	N/A	1902876683	0	0	ELSAADI, MAGDI S MD	9/17/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A49507	N/A	N/A	N/A	N/A	N/A	2015 N WATERMAN AVE STE	None	SAN BERNARDINO	CA	92404	4810	00	06000	34.13318786	-117.2787325	San Bernardino County
351409	Ordering, Referring, Prescribing	N/A	1902933518	0	0	ESCAMILLA, ARTURO C LCSW	3/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75732	N/A	N/A	N/A	N/A	N/A	17707 STUDEBAKER RD	None	CERRITOS	CA	90703	2640	00	06000	33.87008991	-118.0991298	Los Angeles County
351437	Ordering, Referring, Prescribing	N/A	1902978604	0	0	ETEMADI, SARAH PHARMD	3/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54975	N/A	N/A	N/A	N/A	N/A	2300 CAMINO RAMON	None	SAN RAMON	CA	94506	0000	00	06000	37.77580025	-121.9664884	Contra Costa County
351458	Ordering, Referring, Prescribing	N/A	1912025297	0	0	ETIAKA, TABARA	5/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	91151	N/A	N/A	N/A	N/A	N/A	2311 W EL SEGUNDO BLVD	None	HAWTHORNE	CA	90245	3315	00	06000	33.91647947	-118.3189815	Los Angeles County
351478	Ordering, Referring, Prescribing	N/A	1912052283	0	0	EVANS, DAVID A	3/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT50954	N/A	N/A	N/A	N/A	N/A	2350 PROFESSIONAL DR.	None	SANTA ROSA	CA	95403	3018	00	06000	38.462535	-122.7244905	Sonoma County
351582	Ordering, Referring, Prescribing	N/A	1912283581	0	0	ERESO, SHARON L PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	46505	N/A	N/A	N/A	N/A	N/A	3439 VIA MONTEBELLO	None	CARLSBAD	CA	92009	8487	00	06000	33.08171662	-117.2327511	San Diego County
351648	Ordering, Referring, Prescribing	N/A	1912361221	0	0	EIREW, CURTIS J	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	38649	N/A	N/A	N/A	N/A	N/A	33060 ANTELOPE RD	None	MURRIETA	CA	92563	2409	00	06000	33.64097399	-117.1680516	Riverside County
351754	Ordering, Referring, Prescribing	N/A	1912528829	0	0	EHRHORN, BRITTANI N CNP	2/7/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013914	N/A	N/A	N/A	N/A	N/A	1 HOPE DR	None	TUSTIN	CA	92782	0221	00	06000	33.71470753	-117.8323965	Orange County
351759	Ordering, Referring, Prescribing	N/A	1912533324	0	0	ESKANDER, MAGY S	6/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82160	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DRIVE	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
351814	Ordering, Referring, Prescribing	N/A	1912679143	0	0	ERWIN, SHAYNE NP	5/23/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018701	N/A	N/A	N/A	N/A	N/A	1300 N DUTTON AVE	None	SANTA ROSA	CA	95401	7112	00	06000	38.449791	-122.733027	Sonoma County
351919	Ordering, Referring, Prescribing	N/A	1922251057	0	0	ELIAS, DIANE LMFT	11/20/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT80290	N/A	N/A	N/A	N/A	N/A	2121 W TEMPLE ST	None	LOS ANGELES	CA	90026	4915	00	06000	34.07053729	-118.268744	Los Angeles County
351920	Ordering, Referring, Prescribing	N/A	1922259704	0	0	ESCAMILLA, SANDRA LCSW	9/5/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26454	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
351935	Ordering, Referring, Prescribing	N/A	1922293885	0	0	EGAN, JULIA PSYD	11/24/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY26017	N/A	N/A	N/A	N/A	N/A	494 BLOSSOM WAY	None	HAYWARD	CA	94541	1948	00	06000	37.67843796	-122.1037905	Alameda County
352051	Ordering, Referring, Prescribing	N/A	1922478544	0	0	ESPINO, ADRIANA LMFT	2/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116945	N/A	N/A	N/A	N/A	N/A	501 N BROOKHURST ST	None	ANAHEIM	CA	92801	5226	00	06000	33.8384428	-117.9590628	Orange County
352082	Ordering, Referring, Prescribing	N/A	1922506492	0	0	EVANS, BRITNEY S LMFT	9/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	141533	N/A	N/A	N/A	N/A	N/A	24355 CREEKSIDE ROAD	800754	SANTA CLARITA	CA	91380	0721	00	06000	34.42172153	-118.561734	Los Angeles County
352139	Ordering, Referring, Prescribing	N/A	1922596501	0	0	EVRON, EVYATAR MD	7/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL1962	N/A	N/A	N/A	N/A	N/A	8405 BEVERLY BLVD	None	LOS ANGELES	CA	90048	3401	00	06000	34.07607952	-118.373418	Los Angeles County
352159	Ordering, Referring, Prescribing	N/A	1922652916	0	0	EL-GHEZZAOUI, NADA PA	1/31/2020	Taxonomy not applicable	NA	n/a	000	Unknown	57786	N/A	N/A	N/A	N/A	N/A	4425 S CENTRAL AVE	None	LOS ANGELES	CA	90011	3629	00	06000	34.003116	-118.2565185	Los Angeles County
352165	Ordering, Referring, Prescribing	N/A	1922667690	0	0	EWING, DANIELLE R RN BS	6/7/2018	Taxonomy not applicable	NA	n/a	000	Unknown	587616	N/A	N/A	N/A	N/A	N/A	25375 ORCHARD VILLAGE RD	None	VALENCIA	CA	91355	3000	00	06000	34.3894183	-118.5473263	Los Angeles County
352177	Ordering, Referring, Prescribing	N/A	1922703172	0	0	EY, SAVANNAH LPCC	2/18/2025	Taxonomy not applicable	NA	n/a	000	Unknown	18748	N/A	N/A	N/A	N/A	N/A	760 MOUNTAIN VIEW STREET	None	ALTADENA	CA	91001	4925	00	06000	34.19178664	-118.1657029	Los Angeles County
352191	Ordering, Referring, Prescribing	N/A	1922763937	0	0	ESCOBEDO, KARINA PA-C	11/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA60345	N/A	N/A	N/A	N/A	N/A	2975 ZOE AVE	None	HUNTINGTON PARK	CA	90255	5278	00	06000	33.9793863	-118.216134	Los Angeles County
352204	Ordering, Referring, Prescribing	N/A	1922830330	0	0	ESMAILZADEH, JASMINE PA	11/27/2024	Taxonomy not applicable	NA	n/a	000	Unknown	65500	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
352252	Ordering, Referring, Prescribing	N/A	1932239159	0	0	EARLES, KERISHA N LMFT	3/29/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132034	N/A	N/A	N/A	N/A	N/A	41593 WINCHESTER ROAD	122	TEMECULA	CA	92590	4857	00	06000	33.52030169	-117.1659061	Riverside County
352291	Ordering, Referring, Prescribing	N/A	1932324696	0	0	ESCOBAR, JUAN A MD	7/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G58271	N/A	N/A	N/A	N/A	N/A	1711 W TEMPLE STREET	3695	LOS ANGELES	CA	90026	5421	00	06000	34.06891181	-118.2638033	Los Angeles County
352456	Ordering, Referring, Prescribing	N/A	1932614823	0	0	ERICKSON, KRISTIN LMFT	3/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	100363	N/A	N/A	N/A	N/A	N/A	401 THE CITY DR S	None	ORANGE	CA	92868	3303	00	06000	33.78395385	-117.8887742	Orange County
352589	Ordering, Referring, Prescribing	N/A	1932933827	0	0	ESMAEILI, ARASH DMD	8/30/2024	Taxonomy not applicable	NA	n/a	000	Unknown	110690	N/A	N/A	N/A	N/A	N/A	522 S. SAN PEDRO STREET	None	LOS ANGELES	CA	90013	2101	00	06000	34.0436196	-118.2442541	Los Angeles County
352714	Ordering, Referring, Prescribing	N/A	1942500368	0	0	EMDAD, MOJGAN PHARMD	3/24/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63861	N/A	N/A	N/A	N/A	N/A	10675 SCRIPPS POWAY PKWY	None	SAN DIEGO	CA	92131	3919	00	06000	32.93695035	-117.0979638	San Diego County
352723	Ordering, Referring, Prescribing	N/A	1942526108	0	0	ELLIS, STEPHENIE L PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62747	N/A	N/A	N/A	N/A	N/A	1200 DISCOVERY DR	None	BAKERSFIELD	CA	93309	7032	00	06000	35.36397746	-119.0589062	Kern County
352727	Ordering, Referring, Prescribing	N/A	1942532619	0	0	ELLISON, SHERRY PHD	3/14/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY23224	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
352792	Ordering, Referring, Prescribing	N/A	1942637707	0	0	ENGLISH, SARAH A LCSW	1/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW120510	N/A	N/A	N/A	N/A	N/A	3711 LONG BEACH BLVD	6041	LONG BEACH	CA	90807	3315	00	06000	33.824583	-118.1893785	Los Angeles County
352858	Ordering, Referring, Prescribing	N/A	1942734892	0	0	ELLER, ALEXANDER MD	7/31/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157562	N/A	N/A	N/A	N/A	N/A	1900 E 4TH ST	None	SANTA ANA	CA	92705	3962	00	06000	33.74805463	-117.8400671	Orange County
352972	Ordering, Referring, Prescribing	N/A	1952011975	0	0	EZEALAOFOR, CATHERINE O NP	11/6/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022875	N/A	N/A	N/A	N/A	N/A	1670 E 120TH ST	None	LOS ANGELES	CA	90059	3026	00	06000	33.92456051	-118.2417525	Los Angeles County
353002	Ordering, Referring, Prescribing	N/A	1952161515	0	0	ENUKA, PRINCESS MD	8/22/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL15886	N/A	N/A	N/A	N/A	N/A	501 J ST	None	SACRAMENTO	CA	95814	2325	00	06000	38.582118	-121.499325	Sacramento County
353015	Ordering, Referring, Prescribing	N/A	1952335820	0	0	ESSEX, MICHAEL G MD	6/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G85675	N/A	N/A	N/A	N/A	N/A	1600 E BELLE TER	None	BAKERSFIELD	CA	93307	3871	00	06000	35.34672702	-118.9837495	Kern County
353044	Ordering, Referring, Prescribing	N/A	1952432403	0	0	ESPINOZA, AURELIA E LCSW	4/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LMFT22265	N/A	N/A	N/A	N/A	N/A	828 S BASCOM AVE	SUITE 100	SAN JOSE	CA	95128	2651	00	06000	37.31225204	-121.9317854	Santa Clara County
353075	Ordering, Referring, Prescribing	N/A	1952514051	0	0	ENRILE, KATRINE MD	12/22/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A108230	N/A	N/A	N/A	N/A	N/A	9353 VALLEY BLVD	None	ROSEMEAD	CA	91770	1934	00	06000	34.08115618	-118.0651957	Los Angeles County
353120	Ordering, Referring, Prescribing	N/A	1952620676	0	0	ELLIOTT-DEMARS, JOY S	2/11/2014	Taxonomy not applicable	NA	n/a	000	Unknown	PA22562	N/A	N/A	N/A	N/A	N/A	4555 PRECISSI LANE	None	STOCKTON	CA	95207	6239	00	06000	37.98919284	-121.3152121	San Joaquin County
353123	Ordering, Referring, Prescribing	N/A	1952622730	0	0	EADY, YOONIE OT	11/30/2019	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	12307	N/A	N/A	N/A	N/A	N/A	5000 SUNSET BLVD	601	LOS ANGELES	CA	90027	5861	00	06000	34.0981066	-118.2986382	Los Angeles County
353152	Ordering, Referring, Prescribing	N/A	1952673402	0	0	EVOLA, DALE W LMFT	4/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT48473	N/A	N/A	N/A	N/A	N/A	769 W BLAINE ST	A	RIVERSIDE	CA	92507	3970	00	06000	33.98300646	-117.327555	Riverside County
353255	Ordering, Referring, Prescribing	N/A	1952843690	0	0	ENZLER, CHRISTINE F NP	3/23/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	742360	N/A	N/A	N/A	N/A	N/A	2501 W EL SEGUNDO BLVD	STE B	HAWTHORNE	CA	90250	3317	00	06000	33.91648148	-118.3206645	Los Angeles County
353316	Ordering, Referring, Prescribing	N/A	1952950263	0	0	EVANS, JENNIFER A NP	9/3/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012648	N/A	N/A	N/A	N/A	N/A	3030 EXPLORER DR	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
353331	Ordering, Referring, Prescribing	N/A	1952969008	0	0	ENEMMUO, IFEATU B NP	5/21/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011649	N/A	N/A	N/A	N/A	N/A	555 SCHOOL ST	None	PITTSBURG	CA	94565	3937	00	06000	38.01980655	-121.8792708	Contra Costa County
353370	Ordering, Referring, Prescribing	N/A	1962055236	0	0	EISCHEN, JOSEPH NP	7/23/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012234	N/A	N/A	N/A	N/A	N/A	2450 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4356	00	06000	40.14921426	-122.2216794	Tehama County
353620	Ordering, Referring, Prescribing	N/A	1962805259	0	0	ELIOPULOS, STACIE LCSW	8/2/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW117047	N/A	N/A	N/A	N/A	N/A	11603 DONNER PASS RD	None	TRUCKEE	CA	96161	4953	00	06000	39.32609282	-120.2116134	Nevada County
354026	Ordering, Referring, Prescribing	N/A	1972832160	0	0	ESPIRITUSANTO, ALICIA M LCSW	10/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110930	N/A	N/A	N/A	N/A	N/A	30 PROFESSIONAL CENTER P	None	SAN RAFAEL	CA	94903	2757	00	06000	38.00989519	-122.5391142	Marin County
354034	Ordering, Referring, Prescribing	N/A	1972832327	0	0	EVANS, CASSANDRA LMFT	6/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103251	N/A	N/A	N/A	N/A	N/A	1 ST. VIN CENT DR.	None	SAN RAFAEL	CA	94903	1504	00	06000	38.034216	-122.525199	Marin County
354267	Ordering, Referring, Prescribing	N/A	1982192423	0	0	EVERETT, SHIRRELLE M NP	11/25/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009257	N/A	N/A	N/A	N/A	N/A	2145 5TH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
354344	Ordering, Referring, Prescribing	N/A	1982447884	0	0	ECKENROTH, SAGE NP	7/16/2024	Taxonomy not applicable	NA	n/a	000	Unknown	95031140	N/A	N/A	N/A	N/A	N/A	220 ROTANZI ST	None	RAMONA	CA	92065	2583	00	06000	33.02892485	-116.889131	San Diego County
354414	Ordering, Referring, Prescribing	N/A	1982777835	0	0	ELBAUM, DAVID J MD	4/6/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G46033	N/A	N/A	N/A	N/A	N/A	2438 N PONDEROSA DR	C105	CAMARILLO	CA	93010	2465	00	06000	34.24219545	-119.0227012	Ventura County
354447	Ordering, Referring, Prescribing	N/A	1982842092	0	0	EAST, TREVER F PT	2/2/2020	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	35378	N/A	N/A	N/A	N/A	N/A	1311 SANGUINETTI ROAD	C	SONORA	CA	95370	6210	00	06000	37.97447385	-120.3613052	Tuolumne County
354499	Ordering, Referring, Prescribing	N/A	1982953303	0	0	ENCINAS, TIMOTHY P LCSW	11/13/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76349	N/A	N/A	N/A	N/A	N/A	323 S PRAIRIE AVE	350	INGLEWOOD	CA	90301	4523	00	06000	33.96046851	-118.3440301	Los Angeles County
354609	Ordering, Referring, Prescribing	N/A	1992110423	0	0	ESTES, FORREST DO	1/24/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A20625	N/A	N/A	N/A	N/A	N/A	1315 S ADAMS ST	None	FORT WORTH	TX	76104	4404	00	06000	32.72994159	-97.33672572	Tarrant County
354701	Ordering, Referring, Prescribing	N/A	1992267918	0	0	ERSKINE, ASHLEE DO	4/1/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17944	N/A	N/A	N/A	N/A	N/A	2499 E LAKESHORE DR.	SUITE B	LAKE ELSINORE	CA	92530	4411	00	06000	33.66050702	-117.3018956	Riverside County
354708	Ordering, Referring, Prescribing	N/A	1992292007	0	0	EBRAHIMI, NAHRIN V	1/21/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	104489	N/A	N/A	N/A	N/A	N/A	137 N VIRGIL AVE	None	LOS ANGELES	CA	90004	4811	00	06000	34.07457287	-118.2868414	Los Angeles County
354769	Ordering, Referring, Prescribing	N/A	1992420731	0	0	EVERETTE, MONIQUE M LCSW	10/5/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW90786	N/A	N/A	N/A	N/A	N/A	1535 N BROADWAY	None	ESCONDIDO	CA	92026	2099	00	06000	33.14420294	-117.0902479	San Diego County
354780	Ordering, Referring, Prescribing	N/A	1992449490	0	0	EMAMIAN, SOFIA LCSW	5/5/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	18740	N/A	N/A	N/A	N/A	N/A	121 S. LONG BEACH BLVD.	None	COMPTON	CA	90221	3423	00	06000	33.89475493	-118.2080292	Los Angeles County
354823	Ordering, Referring, Prescribing	N/A	1992810394	0	0	ESMUNDO, MARIA LUCINDA D MD	7/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A89045	N/A	N/A	N/A	N/A	N/A	1642 E CAPITOL EXPY	None	SAN JOSE	CA	95121	1800	00	06000	37.3061289	-121.8119182	Santa Clara County
354851	Ordering, Referring, Prescribing	N/A	1992847503	0	0	ESTRADA-LOPEZ, SONIA PSYD	4/9/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY23214	N/A	N/A	N/A	N/A	N/A	26801 MOCINE AVE.	None	HAYWARD	CA	94544	2923	00	06000	37.6467339	-122.075844	Alameda County
354892	Ordering, Referring, Prescribing	N/A	1992929681	0	0	ELLIOTT-MCCREA, KATHLEEN LCSW	5/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23710	N/A	N/A	N/A	N/A	N/A	251 LLEWELLYN AVENUE	None	CAMPBELL	CA	95008	1940	00	06000	37.29173129	-121.9584335	Santa Clara County