Table: enrolled_medi_cal_fee_for_service_ffs_providers , legal_name like I*

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
157	Fee-for-Service	1417674532	1417674532	1	5	IRVINE COTTAGES LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2 BRANDYWINE	None	IRVINE	CA	92620	2507	30	06059	33.71573444	-117.7730804	Orange County
161	Fee-for-Service	1417674532	1417674532	1	4	IRVINE COTTAGES LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7 PRINCETON	None	IRVINE	CA	92620	2644	30	06059	33.71357134	-117.7696171	Orange County
166	Fee-for-Service	1417674532	1417674532	1	13	IRVINE COTTAGES LLC	1/26/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	25665 SABINA AVE	None	MISSION VIEJO	CA	92691	3914	30	06059	33.61167168	-117.6826193	Orange County
171	Fee-for-Service	1417674532	1417674532	1	1	IRVINE COTTAGES LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1 LONGSTREET	None	IRVINE	CA	92620	3368	30	06059	33.70560996	-117.7648088	Orange County
306	Fee-for-Service	1053575738	1053575738	1	1	INLANDPSYCH REDLANDS INC	10/31/2018	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	255 TERRACINA BLVD	SUITE 204	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
409	Fee-for-Service	1497137632	1497137632	2	1	IAROVICOV, HELENA O MD	8/20/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	153795	None	None	0	In state provider	None	200 S WELLS ROAD	100	VENTURA	CA	93004	1378	56	06111	34.29321532	-119.1597424	Ventura County
594	Fee-for-Service	1053575738	1053575738	1	1	INLANDPSYCH REDLANDS INC	11/2/2018	2084P0800X	NA	Psychiatry	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	255 TERRACINA BLVD	SUITE 204	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
788	Fee-for-Service	1851676720	1851676720	1	1	IADAROLA, NICKOLE K LMFT	8/26/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	114141	-	NOT APPLICABLE	0	In state provider	None	2751 NAPA VALLEY CORPORA	BLDG A, SUITES A201, A20	NAPA	CA	94558	6216	28	06055	38.24829023	-122.2745626	Napa County
832	Fee-for-Service	1376607846	1376607846	1	1	IPPOLITO, JOHN M MD	2/1/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	78738	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
884	Fee-for-Service	1053575738	1053575738	1	1	INLANDPSYCH REDLANDS INC	11/8/2018	2084P0800X	NA	Psychiatry	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	255 TERRACINA BLVD	SUITE 204	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
1065	Fee-for-Service	1144303199	1144303199	1	1	ISKANDER, RAY N MD	6/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	25024	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1111 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3131	15	06029	35.64171	-117.669847	Kern County
1117	Fee-for-Service	1700887833	1700887833	1	1	IRANIHA, ANDREW S MD	5/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	55391	02	General Surgery	0	In state provider	None	496 OLD NEWPORT BLVD	STE 2	NEWPORT BEACH	CA	92663	4264	30	06059	33.62902866	-117.9256259	Orange County
1150	Fee-for-Service	1336885128	1336885128	1	1	IWUALA, ANGELA	9/6/2023	363L00000X	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
1170	Fee-for-Service	1053575738	1053575738	1	1	INLANDPSYCH REDLANDS INC	10/31/2018	2084P0800X	NA	Psychiatry	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	255 TERRACINA BLVD	SUITE 204	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
1211	Fee-for-Service	1003572942	1003572942	1	1	IN THE MEANTIME BREATHE FAMI	12/22/2021	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LY COUNSELING SERVICES	4401 ATLANTIC AVE	229	LONG BEACH	CA	90807	2218	19	06037	33.836976	-118.185096	Los Angeles County
1430	Fee-for-Service	1740772383	1740772383	1	1	ICASIANO, HERBERT D DO	7/5/2022	207P00000X	NA	Other	026	PHYSICIANS	19631	None	None	0	In state provider	None	3700 E SOUTH ST	None	LAKEWOOD	CA	90712	1419	19	06037	33.8601747	-118.148313	Los Angeles County
1653	Fee-for-Service	1255508594	1255508594	1	1	IRAEE, ZIBA G MD	4/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135012	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
1854	Fee-for-Service	1811959703	1811959703	1	1	IAN KENJI KOMENAKA, 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
1963	Fee-for-Service	1790323640	1790323640	1	1	IANKOWITZ, MICHELLE B LCSW	5/15/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
2122	Fee-for-Service	1295079564	1295079564	1	1	ILACHTCHOUK, MARIANNA CRNA	7/30/2024	164W00000X	NA	Other	018	NURSE ANESTHETISTS	-	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
2321	Fee-for-Service	1770786469	1770786469	1	1	IMPARATO, JENNIFER M DO	10/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	9838	41	Internal Medicine	0	In state provider	None	12462 PUTNAM ST	STE 506	WHITTIER	CA	90602	1002	19	06037	33.9709236	-118.0460596	Los Angeles County
2397	Fee-for-Service	1568455152	1568455152	1	1	ICHIHANA, RANDALL	9/13/2005	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	MARIN PULMONARY SERVICE	1350 S ELISEO DR	STE 300	GREENBRAE	CA	94904	2011	21	06041	37.94490653	-122.537021	Marin County
2531	Fee-for-Service	1881860815	1881860815	1	1	ITO, TIMOTHY K MD	1/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139817	34	Urology and Urological Surgery	0	In state provider	None	1411 EAST 31ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
2609	Fee-for-Service	1770786469	1770786469	1	1	IMPARATO, JENNIFER M DO	10/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	9838	45	Nephrology (Renal-Kidney)	0	In state provider	None	12462 PUTNAM ST	STE 506	WHITTIER	CA	90602	1002	19	06037	33.9709236	-118.0460596	Los Angeles County
2916	Fee-for-Service	1003378944	1003378944	1	1	IDEAL, MIRANDA G CRNA	5/10/2019	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
3051	Fee-for-Service	1932665296	1932665296	1	1	INFINITI INNOVATIVE GROUP LL	5/15/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	37600 CENTRAL CT	SUITE 218	NEWARK	CA	94560	3456	01	06001	37.5210148	-122.0393441	Alameda County
3064	Fee-for-Service	1568796415	1568796415	1	1	IZQUIERDO, EDUARDO	5/2/2011	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
3147	Fee-for-Service	1548598055	1548598055	1	1	ISLAM, ZUNAIRA	12/4/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148846	None	None	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
3600	Fee-for-Service	1437308947	1437308947	1	1	IOFFE, YEVGENIYA J M MD	8/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102214	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
3699	Fee-for-Service	1992768147	1992768147	1	1	IMAM, NAIYER MD	6/17/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	87434	None	None	0	In state provider	None	1180 POST ST	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
3919	Fee-for-Service	1437537594	1437537594	1	2	INSIGHTFUL MATTERS FAMILY	7/14/2023	106H00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	COUNSELING PROFESSIONALS	18700 BEACH BLVD	STE 160	HUNTINGTON BEACH	CA	92648	2006	30	06059	33.69070037	-117.9886896	Orange County
3928	Fee-for-Service	1710146543	1710146543	1	1	IWANAGA, KENSHO MD	7/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102487	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
3951	Fee-for-Service	1255542536	1255542536	1	1	IGNACIO, PATRICK L MD	12/21/2020	207P00000X	NA	Other	026	PHYSICIANS	101799	None	None	0	In state provider	None	1149 W 190TH ST	None	GARDENA	CA	90248	4321	19	06037	33.85834052	-118.2958065	Los Angeles County
3992	Fee-for-Service	1922594373	1922594373	1	1	IYER, KARTIK	9/21/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	-	08	Family Practice	2	Out of state provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
4063	Fee-for-Service	1538116215	1538116215	1	2	INDUDHARA, RAMAIAH MD	2/12/2018	208800000X	NA	Other	026	PHYSICIANS	81435	34	Urology and Urological Surgery	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7755	13	06025	32.95809	-115.5537045	Imperial County
4088	Fee-for-Service	1831134253	1831134253	1	6	INPATIENT CONSULTANTS OF	10/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CALIFORNIA INC	350 HAWTHORNE AVE	STE 2320	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
4207	Fee-for-Service	1437537594	1437537594	1	2	INSIGHTFUL MATTERS FAMILY	9/10/2018	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNSELING PROFESSIONALS	18700 BEACH BLVD	STE 160	HUNTINGTON BEACH	CA	92648	2006	30	06059	33.69070037	-117.9886896	Orange County
4274	Fee-for-Service	1356445795	1356445795	1	1	INGRAHAM, CHRISTOPHER R MD	10/24/2022	2085R0204X	NA	Other	026	PHYSICIANS	177714	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
4400	Fee-for-Service	1437918307	1437918307	1	1	IGNITE EMERGENCY PHYSICIANS	7/9/2024	207PE0004X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	A MEDICAL CORPORATION	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
4444	Fee-for-Service	1497865315	1497865315	1	1	IHC HEALTH SERVICES, INC	1/1/1999	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CASSIA MEMORIAL HOSPITAL	1501 HILAND AVE	None	BURLEY	ID	83318	2682	00	None	42.53489313	-113.7833899	Cassia County
4495	Fee-for-Service	1437537594	1437537594	1	2	INSIGHTFUL MATTERS FAMILY	9/10/2018	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNSELING PROFESSIONALS	18700 BEACH BLVD	STE 160	HUNTINGTON BEACH	CA	92648	2006	30	06059	33.69070037	-117.9886896	Orange County
4686	Fee-for-Service	1437918307	1437918307	1	1	IGNITE EMERGENCY PHYSICIANS	7/9/2024	207PE0004X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
4732	Fee-for-Service	1497865315	1497865315	1	1	IHC HEALTH SERVICES, INC	1/1/1999	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CASSIA MEMORIAL HOSPITAL	1501 HILAND AVE	None	BURLEY	ID	83318	2682	00	None	42.53489313	-113.7833899	Cassia County
4855	Fee-for-Service	1083002166	1083002166	1	2	INLAND EMPIRE CARDIOVASCULAR	5/10/2021	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	374 E. VANDERBILT WAY	None	SAN BERNARDINO	CA	92408	3593	36	06071	34.06877142	-117.2770094	San Bernardino County
4901	Fee-for-Service	1639481989	1639481989	1	1	IBRAHIM, AHMED M MD	8/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	118014	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
5023	Fee-for-Service	1518152867	1518152867	1	1	IBRAHIM, WAGIH W MD	7/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99134	41	Internal Medicine	0	In state provider	None	1180 E SHAW	#125	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
5198	Fee-for-Service	1407045479	1407045479	2	1	INLAND EMPIRE COLON AND	12/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	64659	None	None	0	In state provider	SURGEONS	245 TERRACINA BLVD	SUITE 211 B	REDLANDS	CA	92373	4878	36	06071	34.03858912	-117.2066515	San Bernardino County
5369	Fee-for-Service	1417199969	1417199969	1	1	ILANO, EARL P MD	12/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117552	None	None	0	In state provider	None	26520 CACTUS AVENUE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
5653	Fee-for-Service	1548254980	1548254980	1	1	INLAND HOSPITAL MEDICAL	1/24/2006	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP INC	17705 SLATE AVE	STE 200	RIVERSIDE	CA	92505	5199	33	06065	33.90267074	-117.4928493	Riverside County
5654	Fee-for-Service	1649227943	1649227943	1	1	IEZZA, HEATHER A MD	6/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92671	40	Pediatrics	0	In state provider	DR BANUELOS	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
5971	Fee-for-Service	1548328933	1548328933	1	1	ISIDORO, FRANCIS P MD	8/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91438	42	Nuclear Medicine	0	In state provider	None	2320 N CALIFORNIA ST	None	STOCKTON	CA	95204	5509	39	06077	37.97483792	-121.2907554	San Joaquin County
6123	Fee-for-Service	1114151875	1114151875	1	1	ISHIHARA, YUMI C MD	7/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115576	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
6139	Fee-for-Service	1720645682	1720645682	1	1	INSIGNIA HEALTH CORP	9/27/2019	207RC0200X	NA	Other	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	525 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
6147	Fee-for-Service	1104812833	1104812833	1	1	IVANOVA, ANA MD	2/4/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	53804	08	Family Practice	0	In state provider	None	18119 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.69977185	-117.9544379	Orange County
6160	Fee-for-Service	1295937175	1295937175	1	1	INTERNATIONAL GLOBAL	3/4/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ENTERPRISES INC	9267 ARCHIBALD AVE	None	RANCHO CUCAMONGA	CA	91730	5207	36	06071	34.08586117	-117.5934218	San Bernardino County
6314	Fee-for-Service	1093778094	1093778094	1	1	ISENBERG, SHERWIN J MD	11/28/1985	207W00000X	NA	Ophthalmology	026	PHYSICIANS	26025	18	Ophthalmology	0	In state provider	JULES STEIN INST	800 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8359	19	06037	34.0658588	-118.4452336	Los Angeles County
6426	Fee-for-Service	1720645682	1720645682	1	1	INSIGNIA HEALTH CORP	9/27/2019	207RC0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	525 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
6436	Fee-for-Service	1104812833	1104812833	1	1	IVANOVA, ANA MD	2/4/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	53804	41	Internal Medicine	0	In state provider	None	18119 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.69977185	-117.9544379	Orange County
6456	Fee-for-Service	1043374879	1043374879	1	1	IVES, CHRISTINE M	1/30/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71615	45	Nephrology (Renal-Kidney)	0	In state provider	None	1165 S DORA ST	STE A2	UKIAH	CA	95482	6353	23	06045	39.13602308	-123.2095502	Mendocino County
6543	Fee-for-Service	1801186549	1801186549	1	1	ISLAND ORTHOPAEDICS, LLC	10/8/2018	207X00000X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	2	Out of state provider	None	3382 WAIALAE AVE	None	HONOLULU	HI	96816	2637	00	None	21.2853424	-157.804115	Honolulu County
6728	Fee-for-Service	1932199833	1932199833	1	1	ISLAND, NURUL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1105 CENTRAL EXPY N	STE 2230	ALLEN	TX	75013	6118	00	None	33.11659392	-96.67184525	Collin County
6891	Fee-for-Service	1043362841	1043362841	1	1	INFORZATO, NANCY M MD	11/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87571	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
6985	Fee-for-Service	1235244716	1235244716	1	1	ILIFF, ROGER, MD	7/28/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38694	08	Family Practice	0	In state provider	None	2850 TELEGRAPH AVE	STE 110	BERKELEY	CA	94705	1159	01	06001	37.85808554	-122.2594469	Alameda County
7115	Fee-for-Service	1831241033	1831241033	1	1	IV LEAGUE INC	1/1/2003	3336S0011X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6076 BRISTOL PKWY	STE 104	CULVER CITY	CA	90230	6600	19	06037	33.98557948	-118.3873452	Los Angeles County
7204	Fee-for-Service	1598960254	1598960254	1	1	IBRAHIM, FREDDIE M MD	5/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98360	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
7393	Fee-for-Service	1265817910	1265817910	1	1	ILLINGWORTH GARCIA, CARLOS I	9/4/2019	2084A2900X	NA	Neurology	026	PHYSICIANS	162566	13	Neurology (M.D. only)	0	In state provider	MD	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
7428	Fee-for-Service	1366018087	1366018087	1	1	IVY COTTAGES INC	1/18/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	9856 MARIPOSA AVE	None	FOUNTAIN VALLEY	CA	92708	2911	30	06059	33.7184513	-117.9572249	Orange County
7719	Fee-for-Service	1053173955	1053173955	1	1	INLAND VALLEY ANESTHESIA PAR	3/1/2024	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	TNERS, INC	36485 INLAND VALLEY DR	None	WILDOMAR	CA	92595	9681	33	06065	33.591699	-117.2368285	Riverside County
7729	Fee-for-Service	1346518263	1346518263	1	1	INMAN, TAYLOR B MD	12/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119318	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
7733	Fee-for-Service	1053326710	1053326710	1	1	IRAGUIMADOZ, VICENTE MD	1/1/1982	2084N0400X	NA	Neurology	026	PHYSICIANS	31274	13	Neurology (M.D. only)	0	In state provider	None	225 DICKINSON ST	# H208	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
7760	Fee-for-Service	1023022308	1023022308	1	1	IGOR V SEMENOV, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	ONE CHILDRENS HOSP DR	4401 PENN AVE	PITTSBURGH	PA	15224	0000	00	None	40.46651441	-79.9524674	Allegheny County
7819	Fee-for-Service	1295978427	1295978427	1	1	INLAND INTERVENTIONAL MEDICA	5/9/2014	208VP0014X	NA	Other	026	PHYSICIANS	80002	05	Anesthesiology	0	In state provider	L ASSOCIATES INC	9327 FAIRWAY VIEW PLACE	STE 210	RANCHO CUCAMONGA	CA	91730	0970	36	06071	34.084008	-117.5600535	San Bernardino County
8237	Fee-for-Service	1427078062	1427078062	1	1	IYER, KAMALNATH A MD INC	11/4/1981	174400000X	NA	Other	026	PHYSICIANS	35898	05	Anesthesiology	0	In state provider	None	841 MOHAWK ST	STE 270	BAKERSFIELD	CA	93309	1547	15	06029	35.36193277	-119.0628694	Kern County
8254	Fee-for-Service	1477887024	1477887024	1	1	INKABI, KOFI E MD	9/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130208	05	Anesthesiology	0	In state provider	None	1165 MONTGOMERY DRIVE	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
8319	Fee-for-Service	1639658016	1639658016	1	1	INDIGENOUS CIRCLE OF WELLNES	12/6/2020	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	S	5800 S EASTERN AVE	260	COMMERCE	CA	90040	4019	19	06037	33.98534547	-118.1620372	Los Angeles County
8503	Fee-for-Service	1134220718	1134220718	1	1	IRWIN, MICHAEL R MD	5/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	50031	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
8606	Fee-for-Service	1639658016	1639658016	1	1	INDIGENOUS CIRCLE OF WELLNES	12/6/2020	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	S	5800 S EASTERN AVE	260	COMMERCE	CA	90040	4019	19	06037	33.98534547	-118.1620372	Los Angeles County
8756	Fee-for-Service	1598889750	1598889750	1	1	IKUHARA, HIDENORI M MD	5/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	63739	41	Internal Medicine	0	In state provider	None	2110 N BELLFLOWER AVE	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
8852	Fee-for-Service	1841243649	1841243649	1	1	IBRAHIM, TAHCIN MD	2/20/2019	207L00000X	NA	Other	026	PHYSICIANS	40663	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
8938	Fee-for-Service	1164664421	1164664421	1	1	IZGUR, VITALY MD DO	4/1/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	171799	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
9118	Fee-for-Service	1609036458	1609036458	1	1	IYER, VIVEK MD	10/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155101	06	Cardiovascular Disease (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
9138	Fee-for-Service	1740856285	1740856285	1	2	IGOR GALAN MD NEUROLOGY AND	10/31/2024	2081P2900X	NA	Physical Medicine and Rehabilitation	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	PAIN MANAGEMENT	310 SOUTH HALCYON RD	102	ARROYO GRANDE	CA	93420	3872	40	06079	35.11464177	-120.5916364	San Luis Obispo County
9205	Fee-for-Service	1164643862	1164643862	1	1	INDIAN HEALTH CENTER OF	2/23/2023	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARA VALLEY	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	5250	43	06085	37.30176	-121.9136465	Santa Clara County
9228	Fee-for-Service	1093045288	1093045288	1	1	ISOLANI-NAGARVALA, TAMINA DO	5/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	10719	41	Internal Medicine	0	In state provider	None	2070 CLINTON AVENUE	None	ALAMEDA	CA	94501	4399	01	06001	37.76333626	-122.253868	Alameda County
9384	Fee-for-Service	1962504225	1962504225	3	1	IMGRX SJ VALLEY	10/7/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY KERMAN	517 S MADERA AVE	None	KERMAN	CA	93630	1523	10	06019	36.72710606	-120.060325	Fresno County
9493	Fee-for-Service	1164643862	1164643862	1	1	INDIAN HEALTH CENTER OF	1/1/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARA VALLEY	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	5250	43	06085	37.30176	-121.9136465	Santa Clara County
9497	Fee-for-Service	1801971577	1801971577	1	1	IM, ALBERT H MD	9/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92252	02	General Surgery	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
9586	Fee-for-Service	1952386781	1952386781	1	1	ISKANDER, RAOUF F MD	5/8/1980	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	33000	04	Otology, Laryngology, Rhinology	0	In state provider	None	2621 S BRISTOL ST	STE 206	SANTA ANA	CA	92704	5700	30	06059	33.711876	-117.885371	Orange County
9702	Fee-for-Service	1396830204	1396830204	4	1	INTERNIST LABORATORY	12/24/2013	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	4980 CARROLL CANYON ROAD	None	SAN DIEGO	CA	92121	1736	37	06073	32.89015334	-117.198667	San Diego County
9752	Fee-for-Service	1609314020	1609314020	1	1	IMRU, RUTH NP	11/6/2019	363LA2100X	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
9780	Fee-for-Service	1164643862	1164643862	1	1	INDIAN HEALTH CENTER OF	3/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARA VALLEY	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	5250	43	06085	37.30176	-121.9136465	Santa Clara County
9843	Fee-for-Service	1467799031	1467799031	1	1	ISLAND, ADREENA LCSW	6/2/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
9880	Fee-for-Service	1144266024	1144266024	1	2	INDIANA UNIVERSITY HEALTH IN	1/1/2018	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	C	1701 N SENATE	None	INDIANAPOLIS	IN	46202	5306	00	None	39.78959047	-86.16551711	Marion County
9893	Fee-for-Service	1467806224	1467806224	1	1	ITTIQ, BILAL MD	10/1/2018	390200000X	NA	Other	026	PHYSICIANS	153186	08	Family 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
9937	Fee-for-Service	1215379268	1215379268	1	1	IKEDA, JOHN S OD	3/23/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8751 VALLEY VIEW ST	STE A	BUENA PARK	CA	90620	3566	30	06059	33.835266	-118.028508	Orange County
9996	Fee-for-Service	1336886860	1336886860	1	1	INFINITE NURSING MEDICAL ASS	1/18/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	ERVICES	3350 SHELBY STREET	STE 200	ONTARIO	CA	91764	4882	36	06071	34.069698	-117.578205	San Bernardino County
10069	Fee-for-Service	1164643862	1164643862	1	1	INDIAN HEALTH CENTER OF	8/17/2011	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARA VALLEY	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	5250	43	06085	37.30176	-121.9136465	Santa Clara County
10138	Fee-for-Service	1225219066	1225219066	1	2	ISHIMARU, DENISE A MD	10/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	92469	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	20911 EARL ST	STE 440	TORRANCE	CA	90503	4351	19	06037	33.840459	-118.3580985	Los Angeles County
10145	Fee-for-Service	1114290780	1114290780	1	1	INDIAN HEALTH CENTER OF	6/25/2012	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARA VALLEY	455 O'CONNOR DRIVE	STE 200	SAN JOSE	CA	95128	1633	43	06085	37.326654	-121.939897	Santa Clara County
10156	Fee-for-Service	1568540474	1568540474	1	1	INOUYE, JOHN S MD	7/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81513	40	Pediatrics	0	In state provider	None	2071 HERNDON AVE	None	CLOVIS	CA	93611	6101	10	06019	36.8375685	-119.6781105	Fresno County
10173	Fee-for-Service	1144266024	1144266024	1	2	INDIANA UNIVERSITY HEALTH IN	1/1/2018	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	C	1701 N SENATE	None	INDIANAPOLIS	IN	46202	5306	00	None	39.78959047	-86.16551711	Marion County
10357	Fee-for-Service	1164643862	1164643862	1	1	INDIAN HEALTH CENTER OF	1/1/1995	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARA VALLEY	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	5250	43	06085	37.30176	-121.9136465	Santa Clara County
10435	Fee-for-Service	1114290780	1114290780	1	1	INDIAN HEALTH CENTER OF	10/18/2012	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARA VALLEY	455 O'CONNOR DRIVE	STE 200	SAN JOSE	CA	95128	1633	43	06085	37.326654	-121.939897	Santa Clara County
10564	Fee-for-Service	1154721793	1154721793	1	1	ILLUMINATE HOSPICE CARE INC	10/4/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3607 WEST MAGNOLIA BLVD	STE #2	BURBANK	CA	91505	2962	19	06037	34.1681505	-118.3462298	Los Angeles County
10586	Fee-for-Service	1508185406	1508185406	1	1	IYER, LAXMI S MD MPH	2/5/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	165408	68	Hematology	0	In state provider	None	4500 BROCKTON AVE	STE 107	RIVERSIDE	CA	92501	4006	33	06065	33.97785263	-117.3836152	Riverside County
10722	Fee-for-Service	1114290780	1114290780	1	1	INDIAN HEALTH CENTER OF	6/25/2012	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARA VALLEY	455 O'CONNOR DRIVE	STE 200	SAN JOSE	CA	95128	1633	43	06085	37.326654	-121.939897	Santa Clara County
10779	Fee-for-Service	1437199882	1437199882	1	1	INLAND RHEUMATOLOGY AND	4/2/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	83	Rheumatology	0	In state provider	OSTEOPOROSIS MED GRP INC	1238 E ARROW HWY	None	UPLAND	CA	91786	4951	36	06071	34.0997565	-117.6351255	San Bernardino County
10852	Fee-for-Service	1154721793	1154721793	1	1	ILLUMINATE 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	3607 WEST MAGNOLIA BLVD	STE #2	BURBANK	CA	91505	2962	19	06037	34.1681505	-118.3462298	Los Angeles County
10872	Fee-for-Service	1508185406	1508185406	1	1	IYER, LAXMI S MD MPH	2/5/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	165408	41	Internal Medicine	0	In state provider	None	4500 BROCKTON AVE	STE 107	RIVERSIDE	CA	92501	4006	33	06065	33.97785263	-117.3836152	Riverside County
11010	Fee-for-Service	1114290780	1114290780	1	1	INDIAN HEALTH CENTER OF	5/3/2016	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	SANTA CLARA VALLEY	455 O'CONNOR DRIVE	STE 200	SAN JOSE	CA	95128	1633	43	06085	37.326654	-121.939897	Santa Clara County
11197	Fee-for-Service	1467437848	1467437848	1	2	INLAND HEM ONC MED GRP I	6/30/2004	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GRP INC	401 E HIGHLAND AVE	STE C	SAN BERNARDINO	CA	92404	3835	36	06071	34.1358627	-117.2757778	San Bernardino County
11558	Fee-for-Service	1164789772	1164789772	1	1	IM, JENNIFER MD	8/27/2021	207R00000X	NA	Other	026	PHYSICIANS	154652	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
11821	Fee-for-Service	1518919687	1518919687	1	1	IZQUIERDO, PASCUAL MD	2/8/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	32702	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	455 OCONNOR DR	STE 310	SAN JOSE	CA	95128	1644	43	06085	37.326654	-121.939897	Santa Clara County
11826	Fee-for-Service	1750657649	1750657649	1	1	INGULSRUD, ERIC B MD	3/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
11835	Fee-for-Service	1104237031	1104237031	1	1	INTENTIONAL HEALTH, AN ACUPU	9/17/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	851 BURLWAY RD.	SUITE 316	BURLINGAME	CA	94010	3103	41	06081	37.59533247	-122.3663718	San Mateo County
11917	Fee-for-Service	1538268073	1538268073	1	1	ISSA, ANTONIOS MD	4/6/1994	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	52946	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
12218	Fee-for-Service	1689325425	1689325425	1	1	IRVIN, KENYATTA NP	11/10/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	607 W AVENUE Q	SUITE-A	PALMDALE	CA	93551	4385	19	06037	34.58716061	-118.1417509	Los Angeles County
12718	Fee-for-Service	1053483354	1053483354	1	1	IMES, RICHARD K MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	38145	18	Ophthalmology	0	In state provider	None	2340 CLAY ST	FL 5	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
12892	Fee-for-Service	1316206220	1316206220	1	1	INVITAE CORPORATION	3/29/2017	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	1400 16TH STREET	None	SAN FRANCISCO	CA	94103	5113	38	06075	37.76620435	-122.4012608	San Francisco County
13059	Fee-for-Service	1457312175	1457312175	1	1	INLAND EMPIRE UROLOGY	9/2/1987	174400000X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	MEDICAL GROUP	4500 BROCKTON AVE	STE 315	RIVERSIDE	CA	92501	4028	33	06065	33.97785263	-117.3836152	Riverside County
13246	Fee-for-Service	1023019353	1023019353	1	2	INTENSIVE HOME HEALTH	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	21671 GATEWAY CENTER DR	STE 104	DIAMOND BAR	CA	91765	2463	19	06037	33.99996376	-117.8347693	Los Angeles County
13276	Fee-for-Service	1942726252	1942726252	1	1	IMPERATO, TOD CNM	6/1/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 HOSPITAL DRIVE	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
13354	Fee-for-Service	1811166218	1811166218	1	1	INLAND HEALTHCARE GROUP AMC	3/9/2010	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1800 MEDICAL CENTER DR	SUITE 104	SAN BERNARDINO	CA	92411	1233	36	06071	34.131816	-117.322587	San Bernardino County
13516	Fee-for-Service	1699745760	1699745760	1	1	IYER, RAJALAKSHMI V MD	8/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	81384	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
13520	Fee-for-Service	1124219068	1124219068	1	1	IDLE, SANDY A LCSW	10/25/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	910 E FLORIDA AVE	C3	HEMET	CA	92543	4544	33	06065	33.74766581	-116.962604	Riverside County
13592	Fee-for-Service	1578342192	1578342192	1	1	IMPERIAL PHARMACEUTICAL SERV	11/8/2023	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	401 E BIRCH ST	STE D	CALEXICO	CA	92231	4351	13	06025	32.67934362	-115.4933372	Imperial County
13625	Fee-for-Service	1528264850	1528264850	1	1	ING, SHARON MD	10/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113588	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
13805	Fee-for-Service	1699745760	1699745760	1	1	IYER, RAJALAKSHMI V MD	8/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	81384	10	Gastroenterology (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
13843	Fee-for-Service	1134633068	1134633068	1	1	INGRAM, KESHIA LMFT	4/19/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
14015	Fee-for-Service	1952540502	1952540502	1	1	IM, MARY J MD	6/11/2020	207L00000X	NA	Other	026	PHYSICIANS	168060	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
14253	Fee-for-Service	1912478686	1912478686	1	1	ICARE PRIVATE DUTY, INC	1/3/2019	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	5473 KEARNY VILLA ROAD	SUITE 110 B	SAN DIEGO	CA	92123	1160	37	06073	32.83489847	-117.1380421	San Diego County
14637	Fee-for-Service	1851830426	1851830426	1	1	II, KHAMILA LMFT	2/10/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	129098	-	NOT APPLICABLE	0	In state provider	None	10603 DOWNEY AVE	10607, 10615 AND 10621	DOWNEY	CA	90241	3426	19	06037	33.94617788	-118.1295872	Los Angeles County
14811	Fee-for-Service	1336256775	1336256775	1	1	IHC HEALTH SERVICES INC	5/21/2009	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SEVIER VALLEY HOSPITAL	1100 N MAIN ST	None	RICHFIELD	UT	84701	1843	00	None	38.78321771	-112.0846004	Sevier County
14841	Fee-for-Service	1427349091	1427349091	1	1	INDRA, SEAN MD	1/31/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	183024	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
15103	Fee-for-Service	1336256775	1336256775	1	1	IHC HEALTH SERVICES INC	9/1/1999	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SEVIER VALLEY HOSPITAL	1100 N MAIN ST	None	RICHFIELD	UT	84701	1843	00	None	38.78321771	-112.0846004	Sevier County
15179	Fee-for-Service	1215912449	1215912449	1	1	IMMOOS, QUYEN T OD	5/24/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	764 SANTA ROSA ST	None	SAN LUIS OBISPO	CA	93401	2804	40	06079	35.28488223	-120.661928	San Luis Obispo County
15282	Fee-for-Service	1417674532	1417674532	1	10	IRVINE COTTAGES LLC	1/26/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	24132 DELPHI STREET	None	MISSION VIEJO	CA	92691	3907	30	06059	33.61169531	-117.6829969	Orange County
15406	Fee-for-Service	1700460920	1700460920	1	1	ILAGAN, ANNA VICTORIA F MD	10/2/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	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
15422	Fee-for-Service	1871695130	1871695130	3	1	IMGRX SJ VALLEY	10/9/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY MENDOTA	121 BARBOZA ST	BLDG 3	MENDOTA	CA	93640	1901	10	06019	36.76619136	-120.3839072	Fresno County
15568	Fee-for-Service	1811200124	1811200124	1	1	IBONIA, KATRINA T MD	3/9/2020	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	165664	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
15595	Fee-for-Service	1902178122	1902178122	1	1	INTENSIVE CARE MEDICAL GROUP	3/12/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
15695	Fee-for-Service	1316944861	1316944861	1	1	IZUMI, STEVEN F MD	7/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	47882	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
15799	Fee-for-Service	1992140446	1992140446	1	1	IN HIS IMAGE FAMILY CLINIC	7/26/2013	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	102441	08	Family Practice	0	In state provider	None	18251 ROSCOE BLVD	STE 105	NORTHRIDGE	CA	91325	4200	19	06037	34.22081017	-118.5314078	Los Angeles County
15853	Fee-for-Service	1669558599	1669558599	1	1	ILANO, AARON MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	75438	02	General Surgery	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
15881	Fee-for-Service	1902178122	1902178122	1	1	INTENSIVE CARE MEDICAL GROUP	3/12/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
16066	Fee-for-Service	1336296516	1336296516	1	1	INTERIM HEALTHCARE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	OF NORTHERN CALIFORNIA	97O EXECUTIVE WAY	None	REDDING	CA	96002	0630	45	06089	40.57618688	-122.3549416	Shasta County
16172	Fee-for-Service	1902178122	1902178122	1	1	INTENSIVE CARE MEDICAL GROUP	3/12/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
16231	Fee-for-Service	1790730596	1790730596	1	1	INFUSYSTEM INC	7/20/2015	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	3851 W HAMLIN RD	None	ROCHESTER	MI	48309	3252	00	None	42.64670444	-83.20597578	Oakland County
16355	Fee-for-Service	1336296516	1336296516	1	1	INTERIM HEALTHCARE	10/6/2006	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	OF NORTHERN CALIFORNIA	97O EXECUTIVE WAY	None	REDDING	CA	96002	0630	45	06089	40.57618688	-122.3549416	Shasta County
16358	Fee-for-Service	1861915993	1861915993	1	1	ISRAEL, SHANIKA CNP	2/28/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1350 FLORIN RD	None	SACRAMENTO	CA	95822	4202	34	06067	38.495232	-121.505409	Sacramento County
16411	Fee-for-Service	1750551719	1750551719	1	1	INLAND EMPIRE EXTRA CARE INC	7/26/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	10841 WHITE OAK AVENUE	SUITE 107	RANCHO CUCAMONGA	CA	91730	3811	36	06071	34.10467596	-117.5661881	San Bernardino County
16577	Fee-for-Service	1396984654	1396984654	1	1	IFEANYI, AMUZIE MD	6/30/1981	193400000X	NA	Other	026	PHYSICIANS	27773	02	General Surgery	0	In state provider	None	2230 LYNN RD	STE 310	THOUSAND OAKS	CA	91360	1992	56	06111	34.20894685	-118.885185	Ventura County
16766	Fee-for-Service	1316968910	1316968910	1	1	IMAGE GUIDED	9/10/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	THERAPEUTICS INC	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
16956	Fee-for-Service	1700414000	1700414000	1	1	IBRAHIM, ANTONY MD	11/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	190645	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
17057	Fee-for-Service	1225163637	1225163637	1	1	IGLEWICZ, ALANA MD	6/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99962	36	Psychiatry	0	In state provider	None	4311 3RD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
17173	Fee-for-Service	1568990190	1568990190	1	1	ITANI, REEM S MD	12/4/2023	208M00000X	NA	Other	026	PHYSICIANS	20928	41	Internal Medicine	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
17382	Fee-for-Service	1669800678	1669800678	1	1	INLAND VALLEY DRUG AND ALCOH	11/30/2015	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	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
17476	Fee-for-Service	1346917465	1346917465	1	1	IN PAIN PHYSICIANS NETWORK I	3/15/2022	208VP0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	8436 W 3RD ST	STE 800	LOS ANGELES	CA	90048	4100	19	06037	34.07313096	-118.3745151	Los Angeles County
17500	Fee-for-Service	1487089579	1487089579	1	1	INNERJOY 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	1965 YOSEMITE AVE	SUITE 115	SIMI VALLEY	CA	93063	5220	56	06111	34.27083489	-118.6784107	Ventura County
17642	Fee-for-Service	1851509566	1851509566	1	1	ISLES, TIFFANY D MD	9/16/2009	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	109130	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	207 W LEGION ROAD	None	BRAWLEY	CA	92227	2737	13	06025	32.95809	-115.5537045	Imperial County
17686	Fee-for-Service	1356754840	1356754840	1	1	IBRAHIM, AHMAD S MD	10/22/2019	207ZP0102X	NA	Other	026	PHYSICIANS	146994	22	Pathology (M.D. only)	0	In state provider	None	2011 ZONAL AVE	STE 303	LOS ANGELES	CA	90089	0110	19	06037	34.05979479	-118.2053794	Los Angeles County
17788	Fee-for-Service	1487089579	1487089579	1	1	INNERJOY HOSPICE CARE INC	12/23/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1965 YOSEMITE AVE	SUITE 115	SIMI VALLEY	CA	93063	5220	56	06111	34.27083489	-118.6784107	Ventura County
17872	Fee-for-Service	1225101884	1225101884	1	1	IMPERIAL, JOANNE C MD	2/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	44420	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
17965	Fee-for-Service	1710990700	1710990700	1	1	ILIC, IRENA L MD	11/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84404	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
17972	Fee-for-Service	1811072580	1811072580	1	1	ISHII, SUZANNE E DPM	1/1/1998	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
18062	Fee-for-Service	1538166715	1538166715	1	1	IRWIN, WES J	11/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83047	05	Anesthesiology	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
18070	Fee-for-Service	1114378619	1114378619	2	1	IDEAL RX LLC	4/3/2025	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6216 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	2913	19	06037	33.98389634	-118.2225777	Los Angeles County
18159	Fee-for-Service	1225101884	1225101884	1	1	IMPERIAL, JOANNE C MD	2/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	44420	10	Gastroenterology (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
18214	Fee-for-Service	1336214634	1336214634	1	1	ILIYA, ILYAS F MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51765	None	None	0	In state provider	None	1580 VALENCIA ST	STE 405	SAN FRANCISCO	CA	94110	4415	38	06075	37.74746923	-122.4202583	San Francisco County
18318	Fee-for-Service	1083375471	1083375471	1	1	INSIGHT FAMILY COUNSELING AN	3/24/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	D WELLNESS SERVICES	12321 MAGNOLIA AVE	SUITE D	RIVERSIDE	CA	92503	4736	33	06065	33.89046742	-117.4991751	Riverside County
18607	Fee-for-Service	1083375471	1083375471	1	1	INSIGHT FAMILY COUNSELING AN	3/24/2023	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	D WELLNESS SERVICES	12321 MAGNOLIA AVE	SUITE D	RIVERSIDE	CA	92503	4736	33	06065	33.89046742	-117.4991751	Riverside County
18857	Fee-for-Service	1649551276	1649551276	1	1	IANCULESCU, ALEXANDRA G MD	9/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123468	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
18915	Fee-for-Service	1245662055	1245662055	1	1	IYER, PRIYANKA MD	11/22/2019	207RR0500X	NA	Other	026	PHYSICIANS	162351	83	Rheumatology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
19028	Fee-for-Service	1962973263	1962973263	1	2	INSPIRE COUNSELING GROUP, MA	3/1/2024	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	RRIAGE AND FAMILY THER	10718 WHITE OAK AVE.	6	GRANADA HILLS	CA	91344	4628	19	06037	34.265538	-118.519724	Los Angeles County
19067	Fee-for-Service	1023465531	1023465531	1	1	IRANPOUR, NEGAUR MD	8/24/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	177175	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
19141	Fee-for-Service	1629462312	1629462312	1	1	INDIAN HEALTH CENTER	7/2/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF SANTA CLARA	2039 FOREST AVENUE	STE 105	SAN JOSE	CA	95128	4833	43	06085	37.32711929	-121.934266	Santa Clara County
19197	Fee-for-Service	1518172931	1518172931	1	1	ISRAEL, MARYANNE M CNP	2/14/2023	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1001 POTRERO AVE	6E/6D37	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
19314	Fee-for-Service	1124000443	1124000443	1	1	ISMAIL, SAAD U MD	10/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107455	41	Internal Medicine	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
19417	Fee-for-Service	1730648650	1730648650	1	1	IP, WILLIAM H MD	8/7/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	182321	20	Orthopedic Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
19428	Fee-for-Service	1629462312	1629462312	1	1	INDIAN HEALTH CENTER	7/2/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF SANTA CLARA	2039 FOREST AVENUE	STE 105	SAN JOSE	CA	95128	4833	43	06085	37.32711929	-121.934266	Santa Clara County
19472	Fee-for-Service	1831898493	1831898493	1	1	INFUSION AND CLINICAL SERVIC	6/22/2023	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	143 KERN AVE	None	MC FARLAND	CA	93250	1348	15	06029	35.67801355	-119.228976	Kern County
19763	Fee-for-Service	1831898493	1831898493	1	1	INFUSION AND CLINICAL SERVIC	6/22/2023	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	143 KERN AVE	None	MC FARLAND	CA	93250	1348	15	06029	35.67801355	-119.228976	Kern County
20113	Fee-for-Service	1689199879	1689199879	1	1	ICHIYASU-LAU, LORRIANE	5/8/2024	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
20266	Fee-for-Service	1427587377	1427587377	1	2	IBRAHIM, TALAB MD	11/3/2020	208M00000X	NA	Other	026	PHYSICIANS	162341	None	None	0	In state provider	None	399 E HIGHLAND AVE	STE 401	SAN BERNARDINO	CA	92402	3862	36	06071	34.1358627	-117.2757898	San Bernardino County
20333	Fee-for-Service	1275982571	1275982571	1	1	IRVINE, CHRISTOPHER J MD	4/17/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157892	08	Family Practice	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
20387	Fee-for-Service	1710023718	1710023718	1	1	ITAGAKI, BRIAN H MD INC	7/13/2010	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	37936	20	Orthopedic Surgery	0	In state provider	None	2200 W 3RD ST	STE 120A	LOS ANGELES	CA	90057	1934	19	06037	34.06329642	-118.2739484	Los Angeles County
20454	Fee-for-Service	1245051226	1245051226	1	1	ISARA, KERI	11/21/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	21515 HAWTHORNE BLVD	STE G100	TORRANCE	CA	90503	6503	19	06037	33.83306687	-118.3530111	Los Angeles County
20486	Fee-for-Service	1720130263	1720130263	1	1	IES MEDICAL GROUP INC	6/19/2007	193400000X	NA	Other	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	None	2333 BUCHANAN STREET	5TH FLOOR GI LAB	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
20587	Fee-for-Service	1780740332	1780740332	1	1	INOUYE, AMY NP	5/13/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
20826	Fee-for-Service	1871906545	1871906545	1	1	ITEN, ANA E MD	5/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139493	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
21107	Fee-for-Service	1710411657	1710411657	1	1	IYENGAR, PREETHA S MD	9/1/2022	208M00000X	NA	Other	026	PHYSICIANS	179176	None	None	0	In state provider	None	1250 16TH STREET	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
21183	Fee-for-Service	1396777801	1396777801	1	1	IKEMIYA, KENNETH A MD	7/3/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	70297	None	None	0	In state provider	None	6235 N FRESNO ST	STE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
21188	Fee-for-Service	1508028200	1508028200	1	1	IMPERIAL BEACH COMMUNITY	9/16/2008	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	CLINIC	949 PALM AVE	None	IMPERIAL BEACH	CA	91932	1503	37	06073	32.58380109	-117.1133687	San Diego County
21219	Fee-for-Service	1134858020	1134858020	1	1	INLAND EMPIRE MARRIAGE COUNS	8/14/2024	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	LING	41880 KALMIA ST	STE 115	MURRIETA	CA	92562	8835	33	06065	33.55740114	-117.2157733	Riverside County
21480	Fee-for-Service	1508028200	1508028200	1	1	IMPERIAL BEACH COMMUNITY	9/16/2008	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CLINIC	949 PALM AVE	None	IMPERIAL BEACH	CA	91932	1503	37	06073	32.58380109	-117.1133687	San Diego County
21510	Fee-for-Service	1669942751	1669942751	1	1	INDEPENDENCE HEALTH	5/15/2019	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	39022 PRESIDIO WAY	None	FREMONT	CA	94538	1221	01	06001	37.54421269	-121.9910888	Alameda County
21519	Fee-for-Service	1275592495	1275592495	1	2	INSCO, RICHARD A MD	1/3/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	64153	None	None	0	In state provider	None	1400 CHURCH ST	BLDG 8	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
21637	Fee-for-Service	1255482774	1255482774	1	1	IMPERIAL UNIFIED SD	1/28/2001	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	219 N E ST	None	IMPERIAL	CA	92251	1176	13	06025	32.84966315	-115.5749092	Imperial County
21772	Fee-for-Service	1912042714	1912042714	1	3	INTECORE INC	3/25/2016	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3626 E CHAPMAN AVE	None	ORANGE	CA	92869	3847	30	06059	33.78777248	-117.8148531	Orange County
22286	Fee-for-Service	1083002166	1083002166	1	3	INLAND EMPIRE CARDIOVASCULAR	11/2/2021	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	6950 BROCKTON AVENUE	SUITE 1	RIVERSIDE	CA	92506	3830	33	06065	33.9474392	-117.3967287	Riverside County
22375	Fee-for-Service	1639106503	1639106503	1	1	ISRAEL, PAUL 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	201 SIVLEY RD SW	None	HUNTSVILLE	AL	35801	5134	00	None	34.72102043	-86.58142219	Madison County
22466	Fee-for-Service	1023269222	1023269222	1	1	ISIS PHYSICAL THERAPY INC	7/15/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11848 BERNARDO PLZ CT	STE 100	SAN DIEGO	CA	92128	2417	37	06073	33.02032564	-117.0761485	San Diego County
22624	Fee-for-Service	1346445764	1346445764	1	1	IONG, KAKIN R MD	7/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112656	41	Internal Medicine	0	In state provider	None	444 BRUCE ST	None	YREKA	CA	96097	3450	47	06093	41.71863548	-122.6458755	Siskiyou County
22646	Fee-for-Service	1912042714	1912042714	1	2	INTECORE INC	3/25/2016	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	26700 TOWNE CENTRE DRIVE	SUITE 120	FOOTHILL RANCH	CA	92610	2843	30	06059	33.67455886	-117.6639195	Orange County
22916	Fee-for-Service	1184141012	1184141012	1	1	IRWIN, SAMANTHA L MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151299	79	Neurology-Child	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
22928	Fee-for-Service	1639673585	1639673585	1	1	IANOVICH, FRANCESCA C MD	4/4/2023	207L00000X	NA	Other	026	PHYSICIANS	166640	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
22963	Fee-for-Service	1215246996	1215246996	1	1	IMPERIAL BEACH COMMUNITY	1/27/2011	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CLINIC	1016 OUTER ROAD	None	SAN DIEGO	CA	92154	1351	37	06073	32.57795659	-117.0825179	San Diego County
22992	Fee-for-Service	1346467354	1346467354	1	1	INTERNATIONAL MEDICAL	2/3/1992	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	LABORATORY	16253 LAGUNA CANYON ROAD	SUITE 100	IRVINE	CA	92618	3610	30	06059	33.65874993	-117.7683873	Orange County
23113	Fee-for-Service	1023354040	1023354040	1	1	INSOURCE DIAGNOSTICS CORP	6/8/2015	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	231 W CHESTNUT AVE	None	MONROVIA	CA	91016	3315	19	06037	34.1426283	-118.0041528	Los Angeles County
23177	Fee-for-Service	1376959510	1376959510	1	1	IMTIAZ, SONAINA MD	3/1/2024	207RE0101X	NA	Endocrinology	026	PHYSICIANS	None	None	None	0	In state provider	None	925 S. EUCLID ST.	None	ANAHEIM	CA	92802	1522	30	06059	33.81918207	-117.9415353	Orange County
23250	Fee-for-Service	1215246996	1215246996	1	1	IMPERIAL BEACH COMMUNITY	1/27/2011	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CLINIC	1016 OUTER ROAD	None	SAN DIEGO	CA	92154	1351	37	06073	32.57795659	-117.0825179	San Diego County
23385	Fee-for-Service	1124552807	1124552807	1	1	ITEEN, ALEXANDER J MD	9/1/2023	207P00000X	NA	Other	026	PHYSICIANS	157713	None	None	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
23505	Fee-for-Service	1851604474	1851604474	1	1	IYER, SAI N MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	129147	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
23543	Fee-for-Service	1215246996	1215246996	1	1	IMPERIAL BEACH COMMUNITY	1/27/2011	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CLINIC	1016 OUTER ROAD	None	SAN DIEGO	CA	92154	1351	37	06073	32.57795659	-117.0825179	San Diego County
23566	Fee-for-Service	1801082482	1801082482	1	1	IOVETTZ-TERESHCHENKO, NADIA	9/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101347	66	Emergency Medicine (Urgent Care)	0	In state provider	MD	500 HOSPITAL ROAD	None	STOCKTON	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
23827	Fee-for-Service	1215246996	1215246996	1	1	IMPERIAL BEACH COMMUNITY	9/15/2011	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CLINIC	1016 OUTER ROAD	None	SAN DIEGO	CA	92154	1351	37	06073	32.57795659	-117.0825179	San Diego County
23888	Fee-for-Service	1033275250	1033275250	1	1	IRVINE UNIFIED SCH DIST	12/30/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	5050 BARRANCA PKWY	None	IRVINE	CA	92604	4652	30	06059	33.67614248	-117.7922942	Orange County
23977	Fee-for-Service	1124760012	1124760012	1	1	INMAN, BARBARA A NP	5/1/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	869 N CHERRY ST	None	TULARE	CA	93274	2207	54	06107	36.220932	-119.337698	Tulare County
24054	Fee-for-Service	1912004367	1912004367	1	1	IZU, BRENT S MD	12/25/2018	208600000X	NA	General Surgery	026	PHYSICIANS	156246	02	General Surgery	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
24247	Fee-for-Service	1396413647	1396413647	1	1	ISLAS, SAMUEL A OT	11/8/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2815 MAIN ST.,	SUITE 205	CORONA	CA	92882	0000	33	06065	33.84741266	-117.570694	Riverside County
24536	Fee-for-Service	1083002166	1083002166	1	1	INLAND EMPIRE CARDIOVASCULAR	7/1/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	CONSULTANTS INC	399 E HIGHLAND AVE	STE 307	SAN BERNARDINO	CA	92404	3853	36	06071	34.1358627	-117.2757898	San Bernardino County
24698	Fee-for-Service	1831164698	1831164698	1	1	INSIGHT HEALTH CORP	4/29/2005	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	INSIGHT IMAGING SAC MRI	2815 J ST	None	SACRAMENTO	CA	95816	4315	34	06067	38.573793	-121.468509	Sacramento County
24832	Fee-for-Service	1326296211	1326296211	1	1	INDIANA UNIVERSITY HEALTH AR	6/24/2019	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	NETT INC	5165 MCCARTY LANE	None	LAFAYETTE	IN	47905	8764	00	None	40.400568	-86.806485	Tippecanoe County
24960	Fee-for-Service	1902835077	1902835077	1	1	IN, GEORGE MD	10/23/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	48565	None	None	0	In state provider	None	500 S VIRGIL AVE	501	LOS ANGELES	CA	90020	1450	19	06037	34.064964	-118.2870335	Los Angeles County
25117	Fee-for-Service	1326296211	1326296211	1	1	INDIANA UNIVERSITY HEALTH AR	6/24/2019	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	NETT INC	5165 MCCARTY LANE	None	LAFAYETTE	IN	47905	8764	00	None	40.400568	-86.806485	Tippecanoe County
25160	Fee-for-Service	1285386409	1285386409	1	1	INTELLIHEALTH CARE MANAGEMEN	1/26/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	26660 PATRICK AVE	None	HAYWARD	CA	94544	3808	01	06001	37.64029048	-122.0808965	Alameda County
25174	Fee-for-Service	1891710554	1891710554	1	1	IMBESI, STEVEN G MD	6/8/1994	2085N0700X	NA	MRI Provider	026	PHYSICIANS	79078	30	Radiology	0	In state provider	None	2525 STOCKTON BLVD	STE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
25253	Fee-for-Service	1699363325	1699363325	1	1	INLAND PSYCHIATRIC MEDICAL G	10/11/2022	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	12442 LIMONITE AVE	UNIT 104	EASTVALE	CA	91752	2467	33	06065	33.97511454	-117.5531895	Riverside County
25406	Fee-for-Service	1528239761	1528239761	1	1	INNOVATIVE PLASTIC &	10/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	90876	None	None	0	In state provider	None	6610 FLANDERS	101	SAN DIEGO	CA	92121	3940	37	06073	32.9060896	-117.1769812	San Diego County
25541	Fee-for-Service	1699363325	1699363325	1	1	INLAND PSYCHIATRIC MEDICAL G	7/5/2021	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC.	12442 LIMONITE AVE	UNIT 104	EASTVALE	CA	91752	2467	33	06065	33.97511454	-117.5531895	Riverside County
25560	Fee-for-Service	1174058598	1174058598	1	1	INSIGHTFULWAYS CORP	12/17/2018	251S00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	384 EAST OLIVE AVENUE	SUITE 2	TURLOCK	CA	95380	4051	50	06099	37.49658844	-120.8452043	Stanislaus County
25829	Fee-for-Service	1699363325	1699363325	1	1	INLAND PSYCHIATRIC MEDICAL G	7/5/2021	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC.	12442 LIMONITE AVE	UNIT 104	EASTVALE	CA	91752	2467	33	06065	33.97511454	-117.5531895	Riverside County
25846	Fee-for-Service	1417674532	1417674532	1	12	IRVINE COTTAGES LLC	1/26/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	24695 DORIA AVE	None	MISSION VIEJO	CA	92691	3907	30	06059	33.60346462	-117.6829718	Orange County
25849	Fee-for-Service	1063643732	1063643732	1	1	IYER, NARAYAN P MD	9/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129376	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
25985	Fee-for-Service	1700383486	1700383486	1	1	IGBINIGIE, MATTHEW O MD	9/23/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
26093	Fee-for-Service	1841809902	1841809902	1	1	INABINET, DEVIN G AU	10/18/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	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
26121	Fee-for-Service	1659424745	1659424745	1	1	INTERCOMMUNITY CARE CTR	8/5/1985	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2626 GRAND AVE	None	LONG BEACH	CA	90815	1707	19	06037	33.80522461	-118.1454423	Los Angeles County
26268	Fee-for-Service	1942285879	1942285879	1	1	IQBAL, RASHID MD	9/30/1990	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	43154	01	General Practice	0	In state provider	None	1525 WEBSTER ST	STE A	FAIRFIELD	CA	94533	4935	48	06095	38.2570563	-122.0475622	Solano County
26390	Fee-for-Service	1982174561	1982174561	1	1	ISAACS, ALEXANDRA C LMFT	3/15/2022	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
26552	Fee-for-Service	1215411848	1215411848	1	1	INCARE HOME CARE LLC	10/1/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	355 W NAPA ST	STE A	SONOMA	CA	95476	6550	49	06097	38.29256873	-122.4647499	Sonoma County
26628	Fee-for-Service	1598096315	1598096315	1	1	INDUSTRIAL MEDICAL SERVICES	7/14/2023	163WG0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	AND URGENT CARE INC.	13024 HESPERIA RD	SUITE 101	VICTORVILLE	CA	92395	8302	36	06071	34.48893153	-117.29123	San Bernardino County
26709	Fee-for-Service	1063892248	1063892248	1	1	ITANI, REEM MD	7/1/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	162097	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
26904	Fee-for-Service	1235123985	1235123985	1	1	IWAHASHI, MARC A MD	12/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68531	08	Family Practice	0	In state provider	None	20555 PROSPECT RD	None	CUPERTINO	CA	95014	5212	43	06085	37.29394737	-122.033201	Santa Clara County
26983	Fee-for-Service	1417674532	1417674532	1	7	IRVINE COTTAGES LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	26722 PEPITA	None	MISSION VIEJO	CA	92691	5443	30	06059	33.59288476	-117.6634741	Orange County
26999	Fee-for-Service	1255684460	1255684460	1	1	INOVA HEALTH CARE SERVICES	4/30/2023	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4320 SEMINARY RD	None	ALEXANDRIA	VA	22304	1535	00	None	38.82433448	-77.10522437	Alexandria city
27288	Fee-for-Service	1255684460	1255684460	1	1	INOVA HEALTH CARE SERVICES	4/30/2023	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4320 SEMINARY RD	None	ALEXANDRIA	VA	22304	1535	00	None	38.82433448	-77.10522437	Alexandria city
27294	Fee-for-Service	1235106196	1235106196	1	1	IWATA, KATHRYN S	9/26/2018	174400000X	NA	Other	026	PHYSICIANS	55363	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1818 VERDUGO BLVD	401	GLENDALE	CA	91208	1421	19	06037	34.20560177	-118.216054	Los Angeles County
27369	Fee-for-Service	1003286253	1003286253	1	1	INLAND URGENT CARE A MEDICAL	8/23/2019	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	LLS	29997 CANYON HILLS RD	STE 1604	LAKE ELSINORE	CA	92532	2581	33	06065	33.66754378	-117.2623698	Riverside County
27459	Fee-for-Service	1164643862	1164643862	1	2	INDIAN HEALTH CENTER OF	8/20/2024	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1118 MERIDIAN AVE	STE 150	SAN JOSE	CA	95125	4329	43	06085	37.303371	-121.9136145	Santa Clara County
27485	Fee-for-Service	1356826515	1356826515	1	1	INTRINSICALLY HEALTHY PSYCHO	5/21/2020	261QM0850X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	LOGICAL SERVICES INC	2575 E PERRIN AVE	STE 110	FRESNO	CA	93720	5204	10	06019	36.87400227	-119.7382724	Fresno County
27586	Fee-for-Service	1912042714	1912042714	1	1	INTECORE INC	3/25/2016	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5 JOURNEY	SUITE 100	ALISO VIEJO	CA	92656	5330	30	06059	33.56960395	-117.7278975	Orange County
27778	Fee-for-Service	1043519341	1043519341	1	1	IBRAHIM, NUHA A MD	4/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139482	41	Internal Medicine	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
27801	Fee-for-Service	1457895633	1457895633	1	1	ITO, MICHAEL M	5/1/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
27904	Fee-for-Service	1386721157	1386721157	1	1	INFECTIOUS DISEASE ASSOC	3/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	77	Infectious Disease	1	Border provider	None	3100 W CHARLESTON BLVD	STE 204	LAS VEGAS	NV	89102	1996	00	None	36.15905845	-115.183809	Clark County
27949	Fee-for-Service	1407486905	1407486905	1	1	INTEGRATIVE PHYSICAL MEDICIN	1/9/2025	208100000X	NA	Physical Medicine and Rehabilitation	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	None	2650 ELM AVE	SUITE 210	LONG BEACH	CA	90806	1651	19	06037	33.805521	-118.1882945	Los Angeles County
28053	Fee-for-Service	1881221273	1881221273	1	1	IBARRA, ALLISON N	3/25/2024	208M00000X	NA	Other	026	PHYSICIANS	186128	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
28160	Fee-for-Service	1710130539	1710130539	1	1	IRHYTHM TECHNOLOGIES, INC.	8/13/2018	293D00000X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	699 8TH ST	SUITE 600	SAN FRANCISCO	CA	94103	4901	38	06075	37.77043229	-122.4043342	San Francisco County
28173	Fee-for-Service	1235148594	1235148594	1	1	IHC HEALTH SERVICES, INC	11/1/2001	282NC2000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	100 N MEDICAL DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77069459	-111.8370155	Salt Lake County
28187	Fee-for-Service	1447833991	1447833991	1	1	ISHISAKA, MIKA M PT	11/21/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7311 GREENHAVEN	200	SACRAMENTO	CA	95831	3572	34	06067	38.492622	-121.5219195	Sacramento County
28322	Fee-for-Service	1457594772	1457594772	1	1	ING, JAKUN W MD	7/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113587	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
28327	Fee-for-Service	1023069424	1023069424	1	1	IWAI, RICK TADASHI OPT	6/30/1990	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	946 N WESTERN AVE	None	SAN PEDRO	CA	90732	2427	19	06037	33.75111361	-118.3090432	Los Angeles County
28367	Fee-for-Service	1972653798	1972653798	1	1	ISAACS, JENNIFER N MD	11/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86356	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
28414	Fee-for-Service	1770769937	1770769937	1	1	IDOS, GREGORY E MD	9/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	102184	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO ST	SUITE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
28457	Fee-for-Service	1235148594	1235148594	1	1	IHC HEALTH SERVICES, INC	11/1/2001	282NC2000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	100 N MEDICAL DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77069459	-111.8370155	Salt Lake County
28470	Fee-for-Service	1689202244	1689202244	1	1	IHEGWORD, ANDREA N MD	2/28/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
28574	Fee-for-Service	1356344667	1356344667	1	1	INCE,CARLOS JR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	900 S CATON AVE	None	BALTIMORE	MD	21229	0000	00	None	39.27291925	-76.67100365	Baltimore city
28658	Fee-for-Service	1306378864	1306378864	1	1	IP, JACK D MD	5/24/2021	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
28705	Fee-for-Service	1770769937	1770769937	1	1	IDOS, GREGORY E MD	9/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	102184	10	Gastroenterology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	SUITE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
28867	Fee-for-Service	1801896105	1801896105	1	1	INFINITY HOME CARE	9/1/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PROVIDERS, INC	9350 FLAIR DR	SUITE 268	EL MONTE	CA	91731	2828	19	06037	34.07192066	-118.0649488	Los Angeles County
29157	Fee-for-Service	1699947051	1699947051	1	1	ILANI, DORIT S PHD	3/5/2025	103TC0700X	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
29163	Fee-for-Service	1700141652	1700141652	1	1	ISSAQ, HELA MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127978	01	General Practice	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
29265	Fee-for-Service	1194222927	1194222927	1	1	INMAN, AMY L	9/3/2021	207P00000X	NA	Other	026	PHYSICIANS	173396	None	None	0	In state provider	None	1350 W COVINA BLVD	None	SAN DIMAS	CA	91773	3219	19	06037	34.09906108	-117.8343639	Los Angeles County
29288	Fee-for-Service	1982698189	1982698189	2	1	INJECTABLE THERAPY SERVICES	4/4/2014	3336H0001X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CA	16625 ARMINTA ST	None	VAN NUYS	CA	91406	1611	19	06037	34.21490549	-118.4953995	Los Angeles County
29616	Fee-for-Service	1609656909	1609656909	1	1	ILOGU, ANTHONY NP	10/24/2023	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
29662	Fee-for-Service	1053572412	1053572412	1	1	IRVING, MICHELLE A S PYSD	7/21/2015	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
29718	Fee-for-Service	1942285879	1942285879	1	3	IQBAL, RASHID MD	2/28/2008	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	43154	10	Gastroenterology (M.D. only)	0	In state provider	None	100 HOSPITAL DR	STE 303	VALLEJO	CA	94589	2580	48	06095	38.13100118	-122.2403008	Solano County
29750	Fee-for-Service	1346291374	1346291374	2	1	IBRAHIM, WASEEM N MD	6/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	44002	13	Neurology (M.D. only)	0	In state provider	None	7172 MAGNOLIA AVE	None	RIVERSIDE	CA	92504	3804	33	06065	33.94477707	-117.4034127	Riverside County
29939	Fee-for-Service	1386609584	1386609584	1	1	ITO, FUMITO MD	12/15/2021	2086X0206X	NA	General Surgery	026	PHYSICIANS	175446	None	None	0	In state provider	None	1450 SAN PABLO STREET	SUITE 6200	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
30163	Fee-for-Service	1649026261	1649026261	1	1	INTEGROCURA INC	11/8/2024	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1009 W SAN BERNARDINO RD	None	COVINA	CA	91722	4106	19	06037	34.0888959	-117.9101503	Los Angeles County
30241	Fee-for-Service	1154420669	1154420669	1	1	ISKANDAR, RUDOLF MD	3/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	67879	25	Physical Medicine and Rehabilitation	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
30862	Fee-for-Service	1295917417	1295917417	1	1	IBANEZ, MARCELINA G MD	3/18/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	64505	08	Family Practice	0	In state provider	None	8100 TIMBERLAKE WAY	STE C	SACRAMENTO	CA	95823	5409	34	06067	38.46348	-121.414536	Sacramento County
31268	Fee-for-Service	1245855923	1245855923	1	1	ISMAIL, ZAYA PT	8/4/2020	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2303 GEER RD	None	TURLOCK	CA	95382	2408	50	06099	37.514097	-120.848997	Stanislaus County
31273	Fee-for-Service	1740856285	1740856285	1	1	IGOR GALAN MD NEUROLOGY AND	3/2/2022	2084P2900X	NA	Neurology	026	PHYSICIANS	None	13	Neurology (M.D. only)	0	In state provider	IN MANAGEMENT PC	201 N COLLEGE DR	101	SANTA MARIA	CA	93454	4614	42	06083	34.954461	-120.424836	Santa Barbara County
31289	Fee-for-Service	1740557388	1740557388	1	1	IKEDA, KRISTEN	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
31556	Fee-for-Service	1346917465	1346917465	1	2	IN PAIN PHYSICIANS NETWORK I	3/15/2022	208VP0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2557 PACIFIC COAST HWY	STE A	TORRANCE	CA	90505	7035	19	06037	33.79006883	-118.3303208	Los Angeles County
31819	Fee-for-Service	1215035274	1215035274	1	2	ISKAROUS, RAGAA Z MD INC	9/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	45155	-	NOT APPLICABLE	0	In state provider	None	11902 ROSECRANS BLVD	STE A & D	NORWALK	CA	90650	4197	19	06037	33.90212464	-118.079675	Los Angeles County
31840	Fee-for-Service	1275996803	1275996803	1	1	IKEZUAGU, UDOKA O MD	10/26/2020	207R00000X	NA	Other	026	PHYSICIANS	158996	41	Internal Medicine	0	In state provider	None	31700 TEMECULA PARKWAY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
32075	Fee-for-Service	1104030055	1104030055	1	1	IYENGAR, SRINIVAS S MD	7/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105824	18	Ophthalmology	0	In state provider	None	2121 WILSHIRE BLVD	STE 301	SANTA MONICA	CA	90403	5743	19	06037	34.03262306	-118.4817131	Los Angeles County
32314	Fee-for-Service	1306905906	1306905906	1	1	IGANET, SHAHROKH MD	12/1/1997	2085R0001X	NA	Other	026	PHYSICIANS	62231	78	Neoplastic Diseases/Oncology	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
32365	Fee-for-Service	1124238761	1124238761	1	1	ISMAIL, AMEERA F F MD	2/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	121403	30	Radiology	0	In state provider	None	2110 BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
32520	Fee-for-Service	1225218662	1225218662	1	1	INFECTIOUS DISEASES	8/1/1996	282E00000X	NA	Hospitals	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CONSULTANTS MEDICAL GRP	1339 4TH AVE	None	SAN FRANCISCO	CA	94122	2615	38	06075	37.76350944	-122.4609575	San Francisco County
32626	Fee-for-Service	1770205130	1770205130	1	1	INLAND EMPIRE MULTISPECIALTY	3/22/2024	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	-NEPHROLOGY	9939 MAGNOLIA AVE	D	RIVERSIDE	CA	92503	3528	33	06065	33.91571158	-117.4549231	Riverside County
32646	Fee-for-Service	1952062036	1952062036	1	1	ILYIN, ALISHA E NP	7/15/2022	363LF0000X	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
32806	Fee-for-Service	1225218662	1225218662	1	1	INFECTIOUS DISEASES	8/1/1996	282E00000X	NA	Hospitals	022	PHYSICIANS GROUP	-	38	Geriatrics	0	In state provider	CONSULTANTS MEDICAL GRP	1339 4TH AVE	None	SAN FRANCISCO	CA	94122	2615	38	06075	37.76350944	-122.4609575	San Francisco County
32833	Fee-for-Service	1649489378	1649489378	1	1	ILFELD, JENNY K MD	6/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	66404	40	Pediatrics	0	In state provider	None	4647 ZION AVENUE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
32871	Fee-for-Service	1922514124	1922514124	1	1	ICHIMARU, JASON K OT	10/25/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	39650 LIBERTY ST	STE 310	FREMONT	CA	94358	2227	01	06001	37.54662058	-121.9736002	Alameda County
32976	Fee-for-Service	1346917465	1346917465	1	5	IN PAIN PHYSICIANS NETWORK I	3/16/2022	208VP0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	8929 WILSHIRE BLVD	SUITE 200	BEVERLY HILLS	CA	90211	1951	19	06037	34.06709669	-118.386182	Los Angeles County
33048	Fee-for-Service	1942200696	1942200696	1	1	IGNATOFF, WILLIAM MD	4/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1601 W SAINT MARYS RD	None	TUCSON	AZ	85745	2623	00	None	32.228199	-111.0000825	Pima County
33097	Fee-for-Service	1225218662	1225218662	1	1	INFECTIOUS DISEASES	8/1/1996	282E00000X	NA	Hospitals	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	CONSULTANTS MEDICAL GRP	1339 4TH AVE	None	SAN FRANCISCO	CA	94122	2615	38	06075	37.76350944	-122.4609575	San Francisco County
33127	Fee-for-Service	1336508266	1336508266	1	1	ISENSTADT, JESSE W	3/1/2024	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
33145	Fee-for-Service	1538547328	1538547328	1	1	ICARE HOME HEALTH SERVICES	9/19/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	17620 SHERMAN WAY	SUITE 103	VAN NUYS	CA	91406	3527	19	06037	34.20105176	-118.5171046	Los Angeles County
33250	Fee-for-Service	1518982206	1518982206	1	1	IQBAL, SYMA MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62095	78	Neoplastic Diseases/Oncology	0	In state provider	None	1355 SAN PABLO ST	None	LOS ANGELES	CA	90033	1035	19	06037	34.06080447	-118.203734	Los Angeles County
33370	Fee-for-Service	1598336778	1598336778	1	1	ISHIKAWA, KORAN LAC	2/1/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	948 DOLORES AVE	None	LOS ALTOS	CA	94024	6010	43	06085	37.35424447	-122.088402	Santa Clara County
33373	Fee-for-Service	1306457817	1306457817	1	1	INDIGO HOME HEALTH CARE INC	9/9/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	11755 VICTORY BLVD	SUITE 211	NORTH HOLLYWOOD	CA	91606	3474	19	06037	34.18670448	-118.389699	Los Angeles County
33384	Fee-for-Service	1245721836	1245721836	1	1	IMAYANAGITA, BRYAN T DO	10/13/2021	390200000X	NA	Other	026	PHYSICIANS	17618	None	None	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90807	1701	19	06037	33.808185	-118.1850575	Los Angeles County
33463	Fee-for-Service	1255880449	1255880449	1	1	INTUITIVE HEALTH MANAGEMENT	10/23/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7887 SOQUEL DR	STE C&D&E	APTOS	CA	95003	3900	44	06087	36.97818934	-121.9069039	Santa Cruz County
33632	Fee-for-Service	1942485115	1942485115	1	1	INNOCENZI, ROBERT A DO I	10/13/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	5773	20	Orthopedic Surgery	0	In state provider	None	13197 CENTRAL AVE	STE 101	CHINO	CA	91710	4178	36	06071	34.013781	-117.689161	San Bernardino County
33900	Fee-for-Service	1275963373	1275963373	1	1	IM, DANIEL D E MD	2/7/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	126828	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
34176	Fee-for-Service	1831134253	1831134253	1	4	INPATIENT CONSULTANTS OF	10/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CALIFORNIA INC	2800 BENEDICT DR	None	SAN LEANDRO	CA	94577	6840	01	06001	37.71593435	-122.131151	Alameda County
34244	Fee-for-Service	1134193980	1134193980	1	1	ISENBARGER, PAUL A	12/1/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	75267	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
34303	Fee-for-Service	1306033147	1306033147	1	1	INGRANDE, JERRY MD	6/16/2009	207L00000X	NA	Other	026	PHYSICIANS	96719	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
34330	Fee-for-Service	1043830813	1043830813	1	1	IKIGAI PHYSICIAN GROUP INC	3/2/2022	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	3429 RENNER DR	None	FORTUNA	CA	95540	3104	12	06023	40.58254803	-124.1353014	Humboldt County
34372	Fee-for-Service	1629436969	1629436969	1	1	INFINITE HOMEHEALTH AND	4/1/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	16200 VENTURA BLVD	SUITE 209	ENCINO	CA	91436	2205	19	06037	34.15659457	-118.485532	Los Angeles County
34373	Fee-for-Service	1760772453	1760772453	1	1	IBEKWE, PEACE N MD	10/17/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3196 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2305	00	None	36.13194	-115.136873	Clark County
34526	Fee-for-Service	1437616422	1437616422	1	1	INTEGRITY GRACE HEALTH CARE	11/19/2019	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	INC	28121 CAMELLIA CT	None	LAGUNA NIGUEL	CA	92677	7077	30	06059	33.554578	-117.7083062	Orange County
34617	Fee-for-Service	1043830813	1043830813	1	1	IKIGAI PHYSICIAN GROUP INC	11/15/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3429 RENNER DR	None	FORTUNA	CA	95540	3104	12	06023	40.58254803	-124.1353014	Humboldt County
34650	Fee-for-Service	1902860778	1902860778	1	1	INGLIS, ANDREW E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73377	36	Psychiatry	0	In state provider	None	1434 SEA RIDGE DR	None	NEWPORT BEACH	CA	92660	8207	30	06059	33.622162	-117.8837626	Orange County
34765	Fee-for-Service	1003407735	1003407735	1	1	INNOVATIVE MEDICAL GROUP TEM	7/26/2024	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ECULA	44045 MARGARITA RD	STE 103	TEMECULA	CA	92592	2729	33	06065	33.48351542	-117.1027964	Riverside County
34811	Fee-for-Service	1780244244	1780244244	1	1	IGNELL, DANIEL P MD	9/3/2024	207RA0401X	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
34940	Fee-for-Service	1467402149	1467402149	1	1	INLAND OB/GYN ASSOC	10/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	WOMENS HEALTH CENTER	401 E HIGHLAND AVE	STE 450	SAN BERNARDINO	CA	92404	3836	36	06071	34.1358627	-117.2757778	San Bernardino County
34972	Fee-for-Service	1609526623	1609526623	1	2	INTERVENTIONAL RADIATION ONC	8/1/2024	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	OLOGY OF CALIFORNIA IN	963 BUTTE ST	None	REDDING	CA	96001	0828	45	06089	40.58567535	-122.3853786	Shasta County
35125	Fee-for-Service	1407566912	1407566912	1	1	ITCHON, REX V CRNA	6/23/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
35186	Fee-for-Service	1053461178	1053461178	1	1	INPATIENT PHYSICIANS NETWORK	3/29/2011	193400000X	NA	Other	026	PHYSICIANS	62314	41	Internal Medicine	0	In state provider	INC	41593 WINCHESTER RD	STE 101	TEMECULA	CA	92590	4858	33	06065	33.52030169	-117.1659061	Riverside County
35202	Fee-for-Service	1013478916	1013478916	1	1	IN TOUCH HOSPICE CARE INC	8/12/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	34 E LIVE OAK AVE	SUITE B	ARCADIA	CA	91006	5278	19	06037	34.10747625	-118.0291303	Los Angeles County
35215	Fee-for-Service	1790861813	1790861813	1	1	ILIC, IVA S MD	10/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97486	08	Family 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
35384	Fee-for-Service	1285649863	1285649863	1	1	IWASKO, NICHOLAS G MD	6/4/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	68230	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
35451	Fee-for-Service	1144608811	1144608811	1	1	INFINITE CARE WOMENS HEALTH	8/17/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	76370	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	229 WEST CHERRY AVE	None	PORTERVILLE	CA	93257	3401	54	06107	36.06917549	-119.0215574	Tulare County
35490	Fee-for-Service	1013478916	1013478916	1	1	IN TOUCH HOSPICE CARE INC	8/12/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	34 E LIVE OAK AVE	SUITE B	ARCADIA	CA	91006	5278	19	06037	34.10747625	-118.0291303	Los Angeles County
35540	Fee-for-Service	1205015211	1205015211	1	1	IQBAL, MARVI MD	10/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98780	07	Dermatology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
35612	Fee-for-Service	1831501493	1831501493	1	1	IMED EQUIP LLC	4/4/2024	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	T	1201 3RD AVE NORTH	None	BIRMINGHAM	AL	35203	1628	00	None	33.51118268	-86.81764327	Jefferson County
35662	Fee-for-Service	1033375563	1033375563	1	1	INDACOCHEA, RICARDO A MD	6/29/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	110199	40	Pediatrics	0	In state provider	None	1400 E PALOMAR ST	None	CHULA VISTA	CA	91913	1800	37	06073	32.62382113	-116.9960539	San Diego County
35672	Fee-for-Service	1932518362	1932518362	1	1	ISSAVI, HORMOZ MD	12/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132076	41	Internal Medicine	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
35782	Fee-for-Service	1104145283	1104145283	1	1	IVESTER, ANNA E MD	5/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128027	01	General Practice	0	In state provider	None	2505 WEST HAMMER LANE	None	STOCKTON	CA	95209	2839	39	06077	38.02139448	-121.347738	San Joaquin County
35850	Fee-for-Service	1740025253	1740025253	1	1	IRIS VND PARTNERS LLC	4/15/2025	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1321 S FAIRMONT AVE	None	LODI	CA	95240	5520	39	06077	38.11639016	-121.2857831	San Joaquin County
35909	Fee-for-Service	1467532630	1467532630	1	1	IMAGAWA, DAVID K MD	8/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	44277	02	General Surgery	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
35949	Fee-for-Service	1033375563	1033375563	1	1	INDACOCHEA, RICARDO A MD	6/29/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	110199	41	Internal Medicine	0	In state provider	None	1400 E PALOMAR ST	None	CHULA VISTA	CA	91913	1800	37	06073	32.62382113	-116.9960539	San Diego County
35958	Fee-for-Service	1295293702	1295293702	1	1	IMPRESS HOME HEALTH CARE INC	3/21/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	10315 WOODLEY AVE	STE 207	GRANADA HILLS	CA	91344	6950	19	06037	34.25814	-118.4848575	Los Angeles County
35960	Fee-for-Service	1932518362	1932518362	1	1	ISSAVI, HORMOZ MD	12/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132076	01	General Practice	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
36079	Fee-for-Service	1437537594	1437537594	1	1	INSIGHTFUL MATTERS FAMILY	7/14/2023	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	COUNSELING PROFESSIONALS	17111 BEACH BLVD	STE 205	HUNTINGTON BEACH	CA	92647	5947	30	06059	33.713937	-117.9892085	Orange County
36240	Fee-for-Service	1538899703	1538899703	1	1	IGLESIAS, ROXANA LPCC	10/4/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
36285	Fee-for-Service	1538416946	1538416946	1	1	INTERVENTIONAL PAIN PHYSICIA	10/21/2019	163WP0000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	NS, INC.	127 RALEY BLVD	100	CHICO	CA	95928	8347	04	06007	39.71601447	-121.7894985	Butte County
36350	Fee-for-Service	1194121897	1194121897	1	1	IRANNEJAD, PARDIS MD	11/17/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	144925	45	Nephrology (Renal-Kidney)	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
36366	Fee-for-Service	1437537594	1437537594	1	1	INSIGHTFUL MATTERS FAMILY	2/5/2018	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNSELING PROFESSIONALS	17111 BEACH BLVD	STE 205	HUNTINGTON BEACH	CA	92647	5947	30	06059	33.713937	-117.9892085	Orange County
36381	Fee-for-Service	1447241302	1447241302	1	1	INVIEW IMAGING MEDICAL CORP	6/15/2010	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	39465 PASEO PADRE PKWY	STE 1000	FREMONT	CA	94538	5347	01	06001	37.55055839	-121.9754757	Alameda County
36392	Fee-for-Service	1659785301	1659785301	1	1	IGNE, ERIN L OD	7/26/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 WILSHIRE BLVD.	SUITE 1275	LOS ANGELES	CA	90025	7143	19	06037	34.04370122	-118.4678993	Los Angeles County
36513	Fee-for-Service	1760530737	1760530737	1	1	ICHIUJI, ANNE M MD	6/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	62359	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
36644	Fee-for-Service	1528167947	1528167947	1	1	ISMAIL, AYAAZ MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6130 N LA CHOLLA BLVD	STE 210	TUCSON	AZ	85741	3574	00	None	32.318055	-111.0109905	Pima County
36655	Fee-for-Service	1437537594	1437537594	1	1	INSIGHTFUL MATTERS FAMILY	2/12/2018	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNSELING PROFESSIONALS	17111 BEACH BLVD	STE 205	HUNTINGTON BEACH	CA	92647	5947	30	06059	33.713937	-117.9892085	Orange County
37378	Fee-for-Service	1952792475	1952792475	2	1	INPATIENT SPECIALISTS OF CAL	1/11/2022	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	IA IV	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
37393	Fee-for-Service	1104249507	1104249507	1	1	ISSA AL RABADI	9/5/2018	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
37556	Fee-for-Service	1881234227	1881234227	1	1	ISAYAN, ARPI LCSW	1/16/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
37571	Fee-for-Service	1467484576	1467484576	1	1	ISIDRO, ROMEO L MD INC	1/14/2021	364SP0809X	NA	Other	026	PHYSICIANS	41854	None	None	0	In state provider	ALLIANCE FOR HUMAN GROWT	17075 DEVONSHIRE ST	SUITE 204	NORTHRIDGE	CA	91325	5408	19	06037	34.25755945	-118.50471	Los Angeles County
37624	Fee-for-Service	1013082726	1013082726	1	1	IBARRA, FERNANDO MD INC	9/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	38493	41	Internal Medicine	0	In state provider	None	850 S ATLANTIC BLVD	STE 101	MONTEREY PARK	CA	91754	6700	19	06037	34.05097684	-118.1379979	Los Angeles County
37635	Fee-for-Service	1609292002	1609292002	1	1	ILES, BENJAMIN W DO	1/24/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	17211	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
37663	Fee-for-Service	1952792475	1952792475	2	1	INPATIENT SPECIALISTS OF CAL	1/11/2022	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	IA IV	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
37913	Fee-for-Service	1013082726	1013082726	1	1	IBARRA, FERNANDO MD INC	9/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	38493	08	Family Practice	0	In state provider	None	850 S ATLANTIC BLVD	STE 101	MONTEREY PARK	CA	91754	6700	19	06037	34.05097684	-118.1379979	Los Angeles County
38208	Fee-for-Service	1649217761	1649217761	1	1	INLAND PSYCHIATRIC MEDICAL G	3/3/1993	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC.	1809 W. REDLANDS BLVD	# 234	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
38287	Fee-for-Service	1124356381	1124356381	1	1	INVERGO, DARBI L DO	1/16/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	16828	14	Neurological Surgery	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
38318	Fee-for-Service	1467437848	1467437848	1	1	INLAND HEM ONC MED GRP I	1/1/1979	193400000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	401 E HIGHLAND AVE	STE C	SAN BERNARDINO	CA	92404	3834	36	06071	34.1358627	-117.2757778	San Bernardino County
38413	Fee-for-Service	1063545812	1063545812	1	1	ITOW, SACHI K	1/31/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	700 EAST CALAVERAS BLVD	None	MILPITAS	CA	95035	5439	43	06085	37.43308793	-121.8951311	Santa Clara County
38496	Fee-for-Service	1649217761	1649217761	1	1	INLAND PSYCHIATRIC MEDICAL G	9/24/2019	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	1809 W. REDLANDS BLVD	# 234	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
38562	Fee-for-Service	1811338270	1811338270	1	1	INTERNAL MEDICINE MDS CORP	9/25/2013	207R00000X	NA	Other	026	PHYSICIANS	102426	41	Internal Medicine	0	In state provider	None	3114 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	2217	19	06037	34.02383346	-118.137193	Los Angeles County
38634	Fee-for-Service	1083172951	1083172951	1	1	IBARRA, ROSCIO LMFT	12/30/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4835 VAN NUYS BLVD	1-200	SHERMAN OAKS	CA	91403	2139	19	06037	34.1587068	-118.4487394	Los Angeles County
38688	Fee-for-Service	1689042558	1689042558	1	1	IRBY, MADELEINE P PT	2/9/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1535 RIVER PARK DR	STE 1000	SACRAMENTO	CA	95815	4601	34	06067	38.600334	-121.4361675	Sacramento County
38783	Fee-for-Service	1649217761	1649217761	1	1	INLAND PSYCHIATRIC MEDICAL G	1/14/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC.	1809 W. REDLANDS BLVD	# 234	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
38834	Fee-for-Service	1609526623	1609526623	1	1	INTERVENTIONAL RADIATION ONC	3/12/2024	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	OLOGY OF CALIFORNIA IN	18092 WIKA RD	140	APPLE VALLEY	CA	92307	1434	36	06071	34.54070062	-117.2694542	San Bernardino County
39073	Fee-for-Service	1649217761	1649217761	1	1	INLAND PSYCHIATRIC MEDICAL G	9/24/2019	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	1809 W. REDLANDS BLVD	# 234	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
39250	Fee-for-Service	1548316243	1548316243	1	1	INLAND PSYCHIATRIC MEDICAL G	7/19/2019	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	162 N SANTA FE ST	None	HEMET	CA	92543	4451	33	06065	33.74923371	-116.9629676	Riverside County
39362	Fee-for-Service	1649217761	1649217761	1	1	INLAND PSYCHIATRIC MEDICAL G	6/19/2020	103T00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	1809 W. REDLANDS BLVD	# 234	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
39481	Fee-for-Service	1255943387	1255943387	1	1	INFINITE HOSPICE	7/6/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5121 VAN NUYS BLVD	SUITE 202	SHERMAN OAKS	CA	91403	1496	19	06037	34.163748	-118.448738	Los Angeles County
39541	Fee-for-Service	1548316243	1548316243	1	1	INLAND PSYCHIATRIC MEDICAL G	7/19/2019	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	162 N SANTA FE ST	None	HEMET	CA	92543	4451	33	06065	33.74923371	-116.9629676	Riverside County
39660	Fee-for-Service	1922444306	1922444306	1	1	ISLAM, FARINA MD	11/19/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	155812	None	None	0	In state provider	None	1812 VERDUGO	None	GLENDALE	CA	91208	1407	19	06037	34.20560177	-118.216054	Los Angeles County
39767	Fee-for-Service	1255943387	1255943387	1	1	INFINITE HOSPICE	7/6/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5121 VAN NUYS BLVD	SUITE 202	SHERMAN OAKS	CA	91403	1496	19	06037	34.163748	-118.448738	Los Angeles County
39825	Fee-for-Service	1548316243	1548316243	1	1	INLAND PSYCHIATRIC MEDICAL G	7/19/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC	162 N SANTA FE ST	None	HEMET	CA	92543	4451	33	06065	33.74923371	-116.9629676	Riverside County
39958	Fee-for-Service	1841209541	1841209541	1	1	ISRAELIT, LYNN S MD	11/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	88041	07	Dermatology	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
40033	Fee-for-Service	1013329374	1013329374	1	1	IBRAHIM, KHALDA A MD	4/8/2022	207ZP0102X	NA	Other	026	PHYSICIANS	168642	None	None	0	In state provider	None	10833 LECONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
40078	Fee-for-Service	1922648104	1922648104	1	1	INFINITE HOPE HOSPICE CORP	12/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	225 W HOSPITALITY LANE	SUITE 305	SAN BERNARDINO	CA	92408	3244	36	06071	34.06586109	-117.2884682	San Bernardino County
40115	Fee-for-Service	1548316243	1548316243	1	1	INLAND PSYCHIATRIC MEDICAL G	7/19/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC	162 N SANTA FE ST	None	HEMET	CA	92543	4451	33	06065	33.74923371	-116.9629676	Riverside County
40294	Fee-for-Service	1417674532	1417674532	1	9	IRVINE COTTAGES LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	24172 VIA LUISA	None	MISSION VIEJO	CA	92691	4327	30	06059	33.61171134	-117.6615024	Orange County
40302	Fee-for-Service	1063280329	1063280329	1	1	IZQUIERDO, JESSICA E CNM	5/5/2024	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	20101 LAKE CHABOT RD	1ST FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
40366	Fee-for-Service	1922648104	1922648104	1	1	INFINITE HOPE HOSPICE CORP	12/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	225 W HOSPITALITY LANE	SUITE 305	SAN BERNARDINO	CA	92408	3244	36	06071	34.06586109	-117.2884682	San Bernardino County
40404	Fee-for-Service	1548316243	1548316243	1	1	INLAND PSYCHIATRIC MEDICAL G	7/19/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC	162 N SANTA FE ST	None	HEMET	CA	92543	4451	33	06065	33.74923371	-116.9629676	Riverside County
40604	Fee-for-Service	1699832261	1699832261	1	1	ISOCARE MEDICAL EXTENDER	9/18/1996	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	13527 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5807	19	06037	33.90932725	-118.3528275	Los Angeles County
40709	Fee-for-Service	1316555204	1316555204	1	1	IMMUNOGENOMICS LLC	7/1/2021	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	202 INDUSTRIAL BLVD	STE 501	SUGAR LAND	TX	77478	2702	00	None	29.62916802	-95.6059647	Fort Bend County
40773	Fee-for-Service	1700225968	1700225968	1	1	IGILIGE, VIVIAN C MD	7/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142643	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
40805	Fee-for-Service	1972169589	1972169589	1	1	ISKANDER, BESHOY MD	8/7/2024	207R00000X	NA	Other	026	PHYSICIANS	186091	41	Internal Medicine	0	In state provider	None	1680 E 120 ST	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
40871	Fee-for-Service	1922073014	1922073014	1	1	IRA CHAPMAN	8/30/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	17 MEDICAL PLAZA	None	MOUNTAIN HOME	AR	72653	2918	00	None	36.340821	-92.393019	Baxter County
41071	Fee-for-Service	1346750650	1346750650	1	1	ISLAS, KARLA LCSW	4/24/2025	No Taxonomy Provided	NA	None	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
41278	Fee-for-Service	1588300545	1588300545	1	1	IVI PHARMACY INC.	1/20/2023	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4766 PARK GRANADA	STE 112	CALABASAS	CA	91302	3347	19	06037	34.15398634	-118.6423535	Los Angeles County
41339	Fee-for-Service	1851830426	1851830426	1	2	II, KHAMILA LMFT	2/10/2022	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
41378	Fee-for-Service	1043395999	1043395999	2	1	IMOTO, KEN OD	11/14/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11436 ARTESIA BLVD	STE D	ARTESIA	CA	90701	3859	19	06037	33.87290578	-118.0898206	Los Angeles County
41732	Fee-for-Service	1235233545	1235233545	1	1	IDEMUNDIA-BRYANT, ANN O MD	1/25/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	54911	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
41765	Fee-for-Service	1023044997	1023044997	1	1	IRODENKO, VIKTORIYA S MD	10/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91995	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
41878	Fee-for-Service	1447377858	1447377858	1	1	IDYLLWILD FIRE PROTECTION	1/1/1979	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	54160 MARANATHA DR	None	IDYLLWILD	CA	92549	0656	33	06065	33.74692472	-116.7155019	Riverside County
42053	Fee-for-Service	1316968910	1316968910	1	2	IMAGE GUIDED	12/4/2019	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	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
42358	Fee-for-Service	1114745783	1114745783	1	1	ILAG, AMANDA NP	2/4/2025	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1144 65TH ST STE F	None	OAKLAND	CA	94608	1053	01	06001	37.84779018	-122.2868874	Alameda County
42513	Fee-for-Service	1871778795	1871778795	1	1	IMSDAHL, KIMBERLY A OT	2/8/2008	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	484 ROHNERT PARK EXPRSWY	None	ROHNERT PARK	CA	94928	7931	49	06097	38.34909126	-122.7208272	Sonoma County
42526	Fee-for-Service	1194133041	1194133041	1	1	ITANO, DANIEL K DO	12/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13692	01	General Practice	0	In state provider	None	9089 BASELINE ROAD	STE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
42730	Fee-for-Service	1346917465	1346917465	1	4	IN PAIN PHYSICIANS NETWORK I	3/16/2022	208VP0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	200 W WARDLOW RD	None	LONG BEACH	CA	90807	4429	19	06037	33.81887418	-118.194168	Los Angeles County
42759	Fee-for-Service	1639144496	1639144496	1	1	INSIGHT HEALTH CORP	12/10/2003	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	SAN FERNANDO VALL MRI CR	6855 NOBLE AVE	None	VAN NUYS	CA	91405	3729	19	06037	34.19496251	-118.4618831	Los Angeles County
42816	Fee-for-Service	1124400585	1124400585	1	1	INTEGRITY HOME HEALTH CARE	3/7/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES, INC	20832 ROSCOE BLVD	SUITE 210	CANOGA PARK	CA	91306	2057	19	06037	34.2199047	-118.5878007	Los Angeles County
42939	Fee-for-Service	1881006120	1881006120	1	1	IBRAHIM, AHMAD DO	10/16/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16622	08	Family Practice	0	In state provider	None	24159 MAGIC MOUNTAIN PKW	None	VALENCIA	CA	91355	3904	19	06037	34.41824519	-118.556987	Los Angeles County
43006	Fee-for-Service	1730712753	1730712753	1	1	INNER VISIONS THERAPEUTIC SO	9/17/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LUTIONS, INC.	21561 FLAMENCO	None	MISSION VIEJO	CA	92692	1212	30	06059	33.64939601	-117.6344447	Orange County
43028	Fee-for-Service	1265462436	1265462436	1	1	ITALIAN MAPLE HOLDINGS	6/1/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LA PALOMA HEALTHCARE CTR	3232 THUNDER DR	None	OCEANSIDE	CA	92056	4447	37	06073	33.18705603	-117.288206	San Diego County
43040	Fee-for-Service	MSS00023F	None	1	1	IMPERIAL COUNTY WORK	3/1/1999	No Taxonomy Provided	NA	None	074	MULTIPURPOSE SENIOR SERVICES PROGRAM	-	-	NOT APPLICABLE	0	In state provider	TRAINING CENTER	210 WAKE AVE	None	EL CENTRO	CA	92243	9632	13	06025	32.77120753	-115.5465405	Imperial County
43122	Fee-for-Service	1346700804	1346700804	1	1	IYPE, ASHBY MD	3/18/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	184651	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
43282	Fee-for-Service	1710087887	1710087887	3	1	IMGRX SJ VALLEY, INC	10/8/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY HURON	16928 11TH ST	None	HURON	CA	93234	9997	10	06019	36.20532278	-120.1027083	Fresno County
43288	Fee-for-Service	1841625456	1841625456	1	1	ISBELL, KATHERINE L	7/19/2017	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	11100 COLOMA RD	None	RANCHO CORDOVA	CA	95670	2804	34	06067	38.616606	-121.271949	Sacramento County
43330	Fee-for-Service	1578671145	1578671145	1	1	IWAI, PAUL P MD	12/28/1994	207P00000X	NA	Other	026	PHYSICIANS	80466	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
43400	Fee-for-Service	1427165463	1427165463	1	1	ITO, JAMES I JR MD	11/27/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	30381	77	Infectious Disease	0	In state provider	None	225 DICKINSON ST	RM H207	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
43411	Fee-for-Service	1184892937	1184892937	1	1	INTELLI HEART SERVICES INC	11/5/2015	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	10850 WILSHIRE BLVD	SUITE 740	LOS ANGELES	CA	90024	4325	19	06037	34.05944235	-118.4413505	Los Angeles County
43445	Fee-for-Service	1588612519	1588612519	1	1	IBARRA, JULIO MD	8/31/1990	207ZP0102X	NA	Other	026	PHYSICIANS	40073	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
43720	Fee-for-Service	1942418884	1942418884	1	1	INSTITUTE ON AGING	3/31/2011	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3575B GEARY BLVD	None	SAN FRANCISCO	CA	94118	3212	38	06075	37.78121015	-122.4576229	San Francisco County
43722	Fee-for-Service	1669191672	1669191672	1	1	IMAGE N YOU ULTRASOUND STUDI	9/8/2023	2085U0001X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	O LLC	20700 AVALON BLVD	190	CARSON	CA	90746	3708	19	06037	33.8437375	-118.2632149	Los Angeles County
43745	Fee-for-Service	1063255347	1063255347	1	1	INTERNATIONAL SCHOOL OF	7/1/2024	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	MONTEREY	1720 YOSEMITE STREET	None	SEASIDE	CA	93955	3914	27	06053	36.61232653	-121.8280153	Monterey County
43750	Fee-for-Service	1700930393	1700930393	1	1	ITO, NOBUKO AU	12/21/2023	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 JOSE FIGUERES AVE	SUITE 280	SAN JOSE	CA	95116	1555	43	06085	37.36122014	-121.8505998	Santa Clara County
44260	Fee-for-Service	1023571601	1023571601	1	1	IMAM, AHMAD S MD	5/22/2024	208800000X	NA	Other	026	PHYSICIANS	None	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
44354	Fee-for-Service	1154315539	1154315539	1	1	IMPERATO,JASON MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	330 MT AUBURN ST	None	CAMBRIDGE	MA	02238	0000	00	None	42.373899	-71.1342405	Middlesex County
44417	Fee-for-Service	1891817870	1891817870	1	1	IRONS, SAMUEL A DPM	5/31/1981	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	8615 FLORENCE AVE	STE 107	DOWNEY	CA	90240	4031	19	06037	33.94842385	-118.1189672	Los Angeles County
44545	Fee-for-Service	1023230141	1023230141	1	1	ISSENMAN, FRANCIE S LCSW	4/1/2002	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4067 SEA VIEW AVE	None	LOS ANGELES	CA	90065	3332	19	06037	34.10712518	-118.2154828	Los Angeles County
44623	Fee-for-Service	1043777311	1043777311	1	1	INTELLECTUAL VIRTUES ACADEMY	7/1/2018	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	OF LONG BEACH	1637 LONG BEACH BLVD	None	LONG BEACH	CA	90813	1929	19	06037	33.78812789	-118.1894978	Los Angeles County
44655	Fee-for-Service	1730294117	1730294117	1	1	INFECTIOUS DISEASE ASSOC	3/31/1986	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	MEDICAL GROUP	2100 WEBSTER ST	STE 404	SAN FRANCISCO	CA	94115	2379	38	06075	37.7904826	-122.4324477	San Francisco County
44838	Fee-for-Service	1063443455	1063443455	1	1	INDIANA UNIVERSITY HEALTH WE	8/1/2019	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ST HOSPITAL INC	1111 RONALD REAGAN PKWY	None	AVON	IN	46123	7085	00	None	39.780369	-86.340438	Hendricks County
44911	Fee-for-Service	1831251610	1831251610	1	1	INTERCOMMUNITY FAMILY	12/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL ASSOC INC	12291 WASHINGTON BLVD	STE 500	WHITTIER	CA	90606	2551	19	06037	33.96734104	-118.0508773	Los Angeles County
44940	Fee-for-Service	1902194533	1902194533	1	1	ISCHAYEK, MICHELLE L DO	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13529	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
44943	Fee-for-Service	1699192518	1699192518	1	1	IGNASIA TANONE	7/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	91-2141 FORT WEAVER RD	None	EWA BEACH	HI	96706	1993	00	None	21.3717827	-158.02605	Honolulu County
45127	Fee-for-Service	1063443455	1063443455	1	1	INDIANA UNIVERSITY HEALTH WE	8/1/2019	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ST HOSPITAL INC	1111 RONALD REAGAN PKWY	None	AVON	IN	46123	7085	00	None	39.780369	-86.340438	Hendricks County
45196	Fee-for-Service	1831251610	1831251610	1	1	INTERCOMMUNITY FAMILY	12/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL ASSOC INC	12291 WASHINGTON BLVD	STE 500	WHITTIER	CA	90606	2551	19	06037	33.96734104	-118.0508773	Los Angeles County
45486	Fee-for-Service	1831251610	1831251610	1	1	INTERCOMMUNITY FAMILY	12/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL ASSOC INC	12291 WASHINGTON BLVD	STE 500	WHITTIER	CA	90606	2551	19	06037	33.96734104	-118.0508773	Los Angeles County
45530	Fee-for-Service	1689669962	1689669962	2	1	IYER, RAJINI R MD	9/12/2010	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	41811	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	760 WASHBURN AVE	STE 9	CORONA	CA	92882	3303	33	06065	33.87374678	-117.5678721	Riverside County
45726	Fee-for-Service	1104352608	1104352608	1	1	ISKANDER, MICHAEL MD	5/1/2020	207R00000X	NA	Other	026	PHYSICIANS	164857	None	None	0	In state provider	None	1680 E 120 ST	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
45848	Fee-for-Service	1881158210	1881158210	1	1	INTEGRATED OCULAR PROSTHETIC	3/4/2019	156FX1700X	NA	Other	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	1324 W CENTER AVE	None	VISALIA	CA	93291	5804	54	06107	36.3312	-119.306538	Tulare County
45933	Fee-for-Service	1013259431	1013259431	1	1	INGALSBE, GRAHAM S MD	7/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
46072	Fee-for-Service	1417674532	1417674532	1	6	IRVINE COTTAGES LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	40 CYPRESS TREE LANE	None	IRVINE	CA	92612	2241	30	06059	33.66379018	-117.8178452	Orange County
46107	Fee-for-Service	1760682793	1760682793	1	1	IMPERIAL VALLEY PODIATRY	9/21/2007	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	ASSOCIATES INC	1503 N IMPERIAL AVE	STE 105	EL CENTRO	CA	92243	6302	13	06025	32.806881	-115.5697535	Imperial County
46179	Fee-for-Service	1639253735	1639253735	1	1	ILARDE, ALDO MD	7/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	48803	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
46413	Fee-for-Service	1881621308	1881621308	1	1	IPPOLITI, ANDREW F MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	26251	10	Gastroenterology (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
46417	Fee-for-Service	1003215914	1003215914	1	1	INSTITUTE ON AGING	2/23/2015	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	None	17555 PEAK AVE	SUITE 100	MORGAN HILL	CA	95037	1755	43	06085	37.1250264	-121.6610516	Santa Clara County
46468	Fee-for-Service	1639253735	1639253735	1	1	ILARDE, ALDO MD	7/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	48803	67	Endocrinology	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
46703	Fee-for-Service	1003215914	1003215914	1	1	INSTITUTE ON AGING	2/23/2015	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	17555 PEAK AVE	SUITE 100	MORGAN HILL	CA	95037	1755	43	06085	37.1250264	-121.6610516	Santa Clara County
46755	Fee-for-Service	1972123859	1972123859	1	1	INTENSIVE HOSPICE CARE INC	5/19/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4605 LANKERSHIM BLVD	STE 106	NORTH HOLLYWOOD	CA	91602	1892	19	06037	34.15389329	-118.3679999	Los Angeles County
46795	Fee-for-Service	1134556012	1134556012	1	1	IMPERIAL HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	675 W FOOTHILL BLVD	SUITE 310	CLAREMONT	CA	91711	3475	19	06037	34.1071593	-117.7257676	Los Angeles County
47045	Fee-for-Service	1972123859	1972123859	1	1	INTENSIVE HOSPICE CARE INC	5/19/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4605 LANKERSHIM BLVD	STE 106	NORTH HOLLYWOOD	CA	91602	1892	19	06037	34.15389329	-118.3679999	Los Angeles County
47084	Fee-for-Service	1134556012	1134556012	1	1	IMPERIAL HOSPICE INC	7/17/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	675 W FOOTHILL BLVD	SUITE 310	CLAREMONT	CA	91711	3475	19	06037	34.1071593	-117.7257676	Los Angeles County
47199	Fee-for-Service	1720069644	1720069644	1	1	IRIARTE, JEANNETTE OD	5/1/1995	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	TOTAL VISION OPT CNTR	13867 FOOTHILL BLVD	STE 108	SYLMAR	CA	91342	3034	19	06037	34.31147201	-118.4354523	Los Angeles County
47236	Fee-for-Service	1427195726	1427195726	1	1	INLAND GRACE ADULT DAY	2/5/2004	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE CENTER	10150 INDIANA AVE	None	RIVERSIDE	CA	92503	5302	33	06065	33.90731411	-117.4533745	Riverside County
47308	Fee-for-Service	1699773788	1699773788	1	1	INGRAM, MICHAEL T MD	7/31/1984	208G00000X	NA	General Surgery	026	PHYSICIANS	42531	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5301 F ST	STE 312	SACRAMENTO	CA	95819	3222	34	06067	38.571354	-121.4368695	Sacramento County
47532	Fee-for-Service	1386248318	1386248318	1	1	IN-HOME HEALTH CARE SUPPORT	5/9/2023	253Z00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	AND SERVICES, LLC	19626 VENTURA BLVD	STE 228	TARZANA	CA	91356	6074	19	06037	34.17266732	-118.5610251	Los Angeles County
47569	Fee-for-Service	1104005933	1104005933	1	1	IQBAL, FATEMA L MD	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101633	None	None	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
47594	Fee-for-Service	1699773788	1699773788	1	1	INGRAM, MICHAEL T MD	7/31/1984	208G00000X	NA	General Surgery	026	PHYSICIANS	42531	33	Thoracic Surgery	0	In state provider	None	5301 F ST	STE 312	SACRAMENTO	CA	95819	3222	34	06067	38.571354	-121.4368695	Sacramento County
47780	Fee-for-Service	1255307963	1255307963	1	1	INSIGHT HEALTH CORP	12/3/2003	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	4211 ROSEWOOD DR	STE 5	PLEASANTON	CA	94588	3049	01	06001	37.69819668	-121.8756028	Alameda County
47785	Fee-for-Service	1912038878	1912038878	1	1	INGRAM, LEWIS E RN	9/6/2007	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
47821	Fee-for-Service	1386248318	1386248318	1	1	IN-HOME HEALTH CARE SUPPORT	8/18/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AND SERVICES, LLC	19626 VENTURA BLVD	STE 228	TARZANA	CA	91356	6074	19	06037	34.17266732	-118.5610251	Los Angeles County
48122	Fee-for-Service	1275646606	1275646606	1	1	IDEA, LILITH B MD	11/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	54277	40	Pediatrics	0	In state provider	None	815 DR MARTIN LUTHER KIN	None	BAKERSFIELD	CA	93307	1365	15	06029	35.3655	-118.985202	Kern County
48191	Fee-for-Service	1407252588	1407252588	1	1	INDIAN HEALTH COUNCIL, INC	6/28/2022	332800000X	NA	Indian Health Care Provider	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	110 1/2 SCHOOL HOUSE CAN	None	SANTA YSABEL	CA	92070	0000	37	06073	33.14616255	-116.6540406	San Diego County
48195	Fee-for-Service	1083764724	1083764724	1	1	INDEPENDENT LIVING SYSTEMS L	1/13/2015	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	LC	500 N BRAND BLVD	675	GLENDALE	CA	91203	1965	19	06037	34.153983	-118.254973	Los Angeles County
48667	Fee-for-Service	1578823647	1578823647	1	1	INLAND BEHAVIORAL AND HEALTH	5/23/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1070 E RAMSEY STREET	None	BANNING	CA	92220	5924	33	06065	33.92534349	-116.8644555	Riverside County
48696	Fee-for-Service	1508318411	1508318411	1	1	INTERVENTIONAL SPINE CENTER	8/27/2018	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	24012 CALLE DE LA PLATA	STE 130	LAGUNA HILLS	CA	92653	3621	30	06059	33.61012113	-117.7115908	Orange County
48823	Fee-for-Service	1316022262	1316022262	1	1	IGE, ERIC B OD INC	4/1/2001	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	17523 CRENSHAW BLVD	None	TORRANCE	CA	90504	3403	19	06037	33.871068	-118.326516	Los Angeles County
48950	Fee-for-Service	1578823647	1578823647	1	1	INLAND BEHAVIORAL AND HEALTH	5/23/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1070 E RAMSEY STREET	None	BANNING	CA	92220	5924	33	06065	33.92534349	-116.8644555	Riverside County
49002	Fee-for-Service	1811992738	1811992738	1	1	IZUCHUKWU, IFEOMA S MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80750	41	Internal Medicine	0	In state provider	None	333 N PRAIRIE AVE	None	INGLEWOOD	CA	90301	4501	19	06037	33.9670722	-118.3439911	Los Angeles County
49030	Fee-for-Service	1629261862	1629261862	1	1	INSUA-LOPEZ, VIVIAN B PSYD	10/18/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	15455 SAN FERNANDO MISSO	#300	MISSION HILLS	CA	91345	1353	19	06037	34.27194157	-118.469079	Los Angeles County
49035	Fee-for-Service	1063654408	1063654408	1	1	INWOOD-ROMANO, LAURA C LMFT	5/26/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21 HANOVER LANE	STE A	CHICO	CA	95973	7269	04	06007	39.75974044	-121.8650578	Butte County
49092	Fee-for-Service	1699135251	1699135251	1	1	INTRA CARE HOSPICE, INC	4/3/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3251 W 6TH ST	SUITE 418	LOS ANGELES	CA	90020	5023	19	06037	34.06363872	-118.2931949	Los Angeles County
49236	Fee-for-Service	1578823647	1578823647	1	1	INLAND BEHAVIORAL AND HEALTH	12/1/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1070 E RAMSEY STREET	None	BANNING	CA	92220	5924	33	06065	33.92534349	-116.8644555	Riverside County
49290	Fee-for-Service	1811992738	1811992738	1	1	IZUCHUKWU, IFEOMA S MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80750	40	Pediatrics	0	In state provider	None	333 N PRAIRIE AVE	None	INGLEWOOD	CA	90301	4501	19	06037	33.9670722	-118.3439911	Los Angeles County
49383	Fee-for-Service	1699135251	1699135251	1	1	INTRA CARE HOSPICE, INC	4/3/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3251 W 6TH ST	SUITE 418	LOS ANGELES	CA	90020	5023	19	06037	34.06363872	-118.2931949	Los Angeles County
49387	Fee-for-Service	1417674532	1417674532	1	11	IRVINE COTTAGES LLC	1/26/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	25642 AURORA WAY	None	MISSION VIEJO	CA	92691	4619	30	06059	33.6032207	-117.6827891	Orange County
49466	Fee-for-Service	1861446056	1861446056	1	1	IDNANI, USHA MD	5/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	54509	41	Internal Medicine	0	In state provider	None	34052 LA PLAZA	SUITE 105	DANA POINT	CA	92629	2587	30	06059	33.46815147	-117.6989145	Orange County
49524	Fee-for-Service	1578823647	1578823647	1	1	INLAND BEHAVIORAL AND HEALTH	5/23/2013	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1070 E RAMSEY STREET	None	BANNING	CA	92220	5924	33	06065	33.92534349	-116.8644555	Riverside County
49532	Fee-for-Service	1821140534	1821140534	1	1	ISHIZAKI, JENIFER K K OD	10/3/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
49700	Fee-for-Service	1023230141	1023230141	1	2	ISSENMAN, FRANCIE S LCSW	7/1/2004	104100000X	NA	Mental Health Outpatient Services	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	PASADENA MTU	315 N PASADENA AVE	None	PASADENA	CA	91103	3567	19	06037	34.15118357	-118.1572237	Los Angeles County
49812	Fee-for-Service	1578823647	1578823647	1	1	INLAND BEHAVIORAL AND HEALTH	7/29/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1070 E RAMSEY STREET	None	BANNING	CA	92220	5924	33	06065	33.92534349	-116.8644555	Riverside County
49894	Fee-for-Service	1952468506	1952468506	1	1	I V RADIOLOGY MED GROUP	7/1/1984	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1415 W ROSS RD	None	EL CENTRO	CA	92243	9585	13	06025	32.78188478	-115.6562473	Imperial County
49977	Fee-for-Service	1982041570	1982041570	1	1	IP, WUI MD	7/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135606	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
50049	Fee-for-Service	1366124166	1366124166	1	1	ILO, KEVIN C MD	5/6/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	1225 15TH ST	2100	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
50099	Fee-for-Service	1033731617	1033731617	1	1	IDT HOSPICE CARE INC	3/7/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8363 RESEDA BLVD	STE 209	NORTHRIDGE	CA	91324	4623	19	06037	34.22255941	-118.5361155	Los Angeles County
50304	Fee-for-Service	1477846160	1477846160	1	1	INGRAM, MARK J PSYD	12/10/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2790 SKYPARK DR	210	TORRANCE	CA	90505	5388	19	06037	33.80456075	-118.3357569	Los Angeles County
50342	Fee-for-Service	1164570040	1164570040	1	1	ISAAC, IZABELLA S MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	61473	13	Neurology (M.D. only)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
50388	Fee-for-Service	1033731617	1033731617	1	1	IDT HOSPICE CARE INC	3/7/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8363 RESEDA BLVD	STE 209	NORTHRIDGE	CA	91324	4623	19	06037	34.22255941	-118.5361155	Los Angeles County
50416	Fee-for-Service	1952759664	1952759664	2	1	IMGRX SONOMA, INC.	3/22/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	MACY	19270 SONOMA HWY	A	SONOMA	CA	95476	5414	49	06097	38.29871411	-122.4751509	Sonoma County
50455	Fee-for-Service	1164461372	1164461372	2	1	IMWALLE, DONALD K MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139920	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
50479	Fee-for-Service	1427329671	1427329671	1	1	ILYAS, SHAHID MD	11/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142799	41	Internal Medicine	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
50706	Fee-for-Service	1992189740	1992189740	1	1	IBRAHIMOVA, AZADA	1/16/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	68	Hematology	2	Out of state provider	None	3333 BURNET AVENUE	None	CINCINNATI	OH	45229	3039	00	None	39.14105892	-84.50040782	Hamilton County
50793	Fee-for-Service	1861782674	1861782674	1	1	IQBAL, AFZAAL M MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143130	05	Anesthesiology	0	In state provider	None	16787 BEACH BLVD	STE 276	HUNTINGTON BEACH	CA	92647	4848	30	06059	33.7187932	-117.9892699	Orange County
50993	Fee-for-Service	1992189740	1992189740	1	1	IBRAHIMOVA, AZADA	1/16/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	3333 BURNET AVENUE	None	CINCINNATI	OH	45229	3039	00	None	39.14105892	-84.50040782	Hamilton County
51075	Fee-for-Service	1386838795	1386838795	1	1	IBRAHIM, AALAMGEER K MD	6/1/2018	2084P0804X	NA	Psychiatry	026	PHYSICIANS	121031	36	Psychiatry	0	In state provider	None	17772 BEACH BLVD	None	HUNTINGTON BEACH	CA	92647	6819	30	06059	33.703677	-117.9865035	Orange County
51091	Fee-for-Service	1851738777	1851738777	1	1	ISOLA, MOLLY K MD	4/1/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	175278	None	None	0	In state provider	None	2601 ALAMEDA AVE	412	BURBANK	CA	91505	4800	19	06037	34.15783817	-118.3293969	Los Angeles County
51096	Fee-for-Service	1316599962	1316599962	1	1	INSTACARE HOSPICE INC	9/22/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	18401 BURBANK BLVD	SUITE 228	TARZANA	CA	91356	1840	19	06037	34.17187827	-118.5339035	Los Angeles County
51128	Fee-for-Service	1659599868	1659599868	1	1	IANNUCCILLI, JASON D MD	6/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111724	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
51288	Fee-for-Service	1104057991	1104057991	1	2	INFINITY CARE SERVICES INC	4/27/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1325 N CENTER ST	STE 2B	STOCKTON	CA	95202	1020	39	06077	37.96586618	-121.2947666	San Joaquin County
51326	Fee-for-Service	1700809472	1700809472	1	1	ISMAIL, MOHAMED H MD	12/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87963	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
51375	Fee-for-Service	1649494733	1649494733	1	1	INDIO EMERGENCY MEDICAL GROU	5/12/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	GROUP	1293 6TH ST	None	COACHELLA	CA	92236	1707	33	06065	33.67731363	-116.1789134	Riverside County
51386	Fee-for-Service	1316599962	1316599962	1	1	INSTACARE HOSPICE INC	9/22/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	18401 BURBANK BLVD	SUITE 228	TARZANA	CA	91356	1840	19	06037	34.17187827	-118.5339035	Los Angeles County
51392	Fee-for-Service	1205311537	1205311537	1	1	IBARRA, VERONICA Y	10/25/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	130 N BRAND BLVD	202	GLENDALE	CA	91203	2644	19	06037	34.147521	-118.2549325	Los Angeles County
51485	Fee-for-Service	1407483563	1407483563	1	1	ISLAM, ALIMUL MD	7/5/2023	207P00000X	NA	Other	026	PHYSICIANS	186590	None	None	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
51576	Fee-for-Service	1104057991	1104057991	1	2	INFINITY CARE SERVICES INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1325 N CENTER ST	STE 2B	STOCKTON	CA	95202	1020	39	06077	37.96586618	-121.2947666	San Joaquin County
51830	Fee-for-Service	1447645304	1447645304	1	1	ISLAM, MAJDEE MD	3/16/2021	208800000X	NA	Other	026	PHYSICIANS	170568	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
51856	Fee-for-Service	1073612784	1073612784	1	1	INLAND EAR NOSE AND THROAT	12/9/2011	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL GROUP, INC	1030 E FOOTHILL BLVD	STE 101	UPLAND	CA	91786	4069	36	06071	34.10681154	-117.637768	San Bernardino County
51869	Fee-for-Service	1275592495	1275592495	1	1	INSCO, RICHARD A MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64153	None	None	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
51947	Fee-for-Service	1942216171	1942216171	1	1	IKNADOSSIAN, RAFFI DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	2750 E WASHINGTON BLVD	STE 140	PASADENA	CA	91107	1449	19	06037	34.1680038	-118.0943955	Los Angeles County
51950	Fee-for-Service	1780295832	1780295832	1	1	IBRAHIM, MARIAM H PHD	2/24/2022	103T00000X	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
52032	Fee-for-Service	1407177082	1407177082	1	1	INDRA, ERIN M MD	1/31/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	183219	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
52040	Fee-for-Service	1700812005	1700812005	1	1	IRWIN, CHARLES E JR MD	1/1/1990	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	23139	40	Pediatrics	0	In state provider	U C MED CTR	230 NEW CLINIC BLDG	None	SAN FRANCISCO	CA	94143	0001	38	06075	0	0	None
52105	Fee-for-Service	1952764599	1952764599	1	1	INOCENCIO, MAXINE MD	9/16/2019	207P00000X	NA	Other	026	PHYSICIANS	158147	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
52116	Fee-for-Service	1740207547	1740207547	1	1	IDSTEN, WILFRED G MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	39473	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 GRAND AVE	CALIFORNIA HOSPITAL, ED	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
52238	Fee-for-Service	1649696600	1649696600	1	1	INDEPENDENT ANESTHESIA	3/23/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PROVIDERS OF CALIFORNIA	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
52307	Fee-for-Service	1861835159	1861835159	1	1	INTRIAGO, RACHEL E MD	9/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146788	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
52406	Fee-for-Service	1376830976	1376830976	1	1	IOFFE, EDWARD MD	12/8/2023	208800000X	NA	Other	026	PHYSICIANS	187202	None	None	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
52526	Fee-for-Service	1649696600	1649696600	1	1	INDEPENDENT ANESTHESIA	8/24/2017	193200000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	PROVIDERS OF CALIFORNIA	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
52536	Fee-for-Service	1457389041	1457389041	1	1	IKHISEMOJIE, UAYEMEN A	3/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	67133	05	Anesthesiology	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
52697	Fee-for-Service	1508531377	1508531377	1	1	INTERSTATE MEDICAL SUPPLY IN	2/17/2022	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	C	135 W BALL RD	STE C	ANAHEIM	CA	92805	6023	30	06059	33.81817351	-117.910107	Orange County
52838	Fee-for-Service	1376083329	1376083329	1	1	IVY W. LIN OPTOMETRY, INC.	2/10/2020	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10000 LAKEWOOD BLVD	None	DOWNEY	CA	90240	4020	19	06037	33.94833058	-118.1166411	Los Angeles County
52872	Fee-for-Service	1881762979	1881762979	2	1	IMAGING CENTERS DIRECT LLC	7/10/2012	2085R0202X	NA	Mammography/MRI Provider	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1125 E 17TH ST	STE W125	SANTA ANA	CA	92701	2213	30	06059	33.76004145	-117.854838	Orange County
52951	Fee-for-Service	1417674532	1417674532	1	2	IRVINE COTTAGES LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	16 PORTER	None	IRVINE	CA	92620	2542	30	06059	33.70710637	-117.7687351	Orange County
53022	Fee-for-Service	1104057991	1104057991	1	1	INFINITY CARE SERVICES INC	3/1/2019	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	None	1325 N CENTER ST	SUITE 2A	STOCKTON	CA	95202	1020	39	06077	37.96586618	-121.2947666	San Joaquin County
53187	Fee-for-Service	1568492916	1568492916	1	1	INDIANA UNIVERSITY HEALTH NO	1/1/2018	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	11700 N MERIDIAN ST	None	CARMEL	IN	46032	4656	00	None	39.95919607	-86.15866148	Hamilton County
53237	Fee-for-Service	1417674532	1417674532	1	3	IRVINE COTTAGES LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	17 YORKTOWN	None	IRVINE	CA	92620	2542	30	06059	33.7129826	-117.769961	Orange County
53304	Fee-for-Service	1669942751	1669942751	1	2	INDEPENDENCE HEALTH	5/15/2019	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	19700 HESPERIAN BLVD	None	HAYWARD	CA	94541	4704	01	06001	37.66794557	-122.1184221	Alameda County
53314	Fee-for-Service	1104057991	1104057991	1	1	INFINITY CARE SERVICES INC	8/27/2010	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1325 N CENTER ST	SUITE 2A	STOCKTON	CA	95202	1020	39	06077	37.96586618	-121.2947666	San Joaquin County
53476	Fee-for-Service	1568492916	1568492916	1	1	INDIANA UNIVERSITY HEALTH NO	1/1/2018	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	11700 N MERIDIAN ST	None	CARMEL	IN	46032	4656	00	None	39.95919607	-86.15866148	Hamilton County
53482	Fee-for-Service	1346541380	1346541380	1	1	IMBERTSON, ERICK J MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	125264	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
53539	Fee-for-Service	1932271517	1932271517	1	1	INYO COUNTY HEALTH DEPT	4/1/1977	No Taxonomy Provided	NA	None	048	COUNTY CLINICS NOT ASSOCIATED WITH HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	CLINIC	155 E MARKET	None	INDEPENDENCE	CA	93526	0000	14	06027	36.80290588	-118.1987645	Inyo County
53542	Fee-for-Service	1669588752	1669588752	1	1	IRISH, MICHELLE D LCSW	3/12/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7221 FLORIN MALL DR	STE A	SACRAMENTO	CA	95823	2781	34	06067	38.494863	-121.4337645	Sacramento County
53655	Fee-for-Service	1932470697	1932470697	1	1	ISAZA, NATALIA MD	9/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	117634	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
53771	Fee-for-Service	1346541380	1346541380	1	1	IMBERTSON, ERICK J MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	125264	10	Gastroenterology (M.D. only)	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
53917	Fee-for-Service	1912999764	1912999764	1	1	IMBUS, CHARLES E MD	4/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34642	13	Neurology (M.D. only)	0	In state provider	None	665 W NAOMI AVE	STE 202	ARCADIA	CA	91007	7563	19	06037	34.12419973	-118.0539868	Los Angeles County
54116	Fee-for-Service	1255441697	1255441697	1	1	INIGUEZ, WALDREDO R MD	5/29/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	39388	40	Pediatrics	0	In state provider	None	1505 W 17TH ST	STE 1	SAN BERNARDINO	CA	92411	1202	36	06071	34.13045153	-117.31869	San Bernardino County
54135	Fee-for-Service	1891730677	1891730677	1	1	INLOW, BRIAN L	7/1/1995	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1011 CASS ST	STE 102	MONTEREY	CA	93940	4531	27	06053	36.59201772	-121.8966282	Monterey County
54243	Fee-for-Service	1598706129	1598706129	1	1	IBRAHIM, EMAD N MD	11/5/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	51062	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
54431	Fee-for-Service	1730173212	1730173212	1	1	IMAM, AQIL P MD	5/28/2019	207K00000X	NA	Other	026	PHYSICIANS	46645	01	General Practice	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
54700	Fee-for-Service	1073716874	1073716874	1	1	ISHIMORI, TETSUO MD	8/31/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30114	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2108 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3703	15	06029	35.3734773	-119.0260883	Kern County
54725	Fee-for-Service	1881649853	1881649853	1	1	IDRISS, ALMOATAZBELLAH M, MD	7/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	54167	67	Endocrinology	0	In state provider	None	43112 15TH STREET WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
54740	Fee-for-Service	1790723419	1790723419	1	1	INLAND VALLEY ANESTHESIA	2/28/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	MEDICAL GROUP	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
54777	Fee-for-Service	1922186659	1922186659	1	1	IYENGAR, PHANIRAJ MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	56469	13	Neurology (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
55057	Fee-for-Service	1215181367	1215181367	1	1	IWATA, ERIKO	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
55061	Fee-for-Service	1063087161	1063087161	2	1	IMGRX SJ VALLEY, INC.	1/19/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY FRESNO	2610 TUOLUMNE ST	PHARMACY SUITE	FRESNO	CA	93721	1227	10	06019	36.74244149	-119.7881115	Fresno County
55257	Fee-for-Service	1720430127	1720430127	1	1	IDREES, MUHAMMAD MD	7/22/2020	207R00000X	NA	Other	026	PHYSICIANS	166760	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
55409	Fee-for-Service	1124550108	1124550108	1	1	ISSEH, MAHMOUD MD	12/17/2022	208M00000X	NA	Other	026	PHYSICIANS	178266	None	None	0	In state provider	None	1100 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6978	38	06075	37.78594176	-122.421322	San Francisco County
55493	Fee-for-Service	1346774445	1346774445	1	1	INLAND PSYCHIATRIC MEDICAL G	7/16/2019	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	24432 MUIRLANDS BLVD	SUTIE 131	LAKE FOREST	CA	92630	3939	30	06059	33.62755212	-117.7028876	Orange County
55700	Fee-for-Service	1558374413	1558374413	1	1	IYER, SRIDHAR S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	42804	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
55751	Fee-for-Service	1306880976	1306880976	1	1	IRAVANI, MOHAMAD MD	7/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	71342	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
55783	Fee-for-Service	1346774445	1346774445	1	1	INLAND PSYCHIATRIC MEDICAL G	7/16/2019	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ROUP, INC.	24432 MUIRLANDS BLVD	SUTIE 131	LAKE FOREST	CA	92630	3939	30	06059	33.62755212	-117.7028876	Orange County
55784	Fee-for-Service	1316968910	1316968910	1	3	IMAGE GUIDED	12/6/2024	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	900 HYDE STREET	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
55994	Fee-for-Service	1144435280	1144435280	1	1	IRVANI, SEPIDEH PHD	9/8/2014	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
56059	Fee-for-Service	1205289493	1205289493	1	1	IMPERIAL ENDOVASCULAR PC	9/19/2016	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	133716	30	Radiology	0	In state provider	None	207 W LEGION ROAD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
56069	Fee-for-Service	1346774445	1346774445	1	1	INLAND PSYCHIATRIC MEDICAL G	1/14/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC.	24432 MUIRLANDS BLVD	SUTIE 131	LAKE FOREST	CA	92630	3939	30	06059	33.62755212	-117.7028876	Orange County
56122	Fee-for-Service	1073777579	1073777579	1	1	ITO, HIROKI MD	7/13/2010	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	94993	41	Internal Medicine	0	In state provider	None	4000 PHYSICIANS BLVD	BLDG E STE 101	BAKERSFIELD	CA	93301	1284	15	06029	35.39685986	-119.0093834	Kern County
56123	Fee-for-Service	1831134253	1831134253	1	1	INPATIENT CONSULTANTS OF	10/1/2002	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CALIFORNIA	1783 EL CAMINO REAL	None	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
56363	Fee-for-Service	1720641400	1720641400	1	1	IWAFUCHI, CAITLIN	10/4/2023	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
56571	Fee-for-Service	1215495551	1215495551	1	1	INTUITIVE PSYCHOTHERAPY ASSO	7/14/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CIATES, LCSW PC	6200 CANOGA AVE	210	WOODLAND HILLS	CA	91367	2450	19	06037	34.183458	-118.5973725	Los Angeles County
56580	Fee-for-Service	1669466363	1669466363	1	1	IMPELLIZERI, JOHN MD	10/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10705	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
56587	Fee-for-Service	1417674532	1417674532	1	8	IRVINE COTTAGES LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	24332 SPARTAN ST	None	MISSION VIEJO	CA	92691	3921	30	06059	33.60866109	-117.683794	Orange County
56745	Fee-for-Service	1396363941	1396363941	1	1	INFINITY WELLNESS INSTITUTE	4/12/2021	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	INC	1561 WESTWOOD BLVD	None	LOS ANGELES	CA	90024	5601	19	06037	34.05310201	-118.439906	Los Angeles County
56943	Fee-for-Service	1265500896	1265500896	2	1	ISKANDER, ROSANNA W MD	7/26/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	40133	08	Family Practice	0	In state provider	None	1330 W COVINA BLVD	102	SAN DIMAS	CA	91773	3200	19	06037	34.09894509	-117.8340464	Los Angeles County
57013	Fee-for-Service	1518302785	1518302785	1	1	IKE, KAITLYN R MD	4/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	134653	01	General Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
57266	Fee-for-Service	1457748287	1457748287	1	1	ICHWAN, BRIAN MD	5/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143753	01	General Practice	0	In state provider	None	1441 FLORIDA AVENUE	None	MODESTO	CA	95350	4418	50	06099	37.66508443	-120.9962589	Stanislaus County
57335	Fee-for-Service	1629133079	1629133079	1	1	IOCCA, MICHAEL J DO	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	6072	41	Internal Medicine	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
57391	Fee-for-Service	1427558949	1427558949	1	1	IGBINOSUN, FOLLEY F NP	1/3/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1521 CUMBERLAND CT	None	PERRIS	CA	92571	3723	33	06065	33.8057656	-117.1929842	Riverside County
57592	Fee-for-Service	1851606198	1851606198	1	1	IGBINOSA, IROGUE I MD	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143655	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	365 HAWTHORNE AVE	STE 301	OAKLAND	CA	94609	3113	01	06001	37.82079728	-122.2633226	Alameda County
57662	Fee-for-Service	1740907476	1740907476	1	1	IBRAHIM AKKARI DPM	10/16/2023	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2376 BAILEY ST	None	ORANGE	CA	92867	1809	30	06059	33.82901501	-117.8283348	Orange County
57780	Fee-for-Service	1952534422	1952534422	1	1	IYER, GAUTHAM S NP	6/19/2017	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
57844	Fee-for-Service	1982635637	1982635637	1	1	ID MED A MEDICAL CORP	11/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	23560 CRENSHAW BLVD	STE 101	TORRANCE	CA	90505	5233	19	06037	33.811677	-118.328042	Los Angeles County
58015	Fee-for-Service	1285682278	1285682278	1	1	IBRAHIM, MOHAMED S MD	3/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138023	05	Anesthesiology	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
58034	Fee-for-Service	1679809537	1679809537	1	1	ITKIN, ALAN H MD	1/24/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175532	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
58203	Fee-for-Service	1740856285	1740856285	1	3	IGOR GALAN MD NEUROLOGY AND	11/6/2024	2084P2900X	NA	Neurology	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	N MANAGEMENT	1300 E CYPRESS ST	BLB B	SANTA MARIA	CA	93454	4614	42	06083	34.95102551	-120.4164	Santa Barbara County
58343	Fee-for-Service	1063770824	1063770824	1	1	IVES TALLMAN, CRYSTAL M MD	11/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127520	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
58375	Fee-for-Service	1306852934	1306852934	1	1	IBRAHIM, MAGED F MD	9/12/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	141296	None	None	0	In state provider	None	16465 SIERRA LAKES PKWY	SUITE 275	FONTANA	CA	92336	1242	36	06071	34.13805177	-117.4457839	San Bernardino County
58394	Fee-for-Service	1215035274	1215035274	1	1	ISKAROUS, RAGAA Z MD INC	4/5/2001	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	45155	None	None	0	In state provider	None	11003 LAKEWOOD AVE	STE 201	DOWNEY	CA	90241	3976	19	06037	33.93718704	-118.123351	Los Angeles County
58858	Fee-for-Service	1215125463	1215125463	1	1	INNOVIS HEALTH LLC	11/16/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3000 32ND AVE SOUTH	None	FARGO	ND	58103	6132	00	None	46.831464	-96.827517	Cass County
58914	Fee-for-Service	1386722874	1386722874	1	1	IZQUIERDO, LINDA L MD	9/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	38146	30	Radiology	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
58989	Fee-for-Service	1427047752	1427047752	1	1	IVERSON, ALAN J MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76656	34	Urology and Urological Surgery	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
59144	Fee-for-Service	1215125463	1215125463	1	1	INNOVIS HEALTH LLC	11/16/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3000 32ND AVE SOUTH	None	FARGO	ND	58103	6132	00	None	46.831464	-96.827517	Cass County
59145	Fee-for-Service	1114023249	1114023249	2	1	IWASIUK, GOSTA W MD	7/14/2015	208600000X	NA	General Surgery	026	PHYSICIANS	22839	02	General Surgery	0	In state provider	None	147 N BRENT	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
59185	Fee-for-Service	1962412486	1962412486	1	1	IHC HEALTH SERVCIES	6/1/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ALTA VIEW HOSP	9660 S 1300 E	None	SANDY	UT	84094	3762	00	None	40.57617253	-111.8531739	Salt Lake County
59308	Fee-for-Service	1689364911	1689364911	1	1	IWUANYANWU, JOHN	12/18/2023	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
59396	Fee-for-Service	1831263540	1831263540	1	1	ISRAELSKI, DENNIS MD	1/1/1995	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	55517	41	Internal Medicine	0	In state provider	None	2900 WHIPPLE AVE	STE 115	REDWOOD CITY	CA	94062	2858	41	06081	37.4783072	-122.2551089	San Mateo County
59426	Fee-for-Service	1689832859	1689832859	1	1	ITOH, MEGUMI MD	6/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108888	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
59476	Fee-for-Service	1962412486	1962412486	1	1	IHC HEALTH SERVCIES	6/1/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ALTA VIEW HOSP	9660 S 1300 E	None	SANDY	UT	84094	3762	00	None	40.57617253	-111.8531739	Salt Lake County
59549	Fee-for-Service	1457770463	1457770463	1	1	IZENBERG, JACOB M MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138976	36	Psychiatry	0	In state provider	None	15400 FOOTHILL BLVD	None	SAN LEANDRO	CA	94578	1009	01	06001	37.7069698	-122.1191104	Alameda County
59685	Fee-for-Service	1831263540	1831263540	1	1	ISRAELSKI, DENNIS MD	1/1/1995	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	55517	77	Infectious Disease	0	In state provider	None	2900 WHIPPLE AVE	STE 115	REDWOOD CITY	CA	94062	2858	41	06081	37.4783072	-122.2551089	San Mateo County
59754	Fee-for-Service	1841242948	1841242948	1	1	ISHAAYA, ABRAHAM M MD	12/31/1993	207RP1001X	NA	Pulmonology	026	PHYSICIANS	71854	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	5901 W OLYMPIC BLVD	STE 200	LOS ANGELES	CA	90036	4663	19	06037	34.05764121	-118.3603115	Los Angeles County
59794	Fee-for-Service	1316533417	1316533417	1	1	INLAND PSYCHIATRIC MEDICAL G	3/19/2021	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC.	1656 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1604668	Los Angeles County
59891	Fee-for-Service	1891353363	1891353363	1	1	INGRAM, MADELINE R CCC-SLP	6/12/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
60001	Fee-for-Service	1861467292	1861467292	1	1	ISIDORO-TORRES, MARINOR C MD	3/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	63740	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
60029	Fee-for-Service	1518994581	1518994581	1	1	ISHIZUE, KENNETH K MD	2/8/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	56343	20	Orthopedic Surgery	0	In state provider	None	1330 NATIVIDAD RD	None	SALINAS	CA	93906	3101	27	06053	36.696996	-121.633173	Monterey County
60042	Fee-for-Service	1841242948	1841242948	1	1	ISHAAYA, ABRAHAM M MD	12/31/1993	207RP1001X	NA	Pulmonology	026	PHYSICIANS	71854	41	Internal Medicine	0	In state provider	None	5901 W OLYMPIC BLVD	STE 200	LOS ANGELES	CA	90036	4663	19	06037	34.05764121	-118.3603115	Los Angeles County
60081	Fee-for-Service	1316533417	1316533417	1	1	INLAND PSYCHIATRIC MEDICAL G	3/19/2021	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	1656 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1604668	Los Angeles County
60179	Fee-for-Service	1497957070	1497957070	1	1	IBRAHIM, ALBEER I MD INC	10/1/2014	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	44213	01	General Practice	0	In state provider	None	16260 VENTURA BLVD	STE 330	ENCINO	CA	91436	2203	19	06037	34.15687678	-118.4876342	Los Angeles County
60223	Fee-for-Service	1134507213	1134507213	1	1	INSPIRATION HOME HEALTH CARE	6/27/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14555 HAMLIN ST	SUITE 1B	VAN NUYS	CA	91411	1612	19	06037	34.18872722	-118.4506359	Los Angeles County
60292	Fee-for-Service	1861467292	1861467292	1	1	ISIDORO-TORRES, MARINOR C MD	3/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	63740	08	Family Practice	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
60367	Fee-for-Service	1316533417	1316533417	1	1	INLAND PSYCHIATRIC MEDICAL G	3/19/2021	103T00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	1656 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1604668	Los Angeles County
60375	Fee-for-Service	1205497765	1205497765	1	1	IVORY HOME HEALTHCARE INC	12/9/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2777 PACIFIC AVE	K2	LONG BEACH	CA	90806	2625	19	06037	33.80761478	-118.193744	Los Angeles County
60621	Fee-for-Service	1750631396	1750631396	1	1	ISSA, DANNY MD	10/1/2019	163WG0100X	NA	Other	026	PHYSICIANS	163853	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
60656	Fee-for-Service	1316533417	1316533417	1	1	INLAND PSYCHIATRIC MEDICAL G	3/19/2021	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC.	1656 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1604668	Los Angeles County
60708	Fee-for-Service	1699492116	1699492116	1	1	I & C FAMILY COUNSELING	8/2/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	25460 MEDICAL CENTER DR	203	MURRIETA	CA	92562	5985	33	06065	33.5570278	-117.1862552	Riverside County
60754	Fee-for-Service	1881865996	1881865996	2	1	IRENE LIN	11/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	901 W REX ALLEN DR	None	WILLCOX	AZ	85643	1009	00	None	32.265	-109.8382095	Cochise County
60793	Fee-for-Service	1730365545	1730365545	1	1	ISHIDA, REBECCA K LMFT	9/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8217 BEVERLY BLVD.,	SUITE 25	LOS ANGELES	CA	90048	4535	19	06037	34.07611172	-118.368623	Los Angeles County
60810	Fee-for-Service	1699842575	1699842575	1	1	ISHIMATSU, CAROL MD	3/25/2004	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	46122	40	Pediatrics	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
60915	Fee-for-Service	1750631396	1750631396	1	1	ISSA, DANNY MD	10/1/2019	163WG0100X	NA	Other	026	PHYSICIANS	163853	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
60945	Fee-for-Service	1316533417	1316533417	1	1	INLAND PSYCHIATRIC MEDICAL G	3/19/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC.	1656 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1604668	Los Angeles County
61043	Fee-for-Service	1144273079	1144273079	1	1	IDAHO EMERGENCY PHYSICIANS	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	WEST VALLEY MEDICAL	1717 ARLINGTON AVE	None	CALDWELL	ID	83605	0000	00	None	43.654374	-116.694738	Canyon County
61081	Fee-for-Service	1861498487	1861498487	1	1	ILANA DORIS-RUTH WEST, 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	19636 N 27TH AVE	STE 204	PHOENIX	AZ	85027	4023	00	None	33.664932	-112.117734	Maricopa County
61087	Fee-for-Service	1134768138	1134768138	1	1	INFINITE HEART HOSPICE LLC	3/19/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	500 S CHINOWTH ST	STE 102	VISALIA	CA	93277	1653	54	06107	36.326583	-119.3357205	Tulare County
61124	Fee-for-Service	1497833222	1497833222	1	1	ISAACSON, JAY ROBERT MD	6/5/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79333	02	General Surgery	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
61233	Fee-for-Service	1316533417	1316533417	1	1	INLAND PSYCHIATRIC MEDICAL G	3/19/2021	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	1656 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1604668	Los Angeles County
61245	Fee-for-Service	1780663609	1780663609	1	1	IRVINE, HENRY A MD	6/14/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	142012	30	Radiology	0	In state provider	None	10101 RIVERSIDE DR	None	TOLUCA LAKE	CA	91602	2517	19	06037	34.15223753	-118.3508865	Los Angeles County
61278	Fee-for-Service	1376847418	1376847418	1	1	IANNACONE, ERIN M MD	7/18/2023	208G00000X	NA	General Surgery	026	PHYSICIANS	114564	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
61281	Fee-for-Service	1326645672	1326645672	1	1	IMPACT HOME HEALTH CARE INC	5/26/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	16430 VENTURA BLVD	202A	ENCINO	CA	91436	2125	19	06037	34.15736278	-118.4911768	Los Angeles County
61374	Fee-for-Service	1134768138	1134768138	1	1	INFINITE HEART HOSPICE LLC	3/19/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	500 S CHINOWTH ST	STE 102	VISALIA	CA	93277	1653	54	06107	36.326583	-119.3357205	Tulare County
62012	Fee-for-Service	1194256347	1194256347	1	1	ITKONEN, MICHELLE R MD	8/2/2021	207L00000X	NA	Other	026	PHYSICIANS	157420	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
62092	Fee-for-Service	1538193826	1538193826	1	1	ITANI, SHAKER H MD	2/8/2015	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	89867	None	None	0	In state provider	None	1447 CEDARWOOD LANE	SUITE A	PLEASANTON	CA	94566	6174	01	06001	37.67102566	-121.8742221	Alameda County
62131	Fee-for-Service	1295892867	1295892867	1	1	ISKANDER, JOHN M MD	8/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	94164	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
62160	Fee-for-Service	1083622567	1083622567	1	3	INLAND EYE SPECIALSTS	4/30/2018	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	31950 HWY 79 SOUTH	STE B7	TEMECULA	CA	92592	9497	33	06065	33.48073126	-117.1004408	Riverside County
62169	Fee-for-Service	1356721641	1356721641	1	1	IRVING, DEVAN DO	10/14/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	18935	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
62592	Fee-for-Service	1942912167	1942912167	1	1	INHALE EXHALE PSYCHOTHERAPY	8/31/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MAS PSYCHOTHERAPY GROUP	310 THIRD AVE	STE C23	CHULA VISTA	CA	91910	3955	37	06073	32.64079747	-117.0798668	San Diego County
62688	Fee-for-Service	1942285879	1942285879	1	2	IQBAL, RASHID MD	1/1/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	43154	10	Gastroenterology (M.D. only)	0	In state provider	None	1261 TRAVIS BLVD	STE 170	FAIRFIELD	CA	94533	4825	48	06095	38.25812361	-122.0495417	Solano County
62715	Fee-for-Service	1396130324	1396130324	1	1	IVERSON, NICHOLAS R MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146324	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
62723	Fee-for-Service	1609827336	1609827336	1	1	ILBEIGI, PEDRAM DO	3/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	8878	34	Urology and Urological Surgery	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5795	36	06071	34.47092468	-117.2977236	San Bernardino County
62735	Fee-for-Service	1831382191	1831382191	1	1	ISKANDER, ELIZABETH S MD	12/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98909	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
62764	Fee-for-Service	1255535134	1255535134	1	1	ISRANI, MANISHA P MD	6/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97157	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
62847	Fee-for-Service	1790718351	1790718351	1	1	IMPERIAL BEACH HEALTH CT	1/2/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	949 PALM AVE	None	IMPERIAL BEACH	CA	91932	1503	37	06073	32.58380109	-117.1133687	San Diego County
62889	Fee-for-Service	1942482104	1942482104	1	1	INLAND BEHAVIORAL AND HEALTH	10/27/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	665 N D ST	STE H	SAN BERNARDINO	CA	92401	1109	36	06071	34.111737	-117.2918735	San Bernardino County
62974	Fee-for-Service	1942285879	1942285879	1	2	IQBAL, RASHID MD	1/1/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	43154	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1261 TRAVIS BLVD	STE 170	FAIRFIELD	CA	94533	4825	48	06095	38.25812361	-122.0495417	Solano County
63052	Fee-for-Service	1255535134	1255535134	1	1	ISRANI, MANISHA P MD	6/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97157	40	Pediatrics	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
63136	Fee-for-Service	1790718351	1790718351	1	1	IMPERIAL BEACH HEALTH CT	6/1/1995	261QC1500X	NA	Other	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	949 PALM AVE	None	IMPERIAL BEACH	CA	91932	1503	37	06073	32.58380109	-117.1133687	San Diego County
63261	Fee-for-Service	1942285879	1942285879	1	2	IQBAL, RASHID MD	1/1/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	43154	41	Internal Medicine	0	In state provider	None	1261 TRAVIS BLVD	STE 170	FAIRFIELD	CA	94533	4825	48	06095	38.25812361	-122.0495417	Solano County
63302	Fee-for-Service	1548957970	1548957970	1	1	INFINITE RESPIRATORY SERVICE	10/13/2023	332BX2000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	S	440 W. FALLBROOK AVE	108	FRESNO	CA	93711	6199	10	06019	36.84938747	-119.7999585	Fresno County
63366	Fee-for-Service	1518697929	1518697929	1	1	ISSA, ANDREW J OT	12/7/2022	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2001 SOLAR DR	STE 150	OXNARD	CA	93036	0680	56	06111	34.22025454	-119.1449192	Ventura County
63423	Fee-for-Service	1790718351	1790718351	1	1	IMPERIAL BEACH HEALTH CT	5/1/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	949 PALM AVE	None	IMPERIAL BEACH	CA	91932	1503	37	06073	32.58380109	-117.1133687	San Diego County
63484	Fee-for-Service	1902887581	1902887581	1	1	INTEGRATIVE RADIA ONCOLO	5/1/2001	193400000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	INTEGRATIVE RADIA ONCOLO	2001 DWIGHT WAY	None	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
63614	Fee-for-Service	1639706039	1639706039	1	1	IBANEZ, SARAH DO	8/23/2024	207P00000X	NA	Other	026	PHYSICIANS	20343	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
63627	Fee-for-Service	1588050074	1588050074	1	1	IACOPETTI, CORINA L MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147812	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
63647	Fee-for-Service	1144663873	1144663873	1	1	INTERIANO, ALEXANDRA NP	10/25/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9675 MONTE VISTA AVE	STE C	MONTCLAIR	CA	91763	2233	36	06071	34.079004	-117.6982135	San Bernardino County
63651	Fee-for-Service	1447397906	1447397906	1	1	IVERSON, WAYNE L MD	8/1/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	30486	41	Internal Medicine	0	In state provider	None	9834 GENESEE AVE	STE 223	LA JOLLA	CA	92037	1215	37	06073	32.884074	-117.225855	San Diego County
63711	Fee-for-Service	1790718351	1790718351	1	1	IMPERIAL BEACH HEALTH CT	5/1/1995	261QC1500X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	949 PALM AVE	None	IMPERIAL BEACH	CA	91932	1503	37	06073	32.58380109	-117.1133687	San Diego County
63770	Fee-for-Service	1902887581	1902887581	1	1	INTEGRATIVE RADIA ONCOLO	5/1/2001	193400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	INTEGRATIVE RADIA ONCOLO	2001 DWIGHT WAY	None	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
63833	Fee-for-Service	1194867473	1194867473	1	1	ISAGHOLIAN, KARO MD INC	4/1/2002	207R00000X	NA	Other	026	PHYSICIANS	73825	41	Internal Medicine	0	In state provider	None	900 N PACIFIC AVE	None	GLENDALE	CA	91203	3644	19	06037	34.15872548	-118.2640471	Los Angeles County
63855	Fee-for-Service	1497999809	1497999809	1	1	ISTRIN, JOSHUA J MD	1/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147763	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
63954	Fee-for-Service	1992112932	1992112932	1	1	IMTIAZ, FATIMA DO	3/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	15390	41	Internal Medicine	0	In state provider	None	1800 N STOCKTON STREET	None	STOCKTON	CA	95204	6019	39	06077	37.96936086	-121.3091262	San Joaquin County
63957	Fee-for-Service	1699258319	1699258319	1	1	IVERS, MARLISSA H CMF	4/15/2020	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	3630 ENTERPRISE STREET	None	SAN DIEGO	CA	92110	3212	37	06073	32.74601586	-117.1985439	San Diego County
64009	Fee-for-Service	1093197550	1093197550	1	1	ISA, EGHOSA DPM	7/5/2018	390200000X	NA	Other	027	PODIATRISTS	-	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
64048	Fee-for-Service	1659765121	1659765121	1	1	ISMAIL, ADNAN MD	6/1/2021	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	155415	None	None	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
64311	Fee-for-Service	1346878105	1346878105	1	1	IGARASHI, RUSSELL DO	5/28/2024	207L00000X	NA	Other	026	PHYSICIANS	21846	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
64444	Fee-for-Service	1528480753	1528480753	1	1	IQBAL SURGICAL ASSOCIATES	12/18/2015	208600000X	NA	General Surgery	026	PHYSICIANS	101690	02	General Surgery	0	In state provider	INC	18225 BROOKHURST STREET	SUITE 5	FOUNTAIN VALLEY	CA	92708	6719	30	06059	33.69890502	-117.9544165	Orange County
64527	Fee-for-Service	1821502139	1821502139	1	1	IQ BUSINESS CONNECTION	7/13/2021	344600000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	898 COMMERCIAL ST	None	SAN JOSE	CA	95112	1410	43	06085	37.36651971	-121.8888046	Santa Clara County
64615	Fee-for-Service	1558820514	1558820514	1	1	INADOMI, MICHAEL J MD	2/28/2023	208800000X	NA	Other	026	PHYSICIANS	179984	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
64674	Fee-for-Service	1427038561	1427038561	1	1	IKEMOTO, NORMAN T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	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
65013	Fee-for-Service	1235104951	1235104951	1	1	INDIK, JULIA H. 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
65120	Fee-for-Service	1346917465	1346917465	1	3	IN PAIN PHYSICIANS NETWORK I	3/16/2022	208VP0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1113 FOOTHILL BLVD	SUITE A	LA CANADA FLINTRI	CA	91011	3207	19	06037	34.20572439	-118.2029328	Los Angeles County
65126	Fee-for-Service	1649540303	1649540303	1	1	INLAND EYE SPECIALISTS	3/22/2012	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	25460 MEDICAL CENTER DR	SUITE 103	MURRIETA	CA	92562	9054	33	06065	33.5570278	-117.1862552	Riverside County
65240	Fee-for-Service	1821300625	1821300625	1	1	IBERRI, DAVID J MD	9/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117947	41	Internal Medicine	0	In state provider	None	300 PASTEUR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
65416	Fee-for-Service	1649540303	1649540303	1	1	INLAND EYE SPECIALISTS	9/14/2022	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	25460 MEDICAL CENTER DR	SUITE 103	MURRIETA	CA	92562	9054	33	06065	33.5570278	-117.1862552	Riverside County
65751	Fee-for-Service	1679886576	1679886576	1	1	ISAACS, DAVID K MD	7/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113129	18	Ophthalmology	0	In state provider	None	100 STEIN PLAZA 1-340	None	LOS ANGELES	CA	90095	0001	19	06037	34.06489065	-118.4443287	Los Angeles County
65765	Fee-for-Service	1487724712	1487724712	1	1	INTERFAITH MEDICAL CENTER	7/27/2011	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1545 ATLANTIC AVE	None	BROOKLYN	NY	11213	1122	00	None	40.678128	-73.9374615	Kings County
65876	Fee-for-Service	1730124520	1730124520	1	1	IKEDA, DANIEL P MD	12/31/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	44382	77	Infectious Disease	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
66006	Fee-for-Service	1376621029	1376621029	1	1	ISHIHARA, KRISTA K MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68165	41	Internal Medicine	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
66165	Fee-for-Service	1730124520	1730124520	1	1	IKEDA, DANIEL P MD	12/31/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	44382	41	Internal Medicine	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
66229	Fee-for-Service	1477585768	1477585768	1	1	IANSMITH, DAVID H. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	80 HUMPHREYS CTR	None	MEMPHIS	TN	38120	2353	00	None	35.12840452	-89.85727502	Shelby County
66282	Fee-for-Service	1477917524	1477917524	1	1	ILANO, LYNETTE E MD	3/12/2020	207R00000X	NA	Other	026	PHYSICIANS	157512	41	Internal Medicine	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
66412	Fee-for-Service	1689271066	1689271066	1	1	INNOVA PHARMACY IV	10/26/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4815 WATT AVE	B101	NORTH HIGHLANDS	CA	95660	5108	34	06067	38.653245	-121.3836075	Sacramento County
66451	Fee-for-Service	1730124520	1730124520	1	1	IKEDA, DANIEL P MD	12/31/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	44382	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
66661	Fee-for-Service	1861625584	1861625584	1	2	IBARRA, NICOLE E LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
66702	Fee-for-Service	1568820306	1568820306	1	1	IQBAL, ASIM P DO	7/1/2018	207P00000X	NA	Other	026	PHYSICIANS	16051	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
66753	Fee-for-Service	1659478600	1659478600	1	2	INLAND VALLEY RETINA MEDICAL	3/15/2017	174400000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	ASSOCIATES, INC.	29798 HAUN RD	SUITE 200	MENIFEE	CA	92586	6541	33	06065	33.68787713	-117.1748638	Riverside County
66850	Fee-for-Service	1912662883	1912662883	1	1	IMPERIAL MANOR SKILLED NURSI	8/9/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CLINIC	290 MAIN STREET	None	BRAWLEY	CA	92227	2351	13	06025	32.97860147	-115.5375855	Imperial County
66905	Fee-for-Service	1306200902	1306200902	1	1	INKELES, MEGAN S MD	8/15/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	168078	07	Dermatology	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
67137	Fee-for-Service	1215009972	1215009972	1	1	IAQUINTA, SALVATORE D MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77491	84	Surgery-Head and Neck	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
67139	Fee-for-Service	1912662883	1912662883	1	1	IMPERIAL MANOR SKILLED NURSI	8/9/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CLINIC	290 MAIN STREET	None	BRAWLEY	CA	92227	2351	13	06025	32.97860147	-115.5375855	Imperial County
67202	Fee-for-Service	1134158868	1134158868	1	1	INTERMED CORPORATION	10/24/1994	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	9660 FLAIR DR	STE 338	EL MONTE	CA	91731	3007	19	06037	34.0720266	-118.0579495	Los Angeles County
67238	Fee-for-Service	1902822778	1902822778	1	1	INGRAM, DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	GLACIER ANESTHESIA	310 SUNNYVIEW LN	None	KALISPELL	MT	59901	3129	00	None	48.214773	-114.3236925	Flathead County
67330	Fee-for-Service	1477873990	1477873990	1	1	INDIO HEALTHCARE & WELLNESS	7/1/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER LLC	82262 VALENCIA STREET	None	INDIO	CA	92201	3120	33	06065	33.72443486	-116.230241	Riverside County
67334	Fee-for-Service	1265942858	1265942858	1	1	IQBAL, NAJAM P CNP	2/18/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
67435	Fee-for-Service	1306176102	1306176102	1	1	IN HOME RESPITE AND CAREGIVE	5/10/2010	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	IN HOME RESPITE & CARE	602 COMMERCE AVENUE	SUITE G	PALMDALE	CA	93551	3882	19	06037	34.58955354	-118.141074	Los Angeles County
67484	Fee-for-Service	1740351790	1740351790	1	1	IHARA, JUN MD	3/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	57155	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
67791	Fee-for-Service	1821238759	1821238759	1	1	INLOW, DEANNA L DPM	1/12/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5 HARRIS COURT	STE T103	MONTEREY	CA	93940	5779	27	06053	36.58051622	-121.8198331	Monterey County
68078	Fee-for-Service	1154687150	1154687150	1	1	ITO, TRACI E MD	8/19/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	174188	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
68097	Fee-for-Service	1275581894	1275581894	1	4	IMPERIAL VALLEY FAMILY	4/12/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CARE MEDICAL GROUP	528 G ST	None	BRAWLEY	CA	92227	2411	13	06025	32.97748458	-115.5329928	Imperial County
68357	Fee-for-Service	1730145186	1730145186	1	1	IBRAHIM, AMIR G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54165	05	Anesthesiology	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
68430	Fee-for-Service	1619900693	1619900693	1	1	INTEGRITY HOME CARE	7/21/2003	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	8954 RESEDA BLVD	SUITE 201	NORTHRIDGE	CA	91324	5017	19	06037	34.233435	-118.5360505	Los Angeles County
68839	Fee-for-Service	1225630486	1225630486	1	1	IMPACT HOSPICE CARE INC	9/12/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	21241 VENTURA BLVD	269	WOODLAND HILLS	CA	91364	2122	19	06037	34.16736368	-118.5947825	Los Angeles County
68944	Fee-for-Service	1851571681	1851571681	1	1	IV, MICHAEL MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	101183	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
68978	Fee-for-Service	1700383684	1700383684	1	1	IHPC HOME HEALTH INC	9/18/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	9017 RESEDA BLVD	STE 215	NORTHRIDGE	CA	91324	6504	19	06037	34.234155	-118.5360975	Los Angeles County
69083	Fee-for-Service	1023153780	1023153780	1	1	ISHAR GROUP HOMES, INC	11/28/2006	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	860 W MAPLE ST	None	ONTARIO	CA	91762	5934	36	06071	34.043256	-117.6655635	San Bernardino County
69108	Fee-for-Service	1689668220	1689668220	1	1	IGNARRO, SHARON W MD	7/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65225	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
69109	Fee-for-Service	1073933180	1073933180	1	1	INSETTA, EMILY R MD	6/24/2020	208M00000X	NA	Other	026	PHYSICIANS	168491	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
69128	Fee-for-Service	1225630486	1225630486	1	1	IMPACT HOSPICE CARE INC	9/12/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	21241 VENTURA BLVD	269	WOODLAND HILLS	CA	91364	2122	19	06037	34.16736368	-118.5947825	Los Angeles County
69213	Fee-for-Service	1396719480	1396719480	1	1	INTERVENTIONAL CARDIOLOGY	4/2/2013	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	23101 SHERMAN PLACE	SUITE 110	WEST HILLS	CA	91307	2002	19	06037	34.20099112	-118.6297991	Los Angeles County
69404	Fee-for-Service	1043048887	1043048887	1	1	INFANT INSTINCTS CONSULTING	1/9/2025	374J00000X	NA	Other	107	DOULA GROUP 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
70004	Fee-for-Service	1861748642	1861748642	1	1	IMAI, AYUMI CNM	5/18/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
70069	Fee-for-Service	1477558120	1477558120	1	1	ISAIANTS, ARAM DPM	4/1/1998	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	CENTRAL FOOT & ANKLE CLN	500 NORTH CENTRAL AVENUE	SUITE 900	GLENDALE	CA	91203	3346	19	06037	34.15321627	-118.2578985	Los Angeles County
70106	Fee-for-Service	1811032261	1811032261	1	1	INGEL, EDWARD	12/5/2008	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	DAVID MEDICAL TRANSPORTA	11830 MOORPARK ST	UNIT C	STUDIO CITY	CA	91604	2134	19	06037	34.1503347	-118.3905039	Los Angeles County
70235	Fee-for-Service	1003856097	1003856097	1	1	IRWIN, DAVID H MD	8/21/1996	207L00000X	NA	Other	026	PHYSICIANS	50717	05	Anesthesiology	0	In state provider	None	2209 WEBSTER ST	None	SAN FRANCISCO	CA	94115	1820	38	06075	37.79112453	-122.4326386	San Francisco County
70267	Fee-for-Service	1033827860	1033827860	1	1	ITALK SPEECH & LANGUAGE THER	7/6/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	APY INC	1633 E 4TH ST	STE 218	SANTA ANA	CA	92701	5163	30	06059	33.7481375	-117.846441	Orange County
70409	Fee-for-Service	1598756686	1598756686	1	1	INGALLS MEMORIAL H0SPITAL	7/3/2003	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	ONE INGALLS DR	None	HARVEY	IL	60426	3558	00	None	41.60623939	-87.65958831	Cook County
70426	Fee-for-Service	1881246635	1881246635	1	1	IZZAT, HEKMAT LCSW	7/26/2024	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
70458	Fee-for-Service	1023087939	1023087939	1	1	IMMERMAN, KATHERINE L MD	9/18/2017	2084P0800X	NA	Psychiatry	026	PHYSICIANS	72710	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
70506	Fee-for-Service	1225582570	1225582570	1	2	IMGRX SLO INC	3/1/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	77 CASA	SUITE 205	SAN LUIS OBISPO	CA	93405	5803	40	06079	35.29306786	-120.6650709	San Luis Obispo County
70697	Fee-for-Service	1598756686	1598756686	1	1	INGALLS MEMORIAL H0SPITAL	7/3/2003	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	ONE INGALLS DR	None	HARVEY	IL	60426	3558	00	None	41.60623939	-87.65958831	Cook County
70809	Fee-for-Service	1467096818	1467096818	1	2	IMMANUEL SOBRIETY INC.	7/15/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	REATMENT PROGRAM	13921 COURAGE ST.	None	MORENO VALLEY	CA	92553	8757	33	06065	33.91845722	-117.2651088	Riverside County
70855	Fee-for-Service	1811137938	1811137938	1	1	IMOOHI, BUCHI S NP	1/24/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3451 W CENTURY BLVD	STE B-3	INGLEWOOD	CA	90303	1218	19	06037	33.948198	-118.3321575	Los Angeles County
70863	Fee-for-Service	1255330403	1255330403	2	1	INTEGRATED CARE SYSTEMS	1/9/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7140 W PERSHING COURT	None	VISALIA	CA	93291	9999	54	06107	36.339669	-119.370834	Tulare County
70914	Fee-for-Service	1083619712	1083619712	1	1	IRAAN GENERAL HOSPITAL DIST	8/31/2021	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	600 HWY 349 NORTH	None	IRAAN	TX	79744	0000	00	None	30.78975522	-101.8426733	Pecos County
70921	Fee-for-Service	1639498579	1639498579	1	1	INTERVENTIONAL SPINE CENTER	8/27/2018	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	2888 LONG BEACH BLVD	STE 210	LONG BEACH	CA	90806	1565	19	06037	33.809706	-118.189343	Los Angeles County
71365	Fee-for-Service	1033226105	1033226105	1	1	ISABEL BASS,S MD	6/27/2011	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
71375	Fee-for-Service	1982279535	1982279535	1	1	IMPERIAL CARE LLC	5/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1700 S IMPERIAL AVE	None	EL CENTRO	CA	92243	4208	13	06025	32.77814282	-115.5696915	Imperial County
71516	Fee-for-Service	1861625584	1861625584	1	1	IBARRA, NICOLE E LMFT	12/2/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	81527	-	NOT APPLICABLE	0	In state provider	None	2015 PIONEER COURT	SUITE B	SAN MATEO	CA	94403	1736	41	06081	37.54712403	-122.3120681	San Mateo County
71799	Fee-for-Service	1629101126	1629101126	1	1	IMLER, DANIEL L MD	3/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93330	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
72033	Fee-for-Service	1790945541	1790945541	1	1	IWASAKI, SUMIE MD	3/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117243	13	Neurology (M.D. only)	0	In state provider	None	2200 O'FARRELL STREET	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
72098	Fee-for-Service	1851561930	1851561930	1	1	INMAN, ANN H OD	2/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3756 SANTA ROSALIA DR	STE 320	LOS ANGELES	CA	90008	3615	19	06037	34.00888336	-118.3389334	Los Angeles County
72629	Fee-for-Service	1750834719	1750834719	1	1	IAATK INC	1/21/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	320 E WALNUT AVE	None	LOMPOC	CA	93436	6835	42	06083	34.6405778	-120.4543983	Santa Barbara County
72682	Fee-for-Service	1588863005	1588863005	1	1	IZQUIERDO, ADRIANA MD	4/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99384	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
72841	Fee-for-Service	1760950588	1760950588	1	1	INTERCARE MEDICAL CLINIC INC	8/8/2019	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	7895 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4043	30	06059	33.75930046	-117.991053	Orange County
73043	Fee-for-Service	1588091169	1588091169	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103TC0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	16279 WALNUT ST	None	HESPERIA	CA	92345	3622	36	06071	34.4213317	-117.3075694	San Bernardino County
73137	Fee-for-Service	1861591752	1861591752	1	1	INTERNATIONAL PEDIATRICS	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67904	40	Pediatrics	0	In state provider	MEDICAL GROUP INC	600 INTERNATIONAL BLVD	STE 102	OAKLAND	CA	94606	2993	01	06001	37.79488125	-122.2528163	Alameda County
73293	Fee-for-Service	1174020655	1174020655	1	1	IVORY, RONDA J LMFT	2/24/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	800 SERENO DR	None	VALLEJO	CA	94589	2411	48	06095	38.12792924	-122.2506587	Solano County
73297	Fee-for-Service	1306897335	1306897335	1	1	IOM HEALTH SYSTEM LP	7/8/2017	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	7950 W JEFFERSON BLVD	None	FORT WAYNE	IN	46804	4140	00	None	41.037687	-85.250502	Allen County
73330	Fee-for-Service	1588091169	1588091169	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC.	16279 WALNUT ST	None	HESPERIA	CA	92345	3622	36	06071	34.4213317	-117.3075694	San Bernardino County
73426	Fee-for-Service	1134837859	1134837859	1	1	ICON NON EMERGENCY MEDICAL T	11/22/2022	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	RANSPORTATION INC	1811 KATELLA AVE	205	ANAHEIM	CA	92804	6664	30	06059	33.80322346	-117.9464535	Orange County
73485	Fee-for-Service	1639154537	1639154537	1	1	IDERA, MICHELE CRNA	11/1/2002	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
73585	Fee-for-Service	1306897335	1306897335	1	1	IOM HEALTH SYSTEM LP	7/8/2017	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	7950 W JEFFERSON BLVD	None	FORT WAYNE	IN	46804	4140	00	None	41.037687	-85.250502	Allen County
73616	Fee-for-Service	1588091169	1588091169	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC.	16279 WALNUT ST	None	HESPERIA	CA	92345	3622	36	06071	34.4213317	-117.3075694	San Bernardino County
73659	Fee-for-Service	1740450923	1740450923	1	1	INLAND HEALTHCARE GROUP AMC	3/9/2010	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1850 N RIVERSIDE AVE	SUITE 180	RIALTO	CA	92376	8071	36	06071	34.132905	-117.3704675	San Bernardino County
73679	Fee-for-Service	1174022941	1174022941	1	1	IQBAL, SAMAR L LMFT	5/25/2023	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
73804	Fee-for-Service	1730422916	1730422916	1	1	IYER, SAPNA P MD	10/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134992	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
73907	Fee-for-Service	1588091169	1588091169	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	16279 WALNUT ST	None	HESPERIA	CA	92345	3622	36	06071	34.4213317	-117.3075694	San Bernardino County
73925	Fee-for-Service	1750498093	1750498093	1	11	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	6386 ALVARADO CT	STE 107	SAN DIEGO	CA	92120	4906	37	06073	32.77666838	-117.0614255	San Diego County
73994	Fee-for-Service	1063078251	1063078251	1	1	INNERPEACE THERAPY	12/31/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14393 PARK AVE	STE 200	VICTORVILLE	CA	92392	3302	36	06071	34.5123	-117.3248825	San Bernardino County
74135	Fee-for-Service	1811055668	1811055668	1	1	IYER, USHA P MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32043	41	Internal Medicine	0	In state provider	None	1211 W LA PALMA AVE	STE 503	ANAHEIM	CA	92801	2812	30	06059	33.84718298	-117.933758	Orange County
74193	Fee-for-Service	1326677857	1326677857	1	1	IMAD ABUMERI, MD INC.	3/1/2020	207T00000X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	SPINE INSTITUTE	2001 F ST	None	BAKERSFIELD	CA	93301	4237	15	06029	35.377398	-119.0235085	Kern County
74195	Fee-for-Service	1588091169	1588091169	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC.	16279 WALNUT ST	None	HESPERIA	CA	92345	3622	36	06071	34.4213317	-117.3075694	San Bernardino County
74406	Fee-for-Service	1801805056	1801805056	1	2	INTEGRATED HEALTHCARE	3/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL GROUP, INC	2850 ARTESIA BLVD	STE 105	REDONDO BEACH	CA	90278	3412	19	06037	33.87277554	-118.357191	Los Angeles County
74456	Fee-for-Service	1881682904	1881682904	1	1	IVATURI,SHYAM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4850 LEMAY FERRY RD	STE 210	SAINT LOUIS	MO	63129	1576	00	None	38.49032388	-90.34700403	St. Louis County
74479	Fee-for-Service	1124411954	1124411954	1	1	IKUTA, PAUL T MD APC	6/18/2015	207L00000X	NA	Other	026	PHYSICIANS	42495	05	Anesthesiology	0	In state provider	None	16453 SOUTH COLORADO AVE	None	PARAMOUNT	CA	90723	5011	19	06037	33.8848803	-118.1614216	Los Angeles County
74572	Fee-for-Service	1659545564	1659545564	1	1	INAMDAR, UTPAL U MD	10/14/2022	207P00000X	NA	Other	026	PHYSICIANS	171022	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
74700	Fee-for-Service	1427755362	1427755362	1	1	INDOCARE LLC	5/26/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	8604 BANFF VISTA DRIVE	None	ELK GROVE	CA	95624	9562	34	06067	38.412729	-121.3871175	Sacramento County
74703	Fee-for-Service	1639348626	1639348626	1	1	ISLAND, EDWINA LMFT	10/24/2024	171M00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	141 PARKER ST	None	VACAVILLE	CA	95688	3921	48	06095	38.35806912	-121.9898561	Solano County
74751	Fee-for-Service	1508262213	1508262213	1	19	INFUSION4HEALTH	7/15/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	11160 S WARNER AVENUE	SUITE 421	FOUNTAIN VALLEY	CA	92708	4056	30	06059	33.71630854	-117.934317	Orange County
74913	Fee-for-Service	1730899667	1730899667	1	1	INLAND PSYCHIATRIC MEDICAL G	3/21/2023	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP INC	1620 S GRAND AVE	None	GLENDORA	CA	91740	5433	19	06037	34.10974369	-117.872489	Los Angeles County
74937	Fee-for-Service	1538125745	1538125745	1	1	IDELSHON, BRADLEY C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	5884	01	General Practice	0	In state provider	None	259 ALTA VISTA WAY	None	LAGUNA BEACH	CA	92651	3972	30	06059	33.522912	-117.763001	Orange County
74938	Fee-for-Service	1760972467	1760972467	1	1	IRIBARREN, FRANCISCO J PSYD	8/30/2018	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
75057	Fee-for-Service	1841673142	1841673142	1	1	IMANZADEH, AMIR MD	6/21/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	172829	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
75196	Fee-for-Service	1134329725	1134329725	1	1	IKHIMIUKOR, EUGENE	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	570 W BROWN RD	None	MESA	AZ	85201	3227	00	None	33.434577	-111.8444355	Maricopa County
75203	Fee-for-Service	1730899667	1730899667	1	1	INLAND PSYCHIATRIC MEDICAL G	3/21/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP INC	1620 S GRAND AVE	None	GLENDORA	CA	91740	5433	19	06037	34.10974369	-117.872489	Los Angeles County
75302	Fee-for-Service	1669621801	1669621801	1	1	IZADIAN, AZAR E MD	7/23/2009	2084N0400X	NA	Neurology	026	PHYSICIANS	88922	36	Psychiatry	0	In state provider	None	1520 SAN PABLO ST	STE 3000	LOS ANGELES	CA	90030	4606	19	06037	34.06269295	-118.2030006	Los Angeles County
75319	Fee-for-Service	1881972586	1881972586	1	1	INATY, HANINE N MD	12/1/2019	207R00000X	NA	Other	026	PHYSICIANS	152832	41	Internal Medicine	0	In state provider	None	2825 J ST	None	SACRAMENTO	CA	95816	4300	34	06067	38.573757	-121.468248	Sacramento County
75391	Fee-for-Service	1780625376	1780625376	1	1	IBRAHIM, DINA MD	10/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	51181	None	None	0	In state provider	None	7887 N CEDAR AVE	None	FRESNO	CA	93720	2685	10	06019	36.850473	-119.756917	Fresno County
75491	Fee-for-Service	1730899667	1730899667	1	1	INLAND PSYCHIATRIC MEDICAL G	3/21/2023	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP INC	1620 S GRAND AVE	None	GLENDORA	CA	91740	5433	19	06037	34.10974369	-117.872489	Los Angeles County
75585	Fee-for-Service	1093087595	1093087595	1	1	IYAMU-SANUSI, TRACEY CNP	8/24/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1350 FLORIN RD	None	SACRAMENTO	CA	95822	4202	34	06067	38.495232	-121.505409	Sacramento County
75587	Fee-for-Service	1669621801	1669621801	1	1	IZADIAN, AZAR E MD	7/23/2009	2084N0400X	NA	Neurology	026	PHYSICIANS	88922	13	Neurology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	STE 3000	LOS ANGELES	CA	90030	4606	19	06037	34.06269295	-118.2030006	Los Angeles County
75628	Fee-for-Service	1508262213	1508262213	1	10	INFUSION4HEALTH	6/16/2023	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	79440 CORPORATE CENTER D	SUITE 101	LA QUINTA	CA	92253	7243	33	06065	33.70937862	-116.2788139	Riverside County
76360	Fee-for-Service	1164756755	1164756755	1	1	INNOVATIVE SUPPLY GROUP, LLC	11/1/2023	332BP3500X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	585 PROSPECT ST	UNIT 304	LAKEWOOD	NJ	08701	5073	00	None	40.07325504	-74.22950708	Ocean County
76477	Fee-for-Service	1053839076	1053839076	1	1	ISLAS, ROXANA E LCSW	12/20/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
76680	Fee-for-Service	1841215803	1841215803	1	1	ISRAEL, RAFI MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72843	18	Ophthalmology	0	In state provider	None	9025 WILSHIRE BLVD	STE 209	BEVERLY HILLS	CA	90211	1825	19	06037	34.06708809	-118.3884174	Los Angeles County
76791	Fee-for-Service	1972633766	1972633766	1	1	INLAND MIDWIFE SERVICES-	1/19/1994	261QA1903X	NA	Other	052	ALTERNATIVE BIRTH CENTERS - SPECIALTY CLINIC	-	-	NOT APPLICABLE	0	In state provider	THE BIRTH CENTER	1200 ARIZONA ST	STE A5	REDLANDS	CA	92374	4538	36	06071	34.06859779	-117.2075976	San Bernardino County
76851	Fee-for-Service	1083616817	1083616817	1	1	IYER, PATTABIRAMAN B MD	8/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34458	08	Family Practice	0	In state provider	LAX	581 4TH AVE	None	GUSTINE	CA	95322	1143	24	06047	37.25582119	-121.0006777	Merced County
77041	Fee-for-Service	1871535286	1871535286	1	2	INTERCOMMUNITY EMERGENCY MED	12/17/2019	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	ICAL GROUP	11500 BROOKSHIRE AVE	None	DOWNEY	CA	90241	4917	19	06037	33.93500365	-118.1321119	Los Angeles County
77115	Fee-for-Service	1508262213	1508262213	1	9	INFUSION4HEALTH	6/28/2023	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	333 UNIVERSITY AVE.	#140	SACRAMENTO	CA	95825	6535	34	06067	38.570976	-121.416651	Sacramento County
77474	Fee-for-Service	1538663588	1538663588	1	1	IHEJIRIKA, JOHN C MD	10/19/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173488	None	None	0	In state provider	None	2651 HIGHLAND	None	SELMA	CA	93662	3392	10	06019	36.57182292	-119.6287694	Fresno County
77718	Fee-for-Service	1316294598	1316294598	3	1	IMGRX SJ VALLEY	10/8/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY EARLIMART	476 E WASHINGTON AVE	None	EARLIMART	CA	93219	0000	54	06107	35.88434376	-119.2716517	Tulare County
77756	Fee-for-Service	1740421973	1740421973	1	1	IZMAILOV, ALEXANDER MD	1/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106955	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
77856	Fee-for-Service	1750469359	1750469359	1	1	IP, KENNETH C MD	12/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60511	18	Ophthalmology	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
78186	Fee-for-Service	1679580880	1679580880	1	1	ISKANDER, MONA Y MD INC	2/28/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	39011	40	Pediatrics	0	In state provider	None	4477 W 118TH ST	STE 301	HAWTHORNE	CA	90250	2257	19	06037	33.92734752	-118.354221	Los Angeles County
78310	Fee-for-Service	1013715721	1013715721	1	1	INHALA LLC	3/10/2025	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	56	06111	0	0	None
78560	Fee-for-Service	1316437395	1316437395	1	1	ISKENDER, SAREL DO	3/8/2022	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
78602	Fee-for-Service	1841592979	1841592979	2	1	INTERIM HEALTHCARE SAN DIEGO	1/15/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	LLC	5625 RUFFIN ROAD	STE 110	SAN DIEGO	CA	92123	6396	37	06073	32.836689	-117.1266525	San Diego County
78614	Fee-for-Service	1245871755	1245871755	1	1	IN HOME CARE HOSPICE INC	1/31/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7415 FOOTHILL BLVD	B	TUJUNGA	CA	91042	2721	19	06037	34.25156599	-118.2935097	Los Angeles County
78694	Fee-for-Service	1194825265	1194825265	3	1	IMGRX SJ VALLEY INC	6/21/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY ORANGE COVE	445 11TH ST	None	ORANGE COVE	CA	93646	2211	10	06019	36.62723052	-119.319103	Fresno County
78700	Fee-for-Service	1588227474	1588227474	1	1	ISLAM, MIMSA	3/6/2023	390200000X	NA	Other	026	PHYSICIANS	183132	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
78822	Fee-for-Service	1548232556	1548232556	1	1	IKEDA, CLYDE J MD	2/8/2015	208200000X	NA	General Surgery	026	PHYSICIANS	49242	24	Plastic Surgery	0	In state provider	None	1199 BUSH ST	STE 640	SAN FRANCISCO	CA	94109	5977	38	06075	37.7891291	-122.4167087	San Francisco County
78890	Fee-for-Service	1841592979	1841592979	2	1	INTERIM HEALTHCARE SAN DIEGO	1/15/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	LLC	5625 RUFFIN ROAD	STE 110	SAN DIEGO	CA	92123	6396	37	06073	32.836689	-117.1266525	San Diego County
78909	Fee-for-Service	1245871755	1245871755	1	1	IN HOME CARE HOSPICE INC	1/31/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7415 FOOTHILL BLVD	B	TUJUNGA	CA	91042	2721	19	06037	34.25156599	-118.2935097	Los Angeles County
79117	Fee-for-Service	1346536919	1346536919	1	1	ISLAS, AMERICA M LMFT	1/29/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4281 KATELLA AVE	SUITE 201	LOS ALAMITOS	CA	90720	3500	30	06059	33.80315853	-118.058328	Orange County
79187	Fee-for-Service	1013913946	1013913946	1	1	INDIO, CITY OF FIRE DEPT	1/1/1984	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	46990 JACKSON ST	None	INDIO	CA	92201	6042	33	06065	33.708051	-116.216391	Riverside County
79429	Fee-for-Service	1508262213	1508262213	1	5	INFUSION4HEALTH	4/12/2023	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	27555 YNEZ RD	SUITE 370	TEMECULA	CA	92591	4678	33	06065	33.50370608	-117.1492569	Riverside County
79511	Fee-for-Service	1972624955	1972624955	1	1	INNOVATIVE MEDICAL SOLUTIONS	1/27/2025	207R00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	INC A MEDICAL GROUP	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	19	06037	34.2214515	-118.4573205	Los Angeles County
79716	Fee-for-Service	1508262213	1508262213	1	5	INFUSION4HEALTH	11/9/2022	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	27555 YNEZ RD	SUITE 370	TEMECULA	CA	92591	4678	33	06065	33.50370608	-117.1492569	Riverside County
79800	Fee-for-Service	1972624955	1972624955	1	1	INNOVATIVE MEDICAL SOLUTIONS	3/22/2023	207R00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	INC A MEDICAL GROUP	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	19	06037	34.2214515	-118.4573205	Los Angeles County
79888	Fee-for-Service	1821041161	1821041161	1	1	ISHIMARU, MARK S MD	7/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	27381	20	Orthopedic Surgery	0	In state provider	None	27800 MEDICAL CENTER RD	STE 126	MISSION VIEJO	CA	92691	6407	30	06059	33.55952733	-117.6645199	Orange County
79923	Fee-for-Service	1871682088	1871682088	1	1	IWACH, ANDREW GEORGE MD	1/1/1989	207W00000X	NA	Ophthalmology	026	PHYSICIANS	56142	18	Ophthalmology	0	In state provider	None	3300 WEBSTER ST	STE 206	OAKLAND	CA	94609	3120	01	06001	37.82132826	-122.2621843	Alameda County
79969	Fee-for-Service	1376986349	1376986349	1	1	IRIZARRY, DRE MD	1/25/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	152899	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
80022	Fee-for-Service	1336531516	1336531516	1	1	INTEGRATIVE CARDIOVASCULAR	10/1/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	42	Nuclear Medicine	0	In state provider	CENTER OF LA JOLLA	9834 GENESSE AVENUE	STE 101	LA JOLLA	CA	92037	1214	37	06073	32.884074	-117.225855	San Diego County
80057	Fee-for-Service	1144208422	1144208422	1	1	IRVINA WILLIAMS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2024 RANDOLPH RD	None	CHARLOTTE	NC	28207	0000	00	None	35.208009	-80.822304	Mecklenburg County
80088	Fee-for-Service	1972624955	1972624955	1	1	INNOVATIVE MEDICAL SOLUTIONS	6/8/2023	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	INC A MEDICAL GROUP	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	19	06037	34.2214515	-118.4573205	Los Angeles County
80289	Fee-for-Service	1104646488	1104646488	1	1	IN YOUR POWER DOULA SERVICES	2/17/2025	374J00000X	NA	Other	107	DOULA GROUP 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
80301	Fee-for-Service	1114384518	1114384518	1	1	ILLUMINATE PLASTIC SURGERY	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	98186	24	Plastic Surgery	0	In state provider	INC	1515 EL CAMINO REAL	SUITE C	PALO ALTO	CA	94306	1000	43	06085	37.4325513	-122.1543492	Santa Clara County
80309	Fee-for-Service	1336531516	1336531516	1	1	INTEGRATIVE CARDIOVASCULAR	10/1/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CENTER OF LA JOLLA	9834 GENESSE AVENUE	STE 101	LA JOLLA	CA	92037	1214	37	06073	32.884074	-117.225855	San Diego County
80375	Fee-for-Service	1972624955	1972624955	1	1	INNOVATIVE MEDICAL SOLUTIONS	1/10/2023	207R00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	INC A MEDICAL GROUP	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	19	06037	34.2214515	-118.4573205	Los Angeles County
80596	Fee-for-Service	1336531516	1336531516	1	1	INTEGRATIVE CARDIOVASCULAR	10/1/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	CENTER OF LA JOLLA	9834 GENESSE AVENUE	STE 101	LA JOLLA	CA	92037	1214	37	06073	32.884074	-117.225855	San Diego County
80603	Fee-for-Service	1215925797	1215925797	1	1	INLAND ARTIFICIAL LIMB	4/10/2006	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	& BRACE INC	680 PARKRIDGE AVE	None	NORCO	CA	92860	3124	33	06065	33.89747604	-117.5675762	Riverside County
80663	Fee-for-Service	1972624955	1972624955	1	1	INNOVATIVE MEDICAL SOLUTIONS	9/1/2001	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INC A MEDICAL GROUP	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	19	06037	34.2214515	-118.4573205	Los Angeles County
80890	Fee-for-Service	1316033087	1316033087	1	1	IMPERIAL CREST HEALTH	10/16/1997	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CARE CENTER	11834 INGLEWOOD AVE	None	HAWTHORNE	CA	90250	2731	19	06037	33.926166	-118.3612935	Los Angeles County
80972	Fee-for-Service	1467096818	1467096818	1	1	IMMANUEL SOBRIETY INC.	7/15/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	REATMENT PROGRAM	23265 PARK VALLEY DR	None	MORENO VALLEY	CA	92553	5963	33	06065	33.937171	-117.2567329	Riverside County
81052	Fee-for-Service	1144233644	1144233644	1	1	IRELAND, RACHEL A MD	10/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84012	40	Pediatrics	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
81060	Fee-for-Service	1184086043	1184086043	1	1	IKEBUDU, ELOKA MD	12/1/2019	207R00000X	NA	Other	026	PHYSICIANS	152383	41	Internal Medicine	0	In state provider	None	1680 E 120 ST	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
81176	Fee-for-Service	1508262213	1508262213	1	17	INFUSION4HEALTH	1/18/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1125 E SPRUCE AVE	SUITE 201	FRESNO	CA	93720	3390	10	06019	36.839817	-119.7616905	Fresno County
81285	Fee-for-Service	1407958234	1407958234	1	1	ISKANDER, RAAFAT S MD	11/4/2003	2084N0400X	NA	Neurology	026	PHYSICIANS	83604	None	None	0	In state provider	GY MEDICAL CLINIC	9025 WILSHIRE BLVD	205	BEVERLY HILLS	CA	90211	1831	19	06037	34.06708809	-118.3884174	Los Angeles County
81298	Fee-for-Service	1184041501	1184041501	1	1	IKOMA, SHOHEI MD	5/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153184	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	RM B186	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
81361	Fee-for-Service	1528021243	1528021243	1	1	IHLER, FREDRICK W LCSW	6/13/1999	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1174 EAST MAIN STREET	SPC 143	EL CAJON	CA	92021	7124	37	06073	32.796882	-116.9423505	San Diego County
81466	Fee-for-Service	1679586093	1679586093	1	1	INESSA SAFRONOVA	7/1/2020	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
81500	Fee-for-Service	1730570763	1730570763	1	1	IMMEDIATE HEALTHCARE CLINIC,	5/14/2020	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC.	11507 OXNARD ST	# 3	NORTH HOLLYWOOD	CA	91606	4809	19	06037	34.17944448	-118.382598	Los Angeles County
81768	Fee-for-Service	1386775211	1386775211	1	1	INYO CO OFFICE OF ED	6/23/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	ALVIN M SASUGA, ADMIN	166 GRANDVIEW DR	None	BISHOP	CA	93514	2984	14	06027	37.36031268	-118.4337689	Inyo County
81786	Fee-for-Service	1730365263	1730365263	1	1	ISHERWOOD, SORREL LCSW	10/16/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
82008	Fee-for-Service	1578515896	1578515896	1	1	IQBAL, MUHAMMAD R MD	10/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94608	41	Internal Medicine	0	In state provider	None	1818 N ORANGE GROVE AVE	STE 204	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
82165	Fee-for-Service	1962478628	1962478628	1	1	INSIGHT HEALTH CORP	11/19/2003	293D00000X	NA	Other	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	INSIGHT IMAGING FULLERTN	301 W BASTANCHURY RD	STE 130	FULLERTON	CA	92835	3423	30	06059	33.89397383	-117.9316737	Orange County
82237	Fee-for-Service	1669799110	1669799110	1	1	ILKHCHOUI, YASHAR	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135166	05	Anesthesiology	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
82391	Fee-for-Service	1750498093	1750498093	1	7	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	2466 1ST AVE	None	SAN DIEGO	CA	92101	1408	37	06073	32.731137	-117.1639695	San Diego County
82428	Fee-for-Service	1962754481	1962754481	1	1	ISEE OPTOMETRY	9/3/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3151 SENTER ROAD	SUITE 130	SAN JOSE	CA	95111	1367	43	06085	37.29305606	-121.8329792	Santa Clara County
82597	Fee-for-Service	1457679656	1457679656	2	1	ICHII, HIROHITO MD	5/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130819	02	General Surgery	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
82651	Fee-for-Service	1538487608	1538487608	1	3	INTERVENTIONAL PAIN SOLUTION	1/26/2024	208VP0014X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	S PC	1158 N COURT ST	None	REDDING	CA	96001	0436	45	06089	40.58710715	-122.3977283	Shasta County
82660	Fee-for-Service	1407990906	1407990906	1	1	ISLAMI-MANUCHEHRY, AMIR M MD	7/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115085	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
82752	Fee-for-Service	1558859546	1558859546	1	1	IKEME, JESSE C MD	7/25/2023	207RN0300X	NA	Nephrology	026	PHYSICIANS	166023	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
82769	Fee-for-Service	1861580771	1861580771	1	1	ISAKARI, MARCIA T MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76167	08	Family Practice	0	In state provider	None	1235 W VINE ST	# 20	LODI	CA	95240	5109	39	06077	38.12279179	-121.2879362	San Joaquin County
82906	Fee-for-Service	1508262213	1508262213	1	14	INFUSION4HEALTH	3/18/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1104 BUCHANAN RD	SUITE B5	ANTIOCH	CA	94509	4205	07	06013	37.99867244	-121.823243	Contra Costa County
83095	Fee-for-Service	1881175685	1881175685	1	1	IRION, AMANDA K NP	4/21/2022	363LA2100X	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
83165	Fee-for-Service	1659415875	1659415875	1	1	IRANY, EVA K MFT	10/24/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	47218	-	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
83195	Fee-for-Service	1700930468	1700930468	1	1	IVANOV, MA P MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	51332	78	Neoplastic Diseases/Oncology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
83227	Fee-for-Service	1083622567	1083622567	1	1	INLAND EYE SPECIALSTS	2/28/1988	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	3953 W STETSON AVE	None	HEMET	CA	92545	9687	33	06065	33.72930152	-117.012681	Riverside County
83228	Fee-for-Service	1932464807	1932464807	1	1	IBARRA, ERIKA P LMFT	9/25/2017	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16661 VENTURA BLVD	SUITE 226A	ENCINO	CA	91436	1914	19	06037	34.15820737	-118.496492	Los Angeles County
83293	Fee-for-Service	1841566767	1841566767	1	1	IWAMOTO, TRACI I MD	10/13/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168201	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
83344	Fee-for-Service	1356038442	1356038442	1	1	IMAGINEECHO LLC	12/10/2024	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	88 EDGEMONT DR	None	DALY CITY	CA	94015	3808	41	06081	37.68129992	-122.4843076	San Mateo County
83488	Fee-for-Service	1700930468	1700930468	1	1	IVANOV, MA P MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	51332	68	Hematology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
83514	Fee-for-Service	1083622567	1083622567	1	1	INLAND EYE SPECIALSTS	6/3/2011	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	3953 W STETSON AVE	None	HEMET	CA	92545	9687	33	06065	33.72930152	-117.012681	Riverside County
83654	Fee-for-Service	1376164152	1376164152	1	1	INGCO, MARIE ALEXIS NP	11/4/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
83769	Fee-for-Service	1700930468	1700930468	1	1	IVANOV, MA P MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	51332	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
83892	Fee-for-Service	1619077724	1619077724	1	1	IRVINE PATHOLOGY MEDICAL	6/22/1992	193400000X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	GROUP, INC	15375 BARRANCA PKWY	STE H-105	IRVINE	CA	92618	2209	30	06059	33.66174175	-117.7431116	Orange County
84155	Fee-for-Service	1508262213	1508262213	1	13	INFUSION4HEALTH	8/24/2023	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	24355 LYONS AVE	STE 211	SANTA CLARITA	CA	91321	2382	19	06037	34.37868281	-118.5605291	Los Angeles County
84332	Fee-for-Service	1316137169	1316137169	1	1	IQBAL,ZAFFAR MD	4/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3636 STOCKTON HILL ROAD	STE 1	KINGMAN	AZ	86409	0514	00	None	35.229123	-114.035958	Mohave County
84355	Fee-for-Service	1255759304	1255759304	1	1	IRMITER, KRISTIN MD	10/30/2017	390200000X	NA	Other	026	PHYSICIANS	149955	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	SUITE 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
84440	Fee-for-Service	1386677326	1386677326	1	1	INLAND EYE SPECIALISTS	4/10/1992	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORP	3953 W STETSON AVE	None	HEMET	CA	92545	9687	33	06065	33.72930152	-117.012681	Riverside County
84447	Fee-for-Service	1770701708	1770701708	1	1	IFEKWUNIGWE, CHRISTOPHER LC	7/2/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
84500	Fee-for-Service	1538279013	1538279013	1	1	ILIC, SERGIO MD	9/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	31668	20	Orthopedic Surgery	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
84572	Fee-for-Service	1992281489	1992281489	1	1	IBRAHIM, MADONNA CPO	8/28/2018	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	7910 FROST ST	SUITE 320	SAN DIEGO	CA	92123	2791	37	06073	32.80027449	-117.153846	San Diego County
84787	Fee-for-Service	1538279013	1538279013	1	1	ILIC, SERGIO MD	9/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	31668	66	Emergency Medicine (Urgent Care)	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
84806	Fee-for-Service	1255769832	1255769832	1	1	IBEAWUCHI, MARTIN E CRNA	8/22/2017	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
85002	Fee-for-Service	1407893894	1407893894	1	2	INGUI, CHRISTIAN J MD	4/13/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	55295	30	Radiology	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
85073	Fee-for-Service	1366606337	1366606337	1	1	IBE, CHIMKAMA MD	3/6/2024	No Taxonomy Provided	NA	None	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
85074	Fee-for-Service	1508262213	1508262213	1	12	INFUSION4HEALTH	8/18/2023	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	8881 FLETCHER PKWY	SUITE 385	LA MESA	CA	91942	6106	37	06073	32.78442148	-117.0073814	San Diego County
85173	Fee-for-Service	1437308673	1437308673	1	1	INDEPENDENT LIVING RESOU	6/27/2007	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1850 GATEWAY BLVD	# 120	CONCORD	CA	94520	3293	07	06013	37.97145047	-122.042286	Contra Costa County
85181	Fee-for-Service	1366787475	1366787475	1	1	INTERNAL MEDICINE CARDIOLOGY	4/2/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	38710	06	Cardiovascular Disease (M.D. only)	0	In state provider	MEDICAL CLINIC INC	6335 N FRESNO ST	STE 101	FRESNO	CA	93710	5272	10	06019	36.82910762	-119.7814105	Fresno County
85352	Fee-for-Service	1508262213	1508262213	1	7	INFUSION4HEALTH	5/10/2023	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2720 N HARBOR BLVD.	#200	FULLERTON	CA	92835	2626	30	06059	33.90126238	-117.9292154	Orange County
85472	Fee-for-Service	1366787475	1366787475	1	1	INTERNAL MEDICINE CARDIOLOGY	4/2/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	38710	41	Internal Medicine	0	In state provider	MEDICAL CLINIC INC	6335 N FRESNO ST	STE 101	FRESNO	CA	93710	5272	10	06019	36.82910762	-119.7814105	Fresno County
85481	Fee-for-Service	1508262213	1508262213	1	25	INFUSION4HEALTH	3/7/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	625 W CITRACADO PARKWAY	SUITE 204	ESCONDIDO	CA	92025	6428	37	06073	33.09166731	-117.0784699	San Diego County
85632	Fee-for-Service	1508262213	1508262213	1	15	INFUSION4HEALTH	1/15/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1981 N BROADWAY	SUITE 190	WALNUT CREEK	CA	94596	3671	07	06013	37.90582392	-122.0613697	Contra Costa County
86787	Fee-for-Service	1043233976	1043233976	1	2	ISSA, JOHN G MD	12/13/2016	208M00000X	NA	Other	026	PHYSICIANS	48968	41	Internal Medicine	0	In state provider	None	1050 LINDEN AVENUE	None	LONG BEACH	CA	90813	3321	19	06037	33.78003775	-118.1866604	Los Angeles County
86890	Fee-for-Service	1033670138	1033670138	1	1	ISHIBASHI, OLIVIA T MD MPH	5/17/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178419	None	None	0	In state provider	None	1920 COLORADO AVENUE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
86912	Fee-for-Service	1700583440	1700583440	1	1	INSPIRE MEDICAL GROUP OF CAL	6/29/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	IFORNIA PC	333 W EL CAMINO REAL	STE 230	SUNNYVALE	CA	94087	1969	43	06085	37.36899556	-122.0358929	Santa Clara County
86950	Fee-for-Service	1215122569	1215122569	1	1	ISKANDER, MARIAN S MD MPH	5/9/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	116127	40	Pediatrics	0	In state provider	None	4477 W 118TH ST	SUITE 301	HAWTHORNE	CA	90250	2258	19	06037	33.92734752	-118.354221	Los Angeles County
87031	Fee-for-Service	1043474596	1043474596	1	1	IMMERMAN, IGOR MD	2/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119472	20	Orthopedic Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
87200	Fee-for-Service	1700583440	1700583440	1	1	INSPIRE MEDICAL GROUP OF CAL	6/29/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	IFORNIA PC	333 W EL CAMINO REAL	STE 230	SUNNYVALE	CA	94087	1969	43	06085	37.36899556	-122.0358929	Santa Clara County
87490	Fee-for-Service	1700583440	1700583440	1	1	INSPIRE MEDICAL GROUP OF CAL	6/29/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	IFORNIA PC	333 W EL CAMINO REAL	STE 230	SUNNYVALE	CA	94087	1969	43	06085	37.36899556	-122.0358929	Santa Clara County
87519	Fee-for-Service	1356309728	1356309728	1	1	IVERSON, DONALD MD	10/31/1988	2084N0400X	NA	Neurology	026	PHYSICIANS	60800	13	Neurology (M.D. only)	0	In state provider	None	2828 ONEIL LN	None	EUREKA	CA	95503	4870	12	06023	40.782087	-124.1350885	Humboldt County
87593	Fee-for-Service	1437362498	1437362498	1	1	ISHIOKA, KEIVN M MD	6/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	93286	30	Radiology	0	In state provider	None	330 LEWIS ST	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
87704	Fee-for-Service	1962755967	1962755967	1	1	INLAND VALLEY CARDIOVASCULAR	6/24/2013	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	CENTER GP	39755 MURRIETA HOT SPRIN	# E-130	MURRIETA	CA	92563	9116	33	06065	33.55575954	-117.1627899	Riverside County
87778	Fee-for-Service	1700583440	1700583440	1	1	INSPIRE MEDICAL GROUP OF CAL	6/29/2023	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	IFORNIA PC	333 W EL CAMINO REAL	STE 230	SUNNYVALE	CA	94087	1969	43	06085	37.36899556	-122.0358929	Santa Clara County
88178	Fee-for-Service	1154540169	1154540169	1	1	INSIGHT OPTOMETRY INC	4/29/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	WANG, AMY OD	9710 LOWER AZUSA ROAD	None	EL MONTE	CA	91731	1024	19	06037	34.089752	-118.0548976	Los Angeles County
88235	Fee-for-Service	1497274617	1497274617	1	1	IM, YOUNG V OT	9/24/2018	225X00000X	NA	Other	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
88306	Fee-for-Service	1548379514	1548379514	1	1	INYANG AKAIFFIOK C	10/30/2002	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	FRIENDLY MEDICAL SUPPLY	2130 HUNTINGTON DR	STE 313	SOUTH PASADENA	CA	91030	4980	19	06037	34.10622227	-118.1358873	Los Angeles County
88623	Fee-for-Service	1750768933	1750768933	1	1	INNERARITY, SKYE K LMFT	5/30/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27595	-	NOT APPLICABLE	0	In state provider	None	500B JEFFERSON BLVD	STE 195	WEST SACRAMENTO	CA	95605	2349	57	06113	38.58811316	-121.5270471	Yolo County
88944	Fee-for-Service	1285159483	1285159483	1	1	INFINITE CARE HOME HEALTH	11/19/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	5301 LAUREL CANYON BLVD	STE 112	VALLEY VILLAGE	CA	91607	2772	19	06037	34.166907	-118.396546	Los Angeles County
88966	Fee-for-Service	1487953030	1487953030	1	1	IZQUIERDO, ROSA M LMFT	4/23/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	26060 ACERO	119	MISSION VIEJO	CA	92691	2768	30	06059	33.61891985	-117.6760873	Orange County
88993	Fee-for-Service	1144636325	1144636325	1	1	ISLAM, TANZEEM MD	2/11/2019	207L00000X	NA	Other	026	PHYSICIANS	154040	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
89055	Fee-for-Service	1780078246	1780078246	1	1	IBARRA, ALEJANDRO MD	9/5/2019	207L00000X	NA	Other	026	PHYSICIANS	161854	05	Anesthesiology	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
89079	Fee-for-Service	1285381756	1285381756	1	1	INLAND EMPIRE MULTISPECIALTY	6/22/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	6926 BROCKTON AVE	SUITE 4	RIVERSIDE	CA	92506	3804	33	06065	33.947919	-117.3967225	Riverside County
89166	Fee-for-Service	1992032072	1992032072	1	1	IMAYANAGITA, WESLEY LCSW	5/14/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	26151 MARGUERITE PKWY	None	MISSION VIEJO	CA	92692	5278	30	06059	33.58277993	-117.6587263	Orange County
89237	Fee-for-Service	1659502433	1659502433	1	1	IVAN DAVID ONGOM MD	2/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	30 E APPLE ST	STE NW3300	DAYTON	OH	45409	2939	00	None	39.7465384	-84.18635983	Montgomery County
89287	Fee-for-Service	1659478600	1659478600	1	1	INLAND VALLEY RETINA MEDICAL	7/1/2001	193400000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	ASSOCIATES, INC.	1810 FULLERTON AVE	STE 206	CORONA	CA	92881	3110	33	06065	33.85971	-117.5503495	Riverside County
89507	Fee-for-Service	1912956855	1912956855	1	1	IM, TAE-WOONG MD	4/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72383	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
89803	Fee-for-Service	1841348646	1841348646	1	1	INNOCEZI, DULCE I MD	9/28/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76655	08	Family Practice	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
89852	Fee-for-Service	1023344991	1023344991	1	1	ILLINGWORTH, MICHAEL L MD	3/8/2011	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	68327	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	681 MEDICAL CENTER DR W	STE 101	CLOVIS	CA	93611	6803	10	06019	36.840375	-119.6624845	Fresno County
89964	Fee-for-Service	1063508711	1063508711	1	1	IANDIORIO, MICHELLE 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	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
90035	Fee-for-Service	1487090015	1487090015	1	1	INZUNZA VELAZQUEZ, PABLO MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137326	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
90140	Fee-for-Service	1821041070	1821041070	1	1	INPATIENT CONSULTANTS OF	5/18/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	1	Border provider	NEVADA INC AMC	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
90349	Fee-for-Service	1275581894	1275581894	1	3	IMPERIAL VALLEY FAMILY	9/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CARE MEDICAL GROUP	125 S 5TH ST	None	BRAWLEY	CA	92227	2402	13	06025	32.97758931	-115.5337892	Imperial County
90429	Fee-for-Service	1821041070	1821041070	1	1	INPATIENT CONSULTANTS OF	5/18/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	1	Border provider	NEVADA INC AMC	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
90714	Fee-for-Service	1821041070	1821041070	1	1	INPATIENT CONSULTANTS OF	5/18/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	1	Border provider	NEVADA INC AMC	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
90735	Fee-for-Service	1457445447	1457445447	1	1	IMAGAWA, KAREN MD	7/1/1996	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	50547	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
90880	Fee-for-Service	1083792758	1083792758	1	1	IQBAL, SHAHNAZ MD	5/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81315	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
91015	Fee-for-Service	1710481858	1710481858	1	1	IMANSJAH, AUDREYANDRA L DO	6/10/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17597	None	None	0	In state provider	None	2300 CAMINO RAMON	None	SAN RAMON	CA	94583	1354	07	06013	37.77580025	-121.9664884	Contra Costa County
91024	Fee-for-Service	1457445447	1457445447	1	1	IMAGAWA, KAREN MD	7/1/1996	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	50547	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
91464	Fee-for-Service	1659478600	1659478600	1	3	INLAND VALLEY RETINA MEDICAL	6/28/2017	174400000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	ASSOCIATES, INC.	41900 WINCHESTER RD	SUITE 201	TEMECULA	CA	92590	3403	33	06065	33.51467986	-117.1703489	Riverside County
91667	Fee-for-Service	1780322271	1780322271	1	1	IP, KURTIS PT	7/19/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
91669	Fee-for-Service	1952934341	1952934341	1	1	INVERARY, COLLIN A CRNA	1/26/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
91694	Fee-for-Service	1467096818	1467096818	1	3	IMMANUEL SOBRIETY INC.	7/15/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	REATMENT PROGRAM	13941 COURAGE STREET	None	MORENO VALLEY	CA	92553	8757	33	06065	33.91845722	-117.2651088	Riverside County
91822	Fee-for-Service	1720211691	1720211691	1	1	ISMAIL, ASHRAF MD	6/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109030	36	Psychiatry	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
91830	Fee-for-Service	1194749580	1194749580	1	1	IHC HOSPITALS, INC.	12/15/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MCKAY-DEE HOSPITAL CTR	4401 HARRISON BLVD	None	OGDEN	UT	84403	3195	00	None	41.18328	-111.9536955	Weber County
91833	Fee-for-Service	1609330299	1609330299	2	1	INTERIANO, ORLANDO E LMFT	6/14/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	423 S. OGDEN DR	None	LOS ANGELES	CA	90062	1202	19	06037	34.067457	-118.360488	Los Angeles County
91900	Fee-for-Service	1306282173	1306282173	1	1	ISAKSON, BENJAMIN S MD	10/2/2020	207P00000X	NA	Other	026	PHYSICIANS	132908	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
91912	Fee-for-Service	1508262213	1508262213	1	16	INFUSION4HEALTH	3/13/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	8339 BRIMHALL RD	SUITE 1301	BAKERSFIELD	CA	93312	4086	15	06029	35.363979	-119.095938	Kern County
91914	Fee-for-Service	1093295248	1093295248	1	1	IZAR HOME HEALTH	3/20/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	18325 SHERMAN WAY	STE B	RESEDA	CA	91335	0708	19	06037	34.20120646	-118.532682	Los Angeles County
91970	Fee-for-Service	1285895045	1285895045	1	1	IVANOV, ALEXANDER MD	10/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151118	14	Neurological Surgery	0	In state provider	None	2800 L ST	STE 300	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
91986	Fee-for-Service	1750498093	1750498093	1	10	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	7625 MESA COLLEGE DR	STE 103	SAN DIEGO	CA	92111	5343	37	06073	32.80089797	-117.1572727	San Diego County
91997	Fee-for-Service	1508262213	1508262213	1	3	INFUSION4HEALTH	4/12/2023	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	501 N CENTRAL AVE	None	GLENDALE	CA	91203	1901	19	06037	34.15290711	-118.257946	Los Angeles County
92121	Fee-for-Service	1194749580	1194749580	1	1	IHC HOSPITALS, INC.	12/15/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MCKAY-DEE HOSPITAL CTR	4401 HARRISON BLVD	None	OGDEN	UT	84403	3195	00	None	41.18328	-111.9536955	Weber County
92284	Fee-for-Service	1508262213	1508262213	1	3	INFUSION4HEALTH	11/3/2022	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	501 N CENTRAL AVE	None	GLENDALE	CA	91203	1901	19	06037	34.15290711	-118.257946	Los Angeles County
92303	Fee-for-Service	1508262213	1508262213	1	8	INFUSION4HEALTH	6/20/2023	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	24012 CALLE DE LA PLATA	SUITE 230	LAGUNA HILLS	CA	92653	7623	30	06059	33.61012113	-117.7115908	Orange County
92344	Fee-for-Service	1932735552	1932735552	1	1	INOSTROZA, BRITTANY CRNA	10/27/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
92374	Fee-for-Service	1265965834	1265965834	1	1	IQBAL, ZARAH U MD	4/10/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	160012	40	Pediatrics	0	In state provider	None	1001 POTRERO AVE	6E/6D37	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
92444	Fee-for-Service	1912014358	1912014358	1	1	IHC HEALTH SERVICES INC	4/6/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	AMERICAN FORK HOSPITAL	170 N 1100 E	None	AMERICAN FORK	UT	84003	2096	00	None	40.38039	-111.769053	Utah County
92586	Fee-for-Service	1336321850	1336321850	1	1	IMAMURA, SUSAN H MD	12/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105062	36	Psychiatry	0	In state provider	None	5755 COTTLE ROAD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
92731	Fee-for-Service	1912014358	1912014358	1	1	IHC HEALTH SERVICES INC	4/6/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	AMERICAN FORK HOSPITAL	170 N 1100 E	None	AMERICAN FORK	UT	84003	2096	00	None	40.38039	-111.769053	Utah County
92883	Fee-for-Service	1508262213	1508262213	1	22	INFUSION4HEALTH	11/8/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7301 MEDICAL CENTER DRIV	SUITE 300	WEST HILLS	CA	91307	1973	19	06037	34.20285756	-118.6294575	Los Angeles County
93048	Fee-for-Service	1073514808	1073514808	1	1	ISOLA, MOPELOLA MD	9/19/2024	208M00000X	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
93168	Fee-for-Service	1508262213	1508262213	1	20	INFUSION4HEALTH	7/15/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9033 WILSHIRE BOULEVARD	SUITE 401	BEVERLY HILLS	CA	90211	1847	19	06037	34.06707946	-118.388943	Los Angeles County
93332	Fee-for-Service	1841266459	1841266459	1	1	INSIGHT HEALTH CORP	11/13/2003	293D00000X	NA	Other	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	VALLEY OPEN MRI	4911 VAN NUYS BLVD	STE 108	SHERMAN OAKS	CA	91403	1716	19	06037	34.1596563	-118.4487403	Los Angeles County
93368	Fee-for-Service	1508262213	1508262213	1	4	INFUSION4HEALTH	11/10/2022	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4520 EXECUTIVE DRIVE	#227	SAN DIEGO	CA	92121	3020	37	06073	32.87608747	-117.2097763	San Diego County
93393	Fee-for-Service	1275087652	1275087652	1	1	ISRAEL, JOYCE	9/22/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 N PEPPER AVE	2ND FL	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
93443	Fee-for-Service	1841334364	1841334364	1	1	INDEPENDENT ANESTHESIOLO	7/13/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
93458	Fee-for-Service	1063841526	1063841526	1	1	IRONS, ANDRIE LMFT	1/7/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	480B TESCONI CIR	None	SANTA ROSA	CA	95401	4691	49	06097	38.44950583	-122.7351601	Sonoma County
93567	Fee-for-Service	1154438596	1154438596	1	1	IHC HEALTH SERVICES INC	10/10/2008	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FILLMORE COMM MED CTR	674 S HIGHWAY 99	None	FILLMORE	UT	84631	5013	00	None	38.95406565	-112.3396449	Millard County
93587	Fee-for-Service	1134228943	1134228943	1	1	IBRAHIM, AMAL S MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	53803	40	Pediatrics	0	In state provider	None	31762 MISSION TRL	None	LAKE ELSINORE	CA	92530	4545	33	06065	33.65782233	-117.2986219	Riverside County
93657	Fee-for-Service	1508262213	1508262213	1	4	INFUSION4HEALTH	4/12/2023	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4520 EXECUTIVE DRIVE	#227	SAN DIEGO	CA	92121	3020	37	06073	32.87608747	-117.2097763	San Diego County
93722	Fee-for-Service	1669448270	1669448270	1	1	INSIGHT HEALTH CORP	4/9/2004	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	WESTLAKE DIAG CENTER	2535 TOWNSGATE RD	STE 110	WESTLAKE VILLAGE	CA	91361	5971	56	06111	34.15873583	-118.8307969	Ventura County
93860	Fee-for-Service	1154438596	1154438596	1	1	IHC HEALTH SERVICES INC	1/1/2003	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FILLMORE COMM MED CTR	674 S HIGHWAY 99	None	FILLMORE	UT	84631	5013	00	None	38.95406565	-112.3396449	Millard County
94239	Fee-for-Service	1114183829	1114183829	1	1	ISKANDER, PAUL J	6/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120148	30	Radiology	0	In state provider	None	10833 LE CONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
94800	Fee-for-Service	1700291655	1700291655	1	1	IQBAL, SAMEEIA MD	1/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149751	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
94803	Fee-for-Service	1760631543	1760631543	1	1	ISKANDER, RAY N MD APC	1/1/1979	193400000X	NA	Other	026	PHYSICIANS	25024	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1505 WILSON TER	STE 130	GLENDALE	CA	91206	4074	19	06037	34.14960934	-118.2313491	Los Angeles County
94925	Fee-for-Service	1952327223	1952327223	1	1	IACOPELLI, JOSEPH CRNA	6/18/2012	No Taxonomy Provided	NA	None	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
95072	Fee-for-Service	1023204781	1023204781	1	1	IGNACIO, SHERYLLENE E MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110259	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
95176	Fee-for-Service	1780659557	1780659557	1	1	IMATANI, RAYMOND J MD	7/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	26483	20	Orthopedic Surgery	0	In state provider	None	41889 EAST FLORIDA AVE	None	HEMET	CA	92544	5042	33	06065	33.7476747	-116.9145363	Riverside County
95185	Fee-for-Service	1932234713	1932234713	1	1	ISMAIL, MAGDY MD	10/31/1991	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	50073	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
95242	Fee-for-Service	1467088773	1467088773	2	1	IMGRX SJ VALLEY, INC.	6/28/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY HURON	17008 13TH ST.	PHARMACY SUITE	HURON	CA	93234	9997	10	06019	36.20838442	-120.1008527	Fresno County
95432	Fee-for-Service	1710679766	1710679766	1	1	INNOVATION PHARMACY INC.	8/15/2023	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	18102 IRVINE BLVD	102	TUSTIN	CA	92780	3423	30	06059	33.74819092	-117.816792	Orange County
95472	Fee-for-Service	1932234713	1932234713	1	1	ISMAIL, MAGDY MD	10/31/1991	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	50073	40	Pediatrics	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
95481	Fee-for-Service	1043254634	1043254634	1	1	INJO, DANIEL MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	41374	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25333 BARTON RD	None	LOMA LINDA	CA	92354	3123	36	06071	34.04801656	-117.251334	San Bernardino County
95690	Fee-for-Service	1841203288	1841203288	2	1	IM, TAEHO MD	6/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	66753	05	Anesthesiology	0	In state provider	None	817 COFFEE ROAD	SUITE C3	MODESTO	CA	95355	4241	50	06099	37.655235	-120.975616	Stanislaus County
95856	Fee-for-Service	1124224878	1124224878	1	1	IMAGING MED ASSOCIATES	5/28/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	OF SAN DIEGO INC	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
96002	Fee-for-Service	1578611562	1578611562	1	1	INADA, SHARON H	12/16/2013	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	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
96016	Fee-for-Service	1336250992	1336250992	1	1	IMPERIAL BURBANK PHYSICAL	7/21/2009	193400000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	THERAPY INC	2222 W BURBANK BLVD	SUITE 101	BURBANK	CA	91506	1280	19	06037	34.1795859	-118.3353987	Los Angeles County
96387	Fee-for-Service	1841584752	1841584752	1	1	IMHOFF, JASON R LCSW	11/22/2023	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
96435	Fee-for-Service	1619933728	1619933728	1	1	IRFAN SIDDIQUE M.D	10/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 N JOHN YOUNG PKWY	STE 101	KISSIMMEE	FL	34741	6601	00	None	28.29397746	-81.41619402	Osceola County
96539	Fee-for-Service	1275028821	1275028821	1	1	IBRAHIM, CLAIRE T CCC-SLP	2/5/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5720 STONEBRIDGE MALL RD	SUITE 390	PLEASANTON	CA	94588	2831	01	06001	37.69247085	-121.9301884	Alameda County
96911	Fee-for-Service	1760269757	1760269757	1	1	IAM & CO INC	11/1/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	12805 COLLINS ST	None	VALLEY VILLAGE	CA	91607	1406	19	06037	34.17372421	-118.4121029	Los Angeles County
96958	Fee-for-Service	1568847044	1568847044	1	1	ING, JESSICA Y MD	8/11/2017	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	136183	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
97318	Fee-for-Service	1942235643	1942235643	1	1	INLAND EYE SPECIALISTS	12/1/2000	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	25395 HANCOCK AVE	STE 100	HEMET	CA	92562	9054	33	06065	33.5591482	-117.185187	Riverside County
97452	Fee-for-Service	1073547014	1073547014	1	1	IWAMOTO, MATHEW M MD	4/13/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	56369	30	Radiology	0	In state provider	None	7055 N FRESNO ST	STE 203	FRESNO	CA	93720	2957	10	06019	36.83880319	-119.7813727	Fresno County
97467	Fee-for-Service	1750498093	1750498093	1	9	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	3366 FIFTH AVE	None	SAN DIEGO	CA	92103	5713	37	06073	32.740425	-117.1603865	San Diego County
97579	Fee-for-Service	1427104116	1427104116	1	1	INLAND PSYCHIATRIC MEDICAL G	7/19/2019	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	23110 ATLANTIC CIR	STE F	MORENO VALLEY	CA	92553	5920	33	06065	33.93308206	-117.2597707	Riverside County
97757	Fee-for-Service	1063617223	1063617223	1	1	IWASAKI, DEBRA H	7/31/2008	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
97867	Fee-for-Service	1427104116	1427104116	1	1	INLAND PSYCHIATRIC MEDICAL G	1/14/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC.	23110 ATLANTIC CIR	STE F	MORENO VALLEY	CA	92553	5920	33	06065	33.93308206	-117.2597707	Riverside County
98000	Fee-for-Service	1639194038	1639194038	1	1	ISHIYAMA, GAIL P MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80933	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA B200	None	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
98047	Fee-for-Service	1043579808	1043579808	1	1	IDOWU, DENNIS A MD	8/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121235	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5 MEDICAL PLAZA DR	STE 250	SANTA ROSA	CA	95661	2868	49	06097	38.76604411	-121.2466761	Placer County
98157	Fee-for-Service	1427104116	1427104116	1	1	INLAND PSYCHIATRIC MEDICAL G	7/19/2019	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	23110 ATLANTIC CIR	STE F	MORENO VALLEY	CA	92553	5920	33	06065	33.93308206	-117.2597707	Riverside County
98434	Fee-for-Service	1073661997	1073661997	1	1	IM, EDWARD S MD	10/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83899	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
98444	Fee-for-Service	1427104116	1427104116	1	1	INLAND PSYCHIATRIC MEDICAL G	7/19/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ROUP, INC.	23110 ATLANTIC CIR	STE F	MORENO VALLEY	CA	92553	5920	33	06065	33.93308206	-117.2597707	Riverside County
98504	Fee-for-Service	1093893620	1093893620	1	1	ISLAM, SALIM MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	54661	05	Anesthesiology	0	In state provider	None	CLAY & BUCHANNAN ST	None	SAN FRANCISCO	CA	94115	0000	38	06075	37.791126	-122.4309105	San Francisco County
98662	Fee-for-Service	1558378695	1558378695	1	1	IRVINE ORTHOPAEDIC	3/24/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	ASSOCIATES	16300 SAND CANYON AVENUE	STE 511	IRVINE	CA	92618	3705	30	06059	33.66115075	-117.7742405	Orange County
98862	Fee-for-Service	1801051321	1801051321	1	1	IZADI, AZADE MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71801	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
98930	Fee-for-Service	1275734469	1275734469	1	1	INLAND BEHAVIORAL AND HEALTH	7/19/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES, INC	1963 NORTH E STREET	None	SAN BERNARDINO	CA	92405	3919	36	06071	34.133193	-117.294134	San Bernardino County
98985	Fee-for-Service	1306305271	1306305271	1	1	IYER, SIVARAMAN K	2/14/2023	390200000X	NA	Other	026	PHYSICIANS	182237	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
99163	Fee-for-Service	1982863767	1982863767	1	1	ISKANDER, KENDRA N MD	1/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144395	02	General Surgery	0	In state provider	None	2321 HARRISON AVE	None	EUREKA	CA	95501	3216	12	06023	40.786857	-124.1396125	Humboldt County
99431	Fee-for-Service	1508262213	1508262213	1	1	INFUSION4HEALTH	4/12/2023	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	77 ROLLING OAKS DR	#201	THOUSAND OAKS	CA	91361	1018	56	06111	34.17577423	-118.8748925	Ventura County
99514	Fee-for-Service	1962459677	1962459677	1	1	IRANI, HORMUZ MD INC	9/29/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	5959 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93309	0436	15	06029	35.36306164	-119.0711264	Kern County
99718	Fee-for-Service	1508262213	1508262213	1	1	INFUSION4HEALTH	10/25/2022	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	77 ROLLING OAKS DR	#201	THOUSAND OAKS	CA	91361	1018	56	06111	34.17577423	-118.8748925	Ventura County
99720	Fee-for-Service	1134145055	1134145055	1	1	INFECTIOUS DISEASE	3/31/1995	207RI0200X	NA	HIV/AIDS/Infectious Disease	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	DOCTORS MED GP INC	365 LENNON LN	STE 200	WALNUT CREEK	CA	94598	5910	07	06013	37.92784983	-122.0301444	Contra Costa County
99768	Fee-for-Service	1427476266	1427476266	1	1	IWAKI, KIMBERLY M MD	10/17/2020	207P00000X	NA	Other	026	PHYSICIANS	155777	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
99862	Fee-for-Service	1982771481	1982771481	1	1	IXANOV, RUSTEM	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO STREET	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
100087	Fee-for-Service	1417062712	1417062712	1	1	IBRAHIM, IHAB I G MD	1/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	49412	41	Internal Medicine	0	In state provider	None	3 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3087	31	06061	38.76566391	-121.2457432	Placer County
100287	Fee-for-Service	1336529148	1336529148	1	2	I S GUJRAL MD	11/8/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9810 PARK ST	None	BELLFLOWER	CA	90706	5936	19	06037	33.87840454	-118.1247975	Los Angeles County
100336	Fee-for-Service	1265497101	1265497101	1	1	ISENBERG, WILLIAM M MD	8/29/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	77313	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3100 SUMMIT ST	FL 5	OAKLAND	CA	94609	3410	01	06001	37.82018974	-122.2643221	Alameda County
100360	Fee-for-Service	1982776704	1982776704	1	1	ISLAM, ARSHIA D MD	9/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51862	41	Internal Medicine	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
100491	Fee-for-Service	1699285064	1699285064	1	1	IFEACHO, IFUNANYA OLIVE	12/15/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	10528 COLE ROAD	None	WHITTIER	CA	90604	1536	19	06037	33.93730989	-118.0047843	Los Angeles County
100679	Fee-for-Service	1063281970	1063281970	1	1	IWASAKI, ROBERT Y PT	4/9/2024	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
100703	Fee-for-Service	1730140591	1730140591	1	1	INDIANA UNIVERSITY HEALTH	1/21/2013	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MORGAN HOSPITAL INC	2209 JOHN R WOODEN DR	None	MARTINSVILLE	IN	46151	1840	00	None	39.42612207	-86.40603125	Morgan County
100776	Fee-for-Service	1699285064	1699285064	1	1	IFEACHO, IFUNANYA OLIVE	12/15/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	10528 COLE ROAD	None	WHITTIER	CA	90604	1536	19	06037	33.93730989	-118.0047843	Los Angeles County
100790	Fee-for-Service	1750498093	1750498093	1	5	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	3921 WARING RD	STE A	OCEANSIDE	CA	92056	4456	37	06073	33.18776771	-117.2893136	San Diego County
100797	Fee-for-Service	1942366992	1942366992	1	1	INLAND CARDIOLOGY MEDICA	4/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	ASSOCIATES	1382 E FOOTHILL BLVD	None	UPLAND	CA	91786	4014	36	06071	34.10697145	-117.6319655	San Bernardino County
100923	Fee-for-Service	1447226816	1447226816	1	1	ILORETA, ELPIDIONESTOR T MD	8/16/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	66476	08	Family Practice	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
100951	Fee-for-Service	1275581894	1275581894	1	6	IMPERIAL VALLEY FAMILY	9/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	CARE MEDICAL GROUP	251 W COLE RD	None	CALEXICO	CA	92231	9722	13	06025	32.6940513	-115.5029267	Imperial County
100993	Fee-for-Service	1730140591	1730140591	1	1	INDIANA UNIVERSITY HEALTH	1/21/2013	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MORGAN HOSPITAL INC	2209 JOHN R WOODEN DR	None	MARTINSVILLE	IN	46151	1840	00	None	39.42612207	-86.40603125	Morgan County
101051	Fee-for-Service	1770135212	1770135212	1	1	IHEOMA NWAOGU MD INC	8/26/2019	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	320 DARDANELLI LN	23B	LOS GATOS	CA	95032	1440	43	06085	37.262079	-121.9673345	Santa Clara County
101152	Fee-for-Service	1407893894	1407893894	1	1	INGUI, CHRISTIAN J MD	5/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1800 E FLORENCE BLVD	None	CASA GRANDE	AZ	85222	0000	00	None	32.881311	-111.7096155	Pinal County
101156	Fee-for-Service	1063591584	1063591584	1	1	INDIANA FIRST MED GROUP	1/1/1979	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	4082 WHITTIER BLVD	STE 103	LOS ANGELES	CA	90023	2559	19	06037	34.02389953	-118.183464	Los Angeles County
101190	Fee-for-Service	1164597472	1164597472	1	1	II FIRNBERG, THOMAS	5/16/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	40218	36	Psychiatry	0	In state provider	None	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
101370	Fee-for-Service	1750747515	1750747515	1	1	IN SERVICES OF SMILES LLC	2/24/2016	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	859 E ROUTE 66	UNIT G	GLENDORA	CA	91740	3615	19	06037	34.12886553	-117.850959	Los Angeles County
101438	Fee-for-Service	1386454379	1386454379	1	1	INLAND EMPIRE BRAIN EXPERTS	3/1/2025	2084N0400X	NA	Neurology	026	PHYSICIANS	None	13	Neurology (M.D. only)	0	In state provider	CORP	6485 DAY ST	STE 103	RIVERSIDE	CA	92507	0930	33	06065	33.931809	-117.2789185	Riverside County
101445	Fee-for-Service	1063591584	1063591584	1	1	INDIANA FIRST MED GROUP	1/1/1979	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	4082 WHITTIER BLVD	STE 103	LOS ANGELES	CA	90023	2559	19	06037	34.02389953	-118.183464	Los Angeles County
101473	Fee-for-Service	1164597472	1164597472	1	1	II FIRNBERG, THOMAS	5/16/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	40218	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
101652	Fee-for-Service	1043229453	1043229453	1	1	ISTWANI, MOSEN MD	2/8/2015	207RN0300X	NA	Nephrology	026	PHYSICIANS	64871	41	Internal Medicine	0	In state provider	MD	502 EUCLID AVENUE	SUITE 104	NATIONAL CITY	CA	91950	2959	37	06073	32.68505421	-117.0832793	San Diego County
101727	Fee-for-Service	1407823909	1407823909	1	1	IRANPUR,PERVEZ T MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70414	05	Anesthesiology	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
101758	Fee-for-Service	1508262213	1508262213	1	18	INFUSION4HEALTH	3/27/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	117 E 8TH ST	SUITE 100	LONG BEACH	CA	90813	4397	19	06037	33.77660645	-118.1920095	Los Angeles County
101786	Fee-for-Service	1801437454	1801437454	1	1	ILLUMINATE HOME HEALTH CARE	1/14/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	10545 BURBANK BLVD	STE 137	N HOLLYWOOD	CA	91601	2249	19	06037	34.1721655	-118.3608315	Los Angeles County
101818	Fee-for-Service	1104116680	1104116680	1	1	IMUS, PAUL M MD	11/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124606	40	Pediatrics	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3049	37	06073	32.781483	-117.007182	San Diego County
101873	Fee-for-Service	1285209882	1285209882	1	1	IRANI, MEHER MD	1/27/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
101911	Fee-for-Service	1891737078	1891737078	2	1	INTEGRITY HEALTHCARE	4/25/2008	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SOLUTIONS INC	5625 RUFFIN RD	STE 225	SAN DIEGO	CA	92123	6392	37	06073	32.836689	-117.1266525	San Diego County
101932	Fee-for-Service	1184081432	1184081432	1	1	IBRAHIM, SAMUEL MD INC	5/27/2016	208600000X	NA	General Surgery	026	PHYSICIANS	120880	02	General Surgery	0	In state provider	None	79180 CORPORATE CENTER D	SUITE 101	LA QUINTA	CA	92253	7235	33	06065	33.71043152	-116.2831995	Riverside County
101938	Fee-for-Service	1043229453	1043229453	1	1	ISTWANI, MOSEN MD	2/8/2015	207RN0300X	NA	Nephrology	026	PHYSICIANS	64871	45	Nephrology (Renal-Kidney)	0	In state provider	MD	502 EUCLID AVENUE	SUITE 104	NATIONAL CITY	CA	91950	2959	37	06073	32.68505421	-117.0832793	San Diego County
101967	Fee-for-Service	1912982463	1912982463	1	1	IRAGORRI, SANDRA MD	7/1/2020	2080P0210X	NA	Nephrology	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
101975	Fee-for-Service	1083983829	1083983829	1	1	IRISH, RACHEL LP	4/2/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1400 QUAIL STREET	SUITE 275	NEWPORT BEACH	CA	92660	2718	30	06059	33.66063101	-117.868116	Orange County
102131	Fee-for-Service	1275581894	1275581894	1	2	IMPERIAL VALLEY FAMILY	2/1/1997	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9300 CAMPUS POINT DR	None	LA JOLLA	CA	92037	1300	37	06073	32.877999	-117.225891	San Diego County
102567	Fee-for-Service	1508262213	1508262213	1	6	INFUSION4HEALTH	5/4/2023	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	24012 CALLE DE LA PLATA	#230	LAGUNA HILLS	CA	92653	7623	30	06059	33.61012113	-117.7115908	Orange County
102587	Fee-for-Service	1205839081	1205839081	1	1	INDUSTRY CONVALESCENT	7/1/1979	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL	555 EL ENCANTO RD	None	CITY OF INDUSTRY	CA	91745	1017	19	06037	34.02094655	-117.9639005	Los Angeles County
102591	Fee-for-Service	1801805056	1801805056	1	1	INTEGRATED HEALTHCARE	3/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	1762 WESTWOOD BLVD	STE 110	LOS ANGELES	CA	90024	5641	19	06037	34.05057734	-118.4376712	Los Angeles County
102841	Fee-for-Service	1821141441	1821141441	1	1	INLAND ENDOSCOPY CENTER	5/18/1994	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CTR & MEDICAL CLINIC	10408 INDUSTRIAL CIR	None	REDLANDS	CA	92374	4548	36	06071	34.06469012	-117.2361582	San Bernardino County
103031	Fee-for-Service	1710446307	1710446307	1	1	INFINITY HOME HEALTH CARE	10/15/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	4368 WOODMAN AVE	None	SHERMAN OAKS	CA	91423	3031	19	06037	34.149978	-118.4312015	Los Angeles County
103115	Fee-for-Service	1699702373	1699702373	1	1	ICZKOWSKI, KENNETH A MD	10/4/2023	207ZP0101X	NA	Other	026	PHYSICIANS	188118	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
103139	Fee-for-Service	1427152842	1427152842	1	1	ISHAK, SALAM G MD	1/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	51301	45	Nephrology (Renal-Kidney)	0	In state provider	None	1398 S STATE ST	STE 150	SAN JACINTO	CA	92583	4934	33	06065	33.77367	-116.9719155	Riverside County
103418	Fee-for-Service	1427152842	1427152842	1	1	ISHAK, SALAM G MD	1/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	51301	41	Internal Medicine	0	In state provider	None	1398 S STATE ST	STE 150	SAN JACINTO	CA	92583	4934	33	06065	33.77367	-116.9719155	Riverside County
103488	Fee-for-Service	1013388966	1013388966	1	1	INDIGO WATERS COUNSELING	5/23/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES, LCSW	13406 DONNER PASS RD	None	TRUCKEE	CA	96161	3822	29	06057	39.32819288	-120.2461775	Nevada County
103654	Fee-for-Service	1164665949	1164665949	1	1	IBARRA, PATRICIA MD	10/1/1996	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	77789	41	Internal Medicine	0	In state provider	None	2601 VIA CAMPO	None	MONTEBELLO	CA	90640	1807	19	06037	34.03278164	-118.1237597	Los Angeles County
103696	Fee-for-Service	1053842179	1053842179	1	1	IBANEZ, KELLY M	6/26/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	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
103914	Fee-for-Service	1396906095	1396906095	1	1	IMRAN SHARIEF, M.D., INC.	3/10/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	None	None	0	In state provider	None	14642 NEWPORT AVE	250	TUSTIN	CA	92780	6057	30	06059	33.73082212	-117.8293987	Orange County
103987	Fee-for-Service	1205905668	1205905668	2	1	INLAND NEPHROLOGY MEDICAL	9/17/2018	207RN0300X	NA	Nephrology	026	PHYSICIANS	66318	13	Neurology (M.D. only)	0	In state provider	ASSOCIATES INC	251 CAJON STREET	SUITE B	REDLANDS	CA	92373	5260	36	06071	34.05221949	-117.1803033	San Bernardino County
104173	Fee-for-Service	1245806512	1245806512	1	1	IMMENSE HOME HEALTH INC	4/28/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2000 W MAGNOLIA BLVD	SUITE 200	BURBANK	CA	91506	1707	19	06037	34.17361386	-118.3297964	Los Angeles County
104243	Fee-for-Service	1861569675	1861569675	1	1	ISHKHANIAN, HAGOP M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39035	20	Orthopedic Surgery	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
104603	Fee-for-Service	1811309818	1811309818	1	1	ILLINGWORTH, MELISSA M LAC	6/7/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	757 FIR ST	None	PARADISE	CA	95969	4532	04	06007	39.75585844	-121.6245441	Butte County
104689	Fee-for-Service	1588906952	1588906952	1	1	ISAACS, NATALIA K	10/26/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2275 S. MAIN ST.	SUITE 201	CORONA	CA	92882	5303	33	06065	33.85511663	-117.5694892	Riverside County
104741	Fee-for-Service	1215030747	1215030747	1	1	INTEGRATIVE MEDICAL CTR	12/1/1993	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	526 W 17TH ST	None	SANTA ANA	CA	92706	3619	30	06059	33.75995449	-117.8736165	Orange County
104769	Fee-for-Service	1417279399	1417279399	1	1	ISIGHT VISION CARE INC	8/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93290	None	None	0	In state provider	None	18693 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	6749	30	06059	33.6908199	-117.954288	Orange County
104889	Fee-for-Service	1790701142	1790701142	1	1	IMPERIAL COUNTY PUBLIC	12/1/1977	No Taxonomy Provided	NA	None	048	COUNTY CLINICS NOT ASSOCIATED WITH HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HEALTH LABORATORY	935 BROADWAY ST	None	EL CENTRO	CA	92243	2349	13	06025	32.7938007	-115.5630093	Imperial County
104927	Fee-for-Service	1114938214	1114938214	1	1	IYABO DARAMOLA MD, INC	2/16/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CARING HEARTS MED CLINIC	2401 REO DR	None	SAN DIEGO	CA	92139	3025	37	06073	32.67512422	-117.064198	San Diego County
104971	Fee-for-Service	1598004863	1598004863	1	1	IMMEDIATE HOSPICE CARE INC	2/28/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14640 VICTORY BLVD	SUITE 224	VAN NUYS	CA	91411	4198	19	06037	34.18663255	-118.452402	Los Angeles County
105050	Fee-for-Service	1750498093	1750498093	1	14	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	675 CAMINO DE LOS MARES	STE 101	SAN CLEMENTE	CA	92673	2836	30	06059	33.45710369	-117.6474248	Orange County
105106	Fee-for-Service	1144505801	1144505801	1	1	INLAND EMPIRE COLON AND	12/8/2014	193400000X	NA	Other	026	PHYSICIANS	64659	None	None	0	In state provider	RECTAL SURGEONS	2970 OLYMPIC BOULEVARD	SUITE 304	LOS ANGELES	CA	90006	2518	19	06037	34.05261802	-118.29967	Los Angeles County
105121	Fee-for-Service	1801970157	1801970157	1	1	IKEDA, TYSON S MD	4/30/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76582	08	Family 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
105175	Fee-for-Service	1790701142	1790701142	1	1	IMPERIAL COUNTY PUBLIC	2/6/1998	251K00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	HEALTH LABORATORY	935 BROADWAY ST	None	EL CENTRO	CA	92243	2349	13	06025	32.7938007	-115.5630093	Imperial County
105257	Fee-for-Service	1598004863	1598004863	1	1	IMMEDIATE 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	14640 VICTORY BLVD	SUITE 224	VAN NUYS	CA	91411	4198	19	06037	34.18663255	-118.452402	Los Angeles County
105338	Fee-for-Service	1912389586	1912389586	1	1	IBARRA, MARINA LCSW	10/21/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1300 SHAW	SUITE 109	FRESNO	CA	93710	7917	10	06019	36.80872147	-119.765979	Fresno County
105346	Fee-for-Service	1689235418	1689235418	1	1	IYER, NEEL S DO	2/25/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	22593	15	Obstetrics (D.O. only)	0	In state provider	None	300 HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
105448	Fee-for-Service	1316004286	1316004286	1	1	ISAACS, JILL R	7/10/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	110 N LA BREA AVE	None	INGLEWOOD	CA	90301	1708	19	06037	33.96345848	-118.3533454	Los Angeles County
105598	Fee-for-Service	1962508960	1962508960	1	1	ISAACS, CAROL L MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	53773	07	Dermatology	0	In state provider	None	650 SANITARUM RD	# 501	DEER PARK	CA	94576	0000	28	06055	38.5417293	-122.4756328	Napa County
105615	Fee-for-Service	1386656635	1386656635	1	1	ISRAEL, MICHELLE MD	3/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74712	38	Geriatrics	0	In state provider	None	201 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1729	19	06037	34.069635	-118.3837975	Los Angeles County
105625	Fee-for-Service	1376623751	1376623751	1	1	IN, JUN	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	FINE ACUPUNCTURE & HERBS	1133 S VERMONT AVE	STE 17	LOS ANGELES	CA	90006	2764	19	06037	34.04982964	-118.2916314	Los Angeles County
105635	Fee-for-Service	1689235418	1689235418	1	1	IYER, NEEL S DO	2/25/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	22593	09	Gynecology (D.O. only)	0	In state provider	None	300 HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
105663	Fee-for-Service	1316996218	1316996218	1	1	INOUYE, CRAIG T MD	7/3/1997	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	53042	30	Radiology	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
105766	Fee-for-Service	1063717072	1063717072	1	1	ITO, CARYN S	6/10/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18700 BEACH BLVD	STE 120	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
105780	Fee-for-Service	1508262213	1508262213	1	2	INFUSION4HEALTH	11/1/2022	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2121 WILSHIRE BLVD	#303	SANTA MONICA	CA	90403	5743	19	06037	34.03262306	-118.4817131	Los Angeles County
105839	Fee-for-Service	1871538140	1871538140	1	1	INLAND SURGERY CENTER	10/22/2003	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	MURRIETA	25395 HANCOCK AVE	SUITE 100	MURRIETA	CA	92562	9054	33	06065	33.5591482	-117.185187	Riverside County
105876	Fee-for-Service	1114421948	1114421948	1	1	IMPERIALE, PAMELA M MD	9/6/2022	390200000X	NA	Other	026	PHYSICIANS	165906	None	None	0	In state provider	None	2660 W COVELL BLVD	None	DAVIS	CA	95616	5645	57	06113	38.56101005	-121.7821776	Yolo County
105903	Fee-for-Service	1386656635	1386656635	1	1	ISRAEL, MICHELLE MD	3/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74712	01	General Practice	0	In state provider	None	201 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1729	19	06037	34.069635	-118.3837975	Los Angeles County
105932	Fee-for-Service	1164681896	1164681896	1	1	ISHIMOTO, GREG S MD	7/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104526	66	Emergency Medicine (Urgent Care)	0	In state provider	None	199 EAST WEBSTER STREET	None	COLUSA	CA	95932	2954	06	06011	39.20737704	-122.0004043	Colusa County
105997	Fee-for-Service	1902144223	1902144223	1	1	INTERCOMMUNITY ANESTHESIOLOG	5/15/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
106070	Fee-for-Service	1508262213	1508262213	1	2	INFUSION4HEALTH	4/12/2023	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2121 WILSHIRE BLVD	#303	SANTA MONICA	CA	90403	5743	19	06037	34.03262306	-118.4817131	Los Angeles County
106095	Fee-for-Service	1043700172	1043700172	1	1	INNOCENTI, SARAH F OT	5/11/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
106200	Fee-for-Service	1114274529	1114274529	1	1	INTAN, SUSIANI MD	5/18/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	168657	13	Neurology (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
106332	Fee-for-Service	1114686631	1114686631	1	1	IN SOMNO SECURITAS A PROFESS	6/21/2023	193400000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	IONAL NURSING CORPORAT	950 BUTTE ST	None	REDDING	CA	96001	0827	45	06089	40.58573576	-122.3853712	Shasta County
106566	Fee-for-Service	1689275588	1689275588	1	1	INTEGRATED HOSPICE CARE INC	8/23/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6354 1/2 VAN NUYS BLVD	STE 102	VAN NUYS	CA	91401	2601	19	06037	34.1858441	-118.4486607	Los Angeles County
106798	Fee-for-Service	1750498093	1750498093	1	1	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	1200 GARDEN VIEW RD	STE 110	ENCINITAS	CA	92024	2475	37	06073	33.0584037	-117.2601559	San Diego County
106854	Fee-for-Service	1689275588	1689275588	1	1	INTEGRATED HOSPICE CARE INC	8/23/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6354 1/2 VAN NUYS BLVD	STE 102	VAN NUYS	CA	91401	2601	19	06037	34.1858441	-118.4486607	Los Angeles County
107102	Fee-for-Service	1528009990	1528009990	1	1	IEROKOMOS, ALEXANDER P MD	1/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	41004	24	Plastic Surgery	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
107421	Fee-for-Service	1609886126	1609886126	1	1	IHC HEALTH SERVICES INC	11/25/2009	284300000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5848 S 300 E	None	MURRAY	UT	84107	6121	00	None	40.6439418	-111.8984544	Salt Lake County
107492	Fee-for-Service	1154551760	1154551760	1	1	IIJIMA, EMI PSYD	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
107498	Fee-for-Service	1023167525	1023167525	1	1	IZUORA, KENNETH E MD	9/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	67	Endocrinology	1	Border provider	None	1701 W CHARLESTON BLVD	STE 215	LAS VEGAS	NV	89102	2325	00	None	36.15878847	-115.163703	Clark County
107594	Fee-for-Service	1558681890	1558681890	1	1	INDEPENDENT LIVING CENTER O	5/16/2011	251B00000X	NA	Other	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	ILC OF KERN COUNTY	5251 OFFICE PARK DRIVE	SUITE 200	BAKERSFIELD	CA	93309	0404	15	06029	35.36594362	-119.0610068	Kern County
107621	Fee-for-Service	1336776285	1336776285	2	1	IMGRX SJ VALLEY, INC.	7/13/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY SELMA	2705 S. HIGHLAND AVE	PHARMACY	SELMA	CA	93662	3389	10	06019	36.5732277	-119.6288883	Fresno County
107710	Fee-for-Service	1609886126	1609886126	1	1	IHC HEALTH SERVICES INC	11/25/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5848 S 300 E	None	MURRAY	UT	84107	6121	00	None	40.6439418	-111.8984544	Salt Lake County
107758	Fee-for-Service	1134544059	1134544059	1	1	IN STRIDE PHYSICAL THERAPY &	9/18/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	REHAB, INC.	581 LIGHTHOUSE AVE	None	PACIFIC GROVE	CA	93950	2646	27	06053	36.62106225	-121.9179244	Monterey County
107852	Fee-for-Service	1306628623	1306628623	1	1	ISIEV, VICTORIA NP	12/20/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	27141 HIDAWAY AVE	204	SANTA CLARITA	CA	91351	4147	19	06037	34.41483	-118.469039	Los Angeles County
107876	Fee-for-Service	1851699557	1851699557	1	1	INGALLA, ANTHONY	2/1/1995	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	14816 CENTRAL AVE	None	CHINO	CA	91710	9509	36	06071	33.98428353	-117.689009	San Bernardino County
108197	Fee-for-Service	1780716795	1780716795	1	1	IVRA, BILLIE F PHD	1/4/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA STREET	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
108409	Fee-for-Service	1871814004	1871814004	1	1	IMAX MEDICAL SERVICES INC	7/11/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	10088 6TH ST	#G	RANCHO CUCAMONGA	CA	91730	5748	36	06071	34.08472955	-117.587261	San Bernardino County
108429	Fee-for-Service	1629140678	1629140678	1	1	ISLAS, JEFFREY T MD	5/31/1996	208600000X	NA	General Surgery	026	PHYSICIANS	69424	None	None	0	In state provider	None	2865 ATLANTIC AVE	STE 223	LONG BEACH	CA	90806	7429	19	06037	33.809418	-118.185058	Los Angeles County
108554	Fee-for-Service	1285381756	1285381756	1	2	INLAND EMPIRE MULTISPECIALTY	4/9/2024	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9939 MAGNOLIA AVE	D	RIVERSIDE	CA	92503	3528	33	06065	33.91571158	-117.4549231	Riverside County
108653	Fee-for-Service	1821627126	1821627126	1	1	INFANTE, SOFIA MD	10/28/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	09	Gynecology (D.O. only)	0	In state provider	None	2907 CHANTICLEER AVE	None	SANTA CRUZ	CA	95065	1815	44	06087	36.98793933	-121.9782322	Santa Cruz County
108762	Fee-for-Service	1801986831	1801986831	1	1	ISAHAKIAN, GAGIK AC	6/1/2000	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	600 W BROADWAY	STE 135	GLENDALE	CA	91204	1070	19	06037	34.14678282	-118.2666498	Los Angeles County
108823	Fee-for-Service	1326799719	1326799719	1	1	ILLUMINATING CARE HOME	4/26/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HEALTH INC	6420 COLDWATER CNYN AVE	SUITE 204	NORTH HOLLYWOOD	CA	91606	1139	19	06037	34.18745584	-118.4137829	Los Angeles County
108832	Fee-for-Service	1376129312	1376129312	1	1	ICETON, JORDAN B MD	5/8/2024	207R00000X	NA	Other	026	PHYSICIANS	None	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
108882	Fee-for-Service	1477631257	1477631257	1	1	ING, DENNIS K MD	7/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	47878	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
108942	Fee-for-Service	1821627126	1821627126	1	1	INFANTE, SOFIA MD	10/28/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	None	2907 CHANTICLEER AVE	None	SANTA CRUZ	CA	95065	1815	44	06087	36.98793933	-121.9782322	Santa Cruz County
109054	Fee-for-Service	1619003258	1619003258	1	1	IBIRONKE, LATISHA F LMFT	1/30/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	46518	-	NOT APPLICABLE	0	In state provider	None	1820 SCENIC AVE	None	BERKELEY	CA	94709	1324	01	06001	37.87536985	-122.2622489	Alameda County
109212	Fee-for-Service	1962586917	1962586917	1	1	IBRAHIM, ISLAM M MD	8/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54272	29	Pulmonary Diseases (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
109231	Fee-for-Service	1821627126	1821627126	1	1	INFANTE, SOFIA MD	10/28/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2907 CHANTICLEER AVE	None	SANTA CRUZ	CA	95065	1815	44	06087	36.98793933	-121.9782322	Santa Cruz County
109371	Fee-for-Service	1104356799	1104356799	1	1	IBIS HEALTH	8/20/2018	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	5189 HOSPITAL RD	None	MARIPOSA	CA	95338	9524	22	06043	37.50033166	-119.9769163	Mariposa County
109414	Fee-for-Service	1154080869	1154080869	1	1	ISAAC, JULIE NP	1/25/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
109463	Fee-for-Service	1508262213	1508262213	1	26	INFUSION4HEALTH	1/28/2025	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2701 W ALAMEDA AVE	SUITE 507	BURBANK	CA	91505	4411	19	06037	34.15751343	-118.3303715	Los Angeles County
109699	Fee-for-Service	1255455564	1255455564	1	1	IVORY, DIANA A LMFT	9/17/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 NORTH LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
109745	Fee-for-Service	1508262213	1508262213	1	27	INFUSION4HEALTH	4/2/2025	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	5620 WILBUR AVE	SUITE 310	TARZANA	CA	91356	1351	19	06037	34.17282089	-118.5446783	Los Angeles County
109746	Fee-for-Service	1235296880	1235296880	2	2	I V RADIOLOGY MEDICAL GROUP	8/23/2022	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
109759	Fee-for-Service	1437350808	1437350808	1	1	IZVERNARI-IM, KIMBERLY C MD	7/6/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97432	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
109890	Fee-for-Service	1093801680	1093801680	1	2	IDEAL CARE HOME	12/1/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	21021 DEVONSHIRE STREET	SUITE 204	CHATSWORTH	CA	91311	8238	19	06037	34.2572805	-118.591686	Los Angeles County
110126	Fee-for-Service	1023122967	1023122967	1	1	INDIO FAMILY CARE CENTER	1/16/1997	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	47923 OASIS ST	None	INDIO	CA	92201	6950	33	06065	33.70080223	-116.2209518	Riverside County
110215	Fee-for-Service	1942629977	1942629977	1	1	INNOVATIVE DIALYSIS OF	10/28/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	PATTERSON LLC	1700 KEYSTONE PACIFIC PK	SUITE A-1	PATTERSON	CA	95363	8874	50	06099	37.47600952	-121.160718	Stanislaus County
110244	Fee-for-Service	1891403473	1891403473	1	1	INUMERABLE, RYAN PT	3/13/2025	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
110422	Fee-for-Service	1023122967	1023122967	1	1	INDIO FAMILY CARE CENTER	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	47923 OASIS ST	None	INDIO	CA	92201	6950	33	06065	33.70080223	-116.2209518	Riverside County
110701	Fee-for-Service	1023122967	1023122967	1	1	INDIO FAMILY CARE CENTER	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	47923 OASIS ST	None	INDIO	CA	92201	6950	33	06065	33.70080223	-116.2209518	Riverside County
110733	Fee-for-Service	1750540621	1750540621	1	1	IRANI, ADIL N MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	75847	42	Nuclear Medicine	0	In state provider	None	1900 MOWRY AVE	STE 309	FREMONT	CA	94538	1722	01	06001	37.55862396	-121.9799952	Alameda County
110848	Fee-for-Service	1700401031	1700401031	1	1	INSPIRE SCHOOL OF ARTS &	7/1/2019	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCIENCES	335 WEST SACRAMENTO AVE	None	CHICO	CA	95926	4580	04	06007	39.73494685	-121.8490876	Butte County
110865	Fee-for-Service	1417137597	1417137597	1	1	INFINITY CARE OF MAYWOOD	8/4/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6025 PINE AVE	None	MAYWOOD	CA	90270	3108	19	06037	33.9845855	-118.188268	Los Angeles County
110978	Fee-for-Service	1669607651	1669607651	1	1	IMMANUEL HOSPICE INC	7/28/2012	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	30 SANTA CLARA ST	STE F	ARCADIA	CA	91006	7022	19	06037	34.14222693	-118.0301451	Los Angeles County
110990	Fee-for-Service	1023122967	1023122967	1	1	INDIO FAMILY CARE CENTER	3/1/1997	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	47923 OASIS ST	None	INDIO	CA	92201	6950	33	06065	33.70080223	-116.2209518	Riverside County
111016	Fee-for-Service	1699853366	1699853366	1	1	INOUYE, ISAO MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	37813	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
111020	Fee-for-Service	1750540621	1750540621	1	1	IRANI, ADIL N MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	75847	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1900 MOWRY AVE	STE 309	FREMONT	CA	94538	1722	01	06001	37.55862396	-121.9799952	Alameda County
111029	Fee-for-Service	1679908479	1679908479	1	1	ISAIS, PABLO D LCSW	4/9/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3840 WOODRUFF AVE	STE 209	LONG BEACH	CA	90808	2149	19	06037	33.828786	-118.1165535	Los Angeles County
111071	Fee-for-Service	1568864080	1568864080	2	1	IMPERIAL BEACH OPTOMETRY	8/12/2015	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	894 PALM AVE	SUITE B	IMPERIAL BEACH	CA	91932	1573	37	06073	32.58408652	-117.114766	San Diego County
111089	Fee-for-Service	1972602720	1972602720	1	1	ISACESCU, VALENTIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	68103	36	Psychiatry	0	In state provider	None	3230 WARING CT	STE H	OCEANSIDE	CA	92056	4509	37	06073	33.18776771	-117.2893136	San Diego County
111144	Fee-for-Service	1023279528	1023279528	1	1	IYENGAR, VIBHA R MD	8/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114870	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
111266	Fee-for-Service	1669607651	1669607651	1	1	IMMANUEL HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	30 SANTA CLARA ST	STE F	ARCADIA	CA	91006	7022	19	06037	34.14222693	-118.0301451	Los Angeles County
111417	Fee-for-Service	1164183927	1164183927	1	1	IDEAL HOME HEALTH CARE, INC	8/1/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2222 WEST BURBANK BLVD	SUITE 201	BURBANK	CA	91506	1280	19	06037	34.1795859	-118.3353987	Los Angeles County
111486	Fee-for-Service	1215332945	1215332945	1	1	IROQUOIS DIALYSIS LLC	10/1/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3660 PARK SIERRA DR	SUITE 103	RIVERSIDE	CA	92505	3071	33	06065	33.90330693	-117.4707039	Riverside County
111662	Fee-for-Service	1881177293	1881177293	1	1	ISEEU OPTOMETRY	10/12/2019	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	72840 HIGHWAY 111	F201	PALM DESERT	CA	92260	3393	33	06065	33.723729	-116.394678	Riverside County
111707	Fee-for-Service	1548441645	1548441645	1	1	INFINITE HOME HEALTH INC	2/26/2007	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	22151 VENTURA BLVD	STE 201	WOODLAND HILLS	CA	91364	5737	19	06037	34.16870042	-118.6099445	Los Angeles County
111805	Fee-for-Service	1023097441	1023097441	1	2	ILLOVSKY, MICHAEL A MD	6/7/2021	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	75130	None	None	0	In state provider	None	1180 POST ST	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
111829	Fee-for-Service	1407991326	1407991326	1	1	INABA, KENJI MD	8/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	91756	02	General Surgery	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
111882	Fee-for-Service	1639448269	1639448269	1	1	IKEDIOBI, OGECHI MD	6/7/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	165972	07	Dermatology	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
111884	Fee-for-Service	1720032998	1720032998	1	1	IN HOME HEALTH LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2511 GARDEN RD	STE A-250	MONTEREY	CA	93940	5306	27	06053	36.58615449	-121.8533458	Monterey County
111900	Fee-for-Service	1275581894	1275581894	1	8	IMPERIAL VALLEY FAMILY	12/27/2007	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CARE MEDICAL GROUP APC	2061 ROSS AVE	STE B	EL CENTRO	CA	92243	4242	13	06025	32.7814167	-115.579257	Imperial County
111906	Fee-for-Service	1912927286	1912927286	1	1	ISAACS, ROBERT T MD	8/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	75679	08	Family Practice	0	In state provider	None	151 E WEBSTER ST	None	COLUSA	CA	95932	2949	06	06011	39.20745427	-122.0008341	Colusa County
112019	Fee-for-Service	1932580115	1932580115	1	1	IVES, REBECCA MD	11/7/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	146519	40	Pediatrics	0	In state provider	None	27303 SLEEPY HOLLOW	None	HAYWARD	CA	94545	4203	01	06001	37.63208871	-122.0939191	Alameda County
112020	Fee-for-Service	1164088068	1164088068	1	1	ISSA, TAMMY MD	11/26/2022	207R00000X	NA	Other	026	PHYSICIANS	178850	None	None	0	In state provider	None	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
112143	Fee-for-Service	1669733275	1669733275	1	1	IVATURI, KAUSHIK MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134126	41	Internal Medicine	0	In state provider	None	3000 Q ST	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
112168	Fee-for-Service	1427767342	1427767342	1	1	INTEGRATED COMMUNITY OPTIONS	3/16/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	324 WAPELLO STREET	None	ALTADENA	CA	91001	4445	19	06037	34.2004281	-118.1374668	Los Angeles County
112174	Fee-for-Service	1720032998	1720032998	1	1	IN HOME HEALTH LLC	5/9/1996	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2511 GARDEN RD	STE A-250	MONTEREY	CA	93940	5306	27	06053	36.58615449	-121.8533458	Monterey County
112188	Fee-for-Service	1275581894	1275581894	1	8	IMPERIAL VALLEY FAMILY	12/27/2007	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	CARE MEDICAL GROUP APC	2061 ROSS AVE	STE B	EL CENTRO	CA	92243	4242	13	06025	32.7814167	-115.579257	Imperial County
112280	Fee-for-Service	1609012285	1609012285	1	1	IDURY, JAYANTHI MD	10/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106098	41	Internal Medicine	0	In state provider	None	3800 DALE ROAD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
112295	Fee-for-Service	1326565565	1326565565	1	1	IM, DAN CHOONG SUNG MD	1/4/2024	207P00000X	NA	Other	026	PHYSICIANS	181359	None	None	0	In state provider	None	1401 S GRANDE AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
112432	Fee-for-Service	1639374747	1639374747	1	1	IMANI, ROBERT B	6/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	96286	36	Psychiatry	0	In state provider	None	1650 W AVE	SUITE J	LANCASTER	CA	93534	2814	19	06037	34.77698824	-118.1594209	Los Angeles County
112628	Fee-for-Service	1396056438	1396056438	1	1	IMOTO, ERIC M M DO	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	13427	78	Neoplastic Diseases/Oncology	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
112652	Fee-for-Service	1013920958	1013920958	1	1	ILLECK, JEFFREY S MD	4/16/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	67729	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	19582 BEACH BLVD STE 202	None	HUNTINGTON BEACH	CA	92648	2996	30	06059	33.67831649	-117.9885198	Orange County
112707	Fee-for-Service	1063623098	1063623098	1	1	IVANICK, NATHANIEL M MD	6/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154270	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
112831	Fee-for-Service	1629409016	1629409016	1	1	INPATIENT CARE OF SOUTHERN	1/15/2014	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CALIFORNIA INC	207 WEST LEGION ROAD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
112918	Fee-for-Service	1396056438	1396056438	1	1	IMOTO, ERIC M M DO	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	13427	68	Hematology	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
112964	Fee-for-Service	1831598762	1831598762	1	1	IQBAL-HOFMEISTER, SAMUEL L	9/25/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10255 LIVE OAK BLVD	None	LIVE OAK	CA	95953	2015	51	06101	39.28004385	-121.661271	Sutter County
113203	Fee-for-Service	1396056438	1396056438	1	1	IMOTO, ERIC M M DO	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	13427	41	Internal Medicine	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
113206	Fee-for-Service	1932631983	1932631983	1	1	IP, ADA MD	6/23/2024	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	188440	06	Cardiovascular Disease (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
113331	Fee-for-Service	1588850374	1588850374	1	1	IMRIE, MEGHAN N MD	6/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	91915	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
113641	Fee-for-Service	1295097582	1295097582	1	1	ISLAM, RAHEEL MD	4/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
113696	Fee-for-Service	1457822603	1457822603	1	1	INSTANT HOME HEALTH CARE INC	5/21/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	21032 DEVONSHIRE ST	STE 206	CHATSWORTH	CA	91311	2368	19	06037	34.25722053	-118.591857	Los Angeles County
113926	Fee-for-Service	1043458086	1043458086	1	1	IBRAHIM, DOREEN I MD	3/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127850	41	Internal Medicine	0	In state provider	None	2001 FOURTH AVENUE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
114016	Fee-for-Service	1396837951	1396837951	1	1	IOWA METHODIST MED CTR	6/9/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1200 PLEASANT ST	None	DES MOINES	IA	50309	1406	00	None	41.58886035	-93.63191864	Polk County
114076	Fee-for-Service	1396103818	1396103818	1	1	IPEMA, TORIANNE	4/22/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	939 ELLIS ST	None	SAN FRANCISCO	CA	94109	7714	38	06075	37.78368811	-122.4218578	San Francisco County
114120	Fee-for-Service	1750498093	1750498093	1	12	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	25405 HANCOCK AVE	STE 107	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
114216	Fee-for-Service	1891803458	1891803458	1	1	IYER, PADMINI R	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	37036	68	Hematology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
114262	Fee-for-Service	1003084534	1003084534	1	1	INENAGA, EIRI H NP	3/9/2020	225XP0200X	NA	Other	019	OCCUPATIONAL 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
114302	Fee-for-Service	1396837951	1396837951	1	1	IOWA METHODIST MED CTR	6/9/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1200 PLEASANT ST	None	DES MOINES	IA	50309	1406	00	None	41.58886035	-93.63191864	Polk County
114372	Fee-for-Service	1386683258	1386683258	1	1	ISTWANI, AMMAR MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80027	30	Radiology	0	In state provider	None	16453 COLORADO AVE	None	PARAMOUNT	CA	90723	5011	19	06037	33.8848803	-118.1614216	Los Angeles County
114482	Fee-for-Service	1457943151	1457943151	1	1	INLAND PHYSICIANS PRIMARY CA	8/27/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	RE SERVICES	9525 MONTE VISTA AVE	STE 105	MONTCLAIR	CA	91763	2231	36	06071	34.080777	-117.698234	San Bernardino County
114501	Fee-for-Service	1891803458	1891803458	1	1	IYER, PADMINI R	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	37036	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
114520	Fee-for-Service	1740357557	1740357557	1	1	IMAM, TALHA H MD	4/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76685	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
114617	Fee-for-Service	1487427142	1487427142	1	1	INLAND EMPIRE PEDIATRIC CARD	11/28/2023	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	None	None	0	In state provider	IOLOGY	15632 BEAR VALLEY RD	SUITE 106	VICTORVILLE	CA	92395	8534	36	06071	34.47085445	-117.3226975	San Bernardino County
114634	Fee-for-Service	1871535286	1871535286	1	1	INTERCOMMUNITY EMERGENCY MED	8/31/1989	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	ICAL GROUP	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
114679	Fee-for-Service	1447428271	1447428271	1	1	IMAM, SYED M PHD	12/17/2020	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	27349 JEFFERSON AVE	SUITE 111	TEMECULA	CA	92590	5634	33	06065	33.51993406	-117.1641955	Riverside County
114790	Fee-for-Service	1891803458	1891803458	1	1	IYER, PADMINI R	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	37036	78	Neoplastic Diseases/Oncology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
114798	Fee-for-Service	1083921357	1083921357	1	1	IM, MARYLUNE LMFT	5/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14500 ROSCOE BLVD	STE 400	PANORAMA CITY	CA	91402	4194	19	06037	34.2215055	-118.44918	Los Angeles County
114987	Fee-for-Service	1073743233	1073743233	1	1	IGNATIUS, MARK I DO	7/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11498	25	Physical Medicine and Rehabilitation	0	In state provider	None	10833 LE CONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
115459	Fee-for-Service	1740796341	1740796341	1	1	IZZO, PAULINA LMFT	11/8/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4849 RONSON CT	SUITE 207	SAN DIEGO	CA	92111	1805	37	06073	32.83028739	-117.1459009	San Diego County
115707	Fee-for-Service	1013622216	1013622216	1	1	INLAND SENIOR MANOR INC	2/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	25871 SUN CITY BLVD	None	MENIFEE	CA	92586	2662	33	06065	33.70493766	-117.2076548	Riverside County
115769	Fee-for-Service	1356428072	1356428072	1	1	ISOM, ROBERT T MD	4/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54526	45	Nephrology (Renal-Kidney)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
115841	Fee-for-Service	1730334525	1730334525	1	1	IKENZE, SHIRLEY A LCSW	3/30/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
116016	Fee-for-Service	1356334510	1356334510	1	1	INDIANA REG MED CTR	2/19/2008	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	835 HOSPITAL RD	None	INDIANA	PA	15701	3629	00	None	40.607514	-79.1563005	Indiana County
116262	Fee-for-Service	1659399012	1659399012	1	1	ILFELD, BRIAN M MD	12/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	61674	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
116302	Fee-for-Service	1356334510	1356334510	1	1	INDIANA REG MED CTR	2/19/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	835 HOSPITAL RD	None	INDIANA	PA	15701	3629	00	None	40.607514	-79.1563005	Indiana County
116350	Fee-for-Service	1750498093	1750498093	1	8	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	4033 3RD AVE	STE 100	SAN DIEGO	CA	92103	2136	37	06073	32.75053781	-117.1627168	San Diego County
116375	Fee-for-Service	1033185749	1033185749	1	1	INSIGHT HEALTH CORP	11/13/2003	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	345 CONVENTION WAY	STE D1	REDWOOD CITY	CA	94063	1402	41	06081	37.49391347	-122.2285705	San Mateo County
116564	Fee-for-Service	1821413907	1821413907	1	1	IKE, ERICA L	8/6/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	16603	40	Pediatrics	0	In state provider	None	18002 WIKA RD	None	APPLE VALLEY	CA	92307	2125	36	06071	34.54046469	-117.2712424	San Bernardino County
116574	Fee-for-Service	1952427601	1952427601	1	1	IKEMOTO, JENNIFER J CNM	9/1/2001	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	37	06073	33.14066871	-117.156095	San Diego County
116600	Fee-for-Service	1295715902	1295715902	1	1	ISLAT, GLENN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	1850 N CENTRAL AVE	STE 1600	PHOENIX	AZ	85004	4633	00	None	33.468345	-112.0745205	Maricopa County
116844	Fee-for-Service	1336463520	1336463520	1	1	INLAND PSYCHIATRIC MEDICAL G	7/22/2019	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	540 W BASELINE RD	SUITE 3	CLAREMONT	CA	91711	1612	19	06037	34.12158153	-117.723276	Los Angeles County
116931	Fee-for-Service	1710081930	1710081930	2	1	ITC MEDICAL SUPPLIES INC	2/26/2018	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	4373 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3003	38	06075	37.78084892	-122.4660749	San Francisco County
116937	Fee-for-Service	1487348876	1487348876	1	1	IRANI, SHAHRZAD NP	6/30/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1317 OAKDALE ROAD	STE. 800	MODESTO	CA	95355	3361	50	06099	37.662489	-120.957588	Stanislaus County
117111	Fee-for-Service	1407837784	1407837784	1	1	ISLAM, YASMEEN M MD	10/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144092	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
117131	Fee-for-Service	1336463520	1336463520	1	1	INLAND PSYCHIATRIC MEDICAL G	7/22/2019	103TC0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	540 W BASELINE RD	SUITE 3	CLAREMONT	CA	91711	1612	19	06037	34.12158153	-117.723276	Los Angeles County
117134	Fee-for-Service	1174054019	1174054019	1	2	IQBAL, AAMIR MD	8/1/2021	207R00000X	NA	Other	026	PHYSICIANS	158421	None	None	0	In state provider	None	2975 NORTH SYCAMORE DR.	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
117191	Fee-for-Service	1730308917	1730308917	1	1	INADA,ROBIN MD	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 STREET	None	HONOLULU	HI	96813	0000	00	None	21.30800017	-157.8550765	Honolulu County
117204	Fee-for-Service	1548222128	1548222128	1	1	ISONO, STEVEN S MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	51315	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
117279	Fee-for-Service	1710322581	1710322581	1	1	IBARRA, BRENDA LMFT	1/6/2020	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
117392	Fee-for-Service	1952428492	1952428492	1	1	IGNATOWICZ, OLGA MD	5/7/2020	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	None	-	NOT APPLICABLE	0	In state provider	None	11512 B AVE	None	AUBURN	CA	95603	2605	31	06061	38.93969517	-121.1046397	Placer County
117396	Fee-for-Service	1487831608	1487831608	1	1	INGRAM, KAREN CNP	8/9/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11103 VENICE BLVD	None	LOS ANGELES	CA	90034	6914	19	06037	34.01379685	-118.4159354	Los Angeles County
117419	Fee-for-Service	1336463520	1336463520	1	1	INLAND PSYCHIATRIC MEDICAL G	7/22/2019	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC	540 W BASELINE RD	SUITE 3	CLAREMONT	CA	91711	1612	19	06037	34.12158153	-117.723276	Los Angeles County
117475	Fee-for-Service	1508262213	1508262213	1	24	INFUSION4HEALTH	3/7/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	440 S MOUNTAIN AVE	SUITE 103	UPLAND	CA	91786	5183	36	06071	34.08821715	-117.6700618	San Bernardino County
117552	Fee-for-Service	1821658550	1821658550	1	1	IMPERIAL MEDICAL TRANSPORT I	8/7/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	NC	2667 CAMINO DEL RIO SOUT	100-C	SAN DIEGO	CA	92108	3707	37	06073	32.76979794	-117.1355701	San Diego County
117641	Fee-for-Service	1003975608	1003975608	1	1	IMAI, RYOKEI K MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71946	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
117686	Fee-for-Service	1720211691	1720211691	1	2	ISMAIL, ASHRAF MD	11/16/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	109030	-	NOT APPLICABLE	0	In state provider	None	4000 BIRCH ST	SUITE 112A	NEWPORT BEACH	CA	92660	2211	30	06059	33.66463772	-117.8698289	Orange County
117707	Fee-for-Service	1336463520	1336463520	1	1	INLAND PSYCHIATRIC MEDICAL G	7/22/2019	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC	540 W BASELINE RD	SUITE 3	CLAREMONT	CA	91711	1612	19	06037	34.12158153	-117.723276	Los Angeles County
117757	Fee-for-Service	1528249430	1528249430	1	1	ING, ARLENE S DO	4/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9407	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
117892	Fee-for-Service	1730357468	1730357468	1	1	IGID SENIOR CARE INC	1/25/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	37620 SIMI ST	None	PALMDALE	CA	93552	4039	19	06037	34.5658724	-118.0144371	Los Angeles County
117968	Fee-for-Service	1144525056	1144525056	1	1	IGNACIO, ALI L LCSW	1/22/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3840 HOMESTEAD ROAD	None	SANTA CLARA	CA	95051	5173	43	06085	37.33774954	-122.002065	Santa Clara County
117974	Fee-for-Service	1932338175	1932338175	1	1	INES, MARLO L LMFT	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	98715	-	NOT APPLICABLE	0	In state provider	None	1303 WEST WALNUT PARKWAY	None	COMPTON	CA	90220	5030	19	06037	33.87724562	-118.2446904	Los Angeles County
117992	Fee-for-Service	1952919797	1952919797	1	1	IL COMPORTO HOSPICE, INC	11/23/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12440 FIRESTONE BLVD	STE 109	NORWALK	CA	90650	9315	19	06037	33.90523023	-118.0681168	Los Angeles County
117994	Fee-for-Service	1336463520	1336463520	1	1	INLAND PSYCHIATRIC MEDICAL G	7/22/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC	540 W BASELINE RD	SUITE 3	CLAREMONT	CA	91711	1612	19	06037	34.12158153	-117.723276	Los Angeles County
118139	Fee-for-Service	1720136708	1720136708	1	1	ISAGHOLIAN, DAVID L MD	8/12/1995	207P00000X	NA	Other	026	PHYSICIANS	78996	66	Emergency Medicine (Urgent Care)	0	In state provider	None	508 E HICKORY AVE	None	LOMPOC	CA	93436	7337	42	06083	34.63568383	-120.4522776	Santa Barbara County
118198	Fee-for-Service	1083622567	1083622567	1	2	INLAND EYE SPECIALSTS	4/30/2018	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	25395 HANCOCK AVE	STE 100	MURRIETA	CA	92562	9054	33	06065	33.5591482	-117.185187	Riverside County
118278	Fee-for-Service	1952919797	1952919797	1	1	IL COMPORTO HOSPICE, INC	11/23/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12440 FIRESTONE BLVD	STE 109	NORWALK	CA	90650	9315	19	06037	33.90523023	-118.0681168	Los Angeles County
118349	Fee-for-Service	1427072032	1427072032	1	1	ISAACS, PAMELA K DO	10/21/2008	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	10007	30	Radiology	0	In state provider	None	1150 N INDIAN CANYON DR	#1	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
118418	Fee-for-Service	1528650223	1528650223	1	1	INLAND PHYSICIANS HOSPITALIS	6/14/2023	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	T SERVICES	9525 MONTE VISTA AVE	105	MONTCLAIR	CA	91763	2208	36	06071	34.080777	-117.698234	San Bernardino County
118435	Fee-for-Service	1619323763	1619323763	1	1	IBRAHIM, LUMA MD	7/27/2020	207R00000X	NA	Other	026	PHYSICIANS	166752	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
118485	Fee-for-Service	1083622567	1083622567	1	2	INLAND EYE SPECIALSTS	12/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	25395 HANCOCK AVE	STE 100	MURRIETA	CA	92562	9054	33	06065	33.5591482	-117.185187	Riverside County
118663	Fee-for-Service	1508262213	1508262213	1	11	INFUSION4HEALTH	6/20/2023	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2720 N HARBOR BLVD.	#200	FULLERTON	CA	92835	2626	30	06059	33.90126238	-117.9292154	Orange County
118761	Fee-for-Service	1588436836	1588436836	1	1	INSIGHT THOUGHTS PSYCHOTHERA	11/4/2024	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	PY SERVICES INC.	9431 HAVEN AVE	STE 100	RANCHO CUCAMONGA	CA	91730	5879	36	06071	34.082244	-117.5756135	San Bernardino County
118890	Fee-for-Service	1033136932	1033136932	1	1	ICHINO, JAKE H MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	1	Border provider	None	343 ELM ST	STE 400	RENO	NV	89503	4541	00	None	39.53251653	-119.8196372	Washoe County
118948	Fee-for-Service	1346846029	1346846029	1	1	IDAN HOME HEALTH INC	2/16/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	620 W ROUTE 66	SUITE 200	GLENDORA	CA	91740	4173	19	06037	34.1286087	-117.8755695	Los Angeles County
119082	Fee-for-Service	1306001698	1306001698	1	1	ISPAS, ALEXANDRA PSYD	11/18/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
119152	Fee-for-Service	1750540498	1750540498	1	1	IRFAN AHMED MD	9/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3555 S VAL VISTA DR	None	GILBERT	AZ	85297	7323	00	None	33.286572	-111.7527525	Maricopa County
119333	Fee-for-Service	1831103092	1831103092	1	1	IRVING L. SCHWARTZ 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	927 BROADWAY ST	STE 121	QUINCY	IL	62301	2727	00	None	39.93567782	-91.40041752	Adams County
119334	Fee-for-Service	1891355798	1891355798	1	1	IBARRA, BEAIVANA C NP	4/19/2021	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
119455	Fee-for-Service	1447204839	1447204839	1	1	ISBELL, EARL S MD	8/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	34651	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
119673	Fee-for-Service	1659720811	1659720811	1	1	IGNACIO M. CARRILLO-NUNEZ, M	5/11/2020	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	None	13	Neurology (M.D. only)	0	In state provider	D A PROFESSIONAL CORPORA	18111 BROOKHURST	STE 6200	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
119676	Fee-for-Service	1043771769	1043771769	1	1	IYENGAR, RAHUL S MD	7/18/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	181423	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
119859	Fee-for-Service	1164693511	1164693511	1	1	ISLAM, SUMAIYA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	515 N MESA DR	None	MESA	AZ	85201	5914	00	None	33.424767	-111.8219445	Maricopa County
120089	Fee-for-Service	1720254311	1720254311	1	1	INDEPENDENT LIFE MEDICAL	4/4/2011	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	SUPPLIES LLC	2036 BLAKE ST	None	BERKELEY	CA	94704	2604	01	06001	37.86293275	-122.2681615	Alameda County
120299	Fee-for-Service	1053180307	1053180307	1	1	INLAND VALLEY DRUG AND ALCOH	3/27/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1874 BUSINESS CENTER DR	None	SAN BERNARDINO	CA	92408	3457	36	06071	34.06853739	-117.2814025	San Bernardino County
120317	Fee-for-Service	1790768794	1790768794	1	1	IMAMOTO, NANCY T	1/30/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	17801 PIONEER BLVD	STE F	ARTESIA	CA	90701	3962	19	06037	33.8693187	-118.0823685	Los Angeles County
120590	Fee-for-Service	1366048019	1366048019	2	1	INSPIRE DIAGNOSTICS LLC	4/7/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	26497 RANCHO PKWY S	None	LAKE FOREST	CA	92630	8326	30	06059	33.67489856	-117.6723891	Orange County
120735	Fee-for-Service	1194176735	1194176735	1	1	IOANNIDES, KIMON L MD	5/7/2019	207P00000X	NA	Other	026	PHYSICIANS	160874	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
120736	Fee-for-Service	1750498093	1750498093	1	2	IMAGING HEALTHCARE SPEC	12/29/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP INC	855 3RD AVE	STE 1110	CHULA VISTA	CA	91911	1350	37	06073	32.62197574	-117.0723222	San Diego County
120821	Fee-for-Service	1275859373	1275859373	1	1	INLAND GASTROENTEROLOGY	11/10/2010	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL ASSOCIATES INC	10408 INDUSTRIAL CIR	None	REDLANDS	CA	92374	4548	36	06071	34.06469012	-117.2361582	San Bernardino County
121049	Fee-for-Service	1073744660	1073744660	1	1	INLAND VALLEY DRUG AND	11/13/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	939 N D ST	BLDGS A, B	SN BERNRDNO	CA	92410	3519	36	06071	34.116534	-117.2918645	San Bernardino County
121070	Fee-for-Service	1538487608	1538487608	1	2	INTERVENTIONAL PAIN SOLUTION	1/26/2024	208VP0014X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	S PC	605 W EAST AVE	None	CHICO	CA	95926	7201	04	06007	39.75094119	-121.8710492	Butte County
121110	Fee-for-Service	1275859373	1275859373	1	1	INLAND GASTROENTEROLOGY	11/10/2010	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	MEDICAL ASSOCIATES INC	10408 INDUSTRIAL CIR	None	REDLANDS	CA	92374	4548	36	06071	34.06469012	-117.2361582	San Bernardino County
121229	Fee-for-Service	1578535761	1578535761	1	1	INDRA SINGH	10/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1400 8TH AVE	None	FORT WORTH	TX	76104	4110	00	None	32.72995601	-97.34376587	Tarrant County
121302	Fee-for-Service	1326361775	1326361775	1	1	IIDA, WANDA M MD	5/19/2014	207L00000X	NA	Other	026	PHYSICIANS	45188	05	Anesthesiology	0	In state provider	None	2900 EUREKA WAY	None	REDDING	CA	96001	0220	45	06089	40.58549966	-122.4167649	Shasta County
121427	Fee-for-Service	1821030446	1821030446	1	1	INDIAN HEALTH COUNCIL, INC	4/3/2019	332800000X	NA	Indian Health Care Provider	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY	50100 GOLSH RD	None	VALLEY CENTER	CA	92082	5338	37	06073	33.27715948	-116.9618201	San Diego County
121431	Fee-for-Service	1508262213	1508262213	1	21	INFUSION4HEALTH	7/15/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3300 WEBSTER STREET	SUITE 900	OAKLAND	CA	94609	3156	01	06001	37.82132826	-122.2621843	Alameda County
121649	Fee-for-Service	1619326048	1619326048	1	1	ICON MEDICAL SOLUTIONS CORP	10/21/2019	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	40 SPRUCE ST	STE 202	LEOMINSTER	MA	01453	3367	00	None	42.526512	-71.7546555	Worcester County
121650	Fee-for-Service	1659554509	1659554509	1	1	IKEDILO, ADANNA O	4/9/2012	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	116330	None	None	0	In state provider	None	1101 N CHERRY ST	None	TULARE	CA	93274	2231	54	06107	36.22333808	-119.337575	Tulare County
121714	Fee-for-Service	1124006838	1124006838	1	1	INGAGLIO, JAMES J MD	10/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	66694	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
121926	Fee-for-Service	1841339165	1841339165	2	1	IOFEL, RINA DO	2/9/2022	207QG0300X	NA	Adult Primary Care	026	PHYSICIANS	8645	None	None	0	In state provider	None	6234 FOUNTAIN	B	LOS ANGELES	CA	90028	8214	19	06037	34.094347	-118.3252354	Los Angeles County
122004	Fee-for-Service	1417988379	1417988379	1	1	INLAND EMPIRE GASTRO	12/19/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INLAND VALLEY GASTRO MED	40404 CALIFORNIA OAKS RD	STE C	MURRIETA	CA	92562	5786	33	06065	33.57857707	-117.1998797	Riverside County
122329	Fee-for-Service	1528481546	1528481546	1	1	IBRAHIM, DINA R M OD	3/20/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
122398	Fee-for-Service	1841980489	1841980489	1	1	INLAND EMPIRE COUNSELING	3/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	141 N ARROWHEAD AVE	SUITE 5	SAN BERNARDINO	CA	92408	1016	36	06071	34.101522	-117.289612	San Bernardino County
122518	Fee-for-Service	1609407402	1609407402	1	1	INTERIANO, ALEXANDER L CNP	4/9/2021	363L00000X	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
122532	Fee-for-Service	1205022969	1205022969	1	1	IKOSSI, DANAGRA G MD	9/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80883	02	General Surgery	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
122669	Fee-for-Service	1841384500	1841384500	1	1	ITO, ANGIE LCSW	5/11/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1434 THIRD ST	SUITE 3D	NAPA	CA	94559	2891	28	06055	38.29592269	-122.2881544	Napa County
122670	Fee-for-Service	1447831219	1447831219	1	3	INTIMATE JOURNEY BIRTH & WEL	5/14/2021	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	LNESS	4251 S HIGUERA ST	STE 300	SAN LUIS OBISPO	CA	93401	7700	40	06079	35.24181209	-120.6767798	San Luis Obispo County
122953	Fee-for-Service	1164454666	1164454666	1	1	IRVINE EMERGENCY PHYS	8/22/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL GROUP	16200 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.6617581	-117.7736362	Orange County
123079	Fee-for-Service	1871871723	1871871723	1	1	INPATIENT SERVICES OF	12/1/2011	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CALIFORNIA INC	768 MOUNTAIN RANCH ROAD	None	SAN ANDREAS	CA	95249	9707	05	06009	38.19058212	-120.6709481	Calaveras County
123241	Fee-for-Service	1598754533	1598754533	1	1	IRINA NISTOR MD	5/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9003 E SHEA BLVD	None	SCOTTSDALE	AZ	85260	6709	00	None	33.580377	-111.88548	Maricopa County
123319	Fee-for-Service	1558356014	1558356014	1	1	ISSA, SAMI A MD	4/28/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	48020	08	Family Practice	0	In state provider	None	7011 N HOWARD ST	STE 201	FRESNO	CA	93720	2955	10	06019	36.8382219	-119.783793	Fresno County
123440	Fee-for-Service	1720032998	1720032998	1	2	IN HOME HEALTH LLC	6/10/2009	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	824 BAY AVENUE	STE 40	CAPITOLA	CA	95010	2925	44	06087	36.98166938	-121.9559707	Santa Cruz County
123618	Fee-for-Service	1225565104	1225565104	1	1	IMPERIO, SHERWIN NP	4/20/2018	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4510 E PACIFIC COAST	STE 120	LONG BEACH	CA	90804	6939	19	06037	33.78815204	-118.1400821	Los Angeles County
123654	Fee-for-Service	1275863144	1275863144	1	1	ISLAND, MILTON L LCSW	6/29/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25000 AVENUE STANFORD	167	VALENCIA	CA	91355	4553	19	06037	34.43847322	-118.5729968	Los Angeles County
123730	Fee-for-Service	1720032998	1720032998	1	2	IN HOME HEALTH LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	824 BAY AVENUE	STE 40	CAPITOLA	CA	95010	2925	44	06087	36.98166938	-121.9559707	Santa Cruz County
123789	Fee-for-Service	1083622567	1083622567	1	3	INLAND EYE SPECIALSTS	12/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	31950 HWY 79 SOUTH	STE B7	TEMECULA	CA	92592	9497	33	06065	33.48073126	-117.1004408	Riverside County
124062	Fee-for-Service	1245213859	1245213859	1	1	ISHIDA, WARREN Y MD	5/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	35545	14	Neurological Surgery	0	In state provider	None	300 UCLA MEDICAL PLZ	STE 200	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
124126	Fee-for-Service	1508262213	1508262213	1	23	INFUSION4HEALTH	4/10/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1400 REYNOLDS AVE	SUITE 201	IRVINE	CA	92614	5563	30	06059	33.6957272	-117.8542013	Orange County
124131	Fee-for-Service	1952822868	1952822868	1	1	IYER, VARSHNI R MD	11/4/2020	390200000X	NA	Other	026	PHYSICIANS	169983	40	Pediatrics	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
124156	Fee-for-Service	1548229750	1548229750	1	1	IIDA, CALVIN T MD	5/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
124482	Fee-for-Service	1275581894	1275581894	1	1	IMPERIAL VALLEY FAMILY	5/10/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	CARE MEDICAL GROUP	1550 N IMPERIAL AVE	None	EL CENTRO	CA	92243	6304	13	06025	32.80696546	-115.5702795	Imperial County
124679	Fee-for-Service	1437296613	1437296613	1	1	IKEFUGI, TAE K OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	410 W CENTRAL AVE	STE 109	BREA	CA	92821	3009	30	06059	33.93194416	-117.9031642	Orange County
124709	Fee-for-Service	1487728085	1487728085	1	1	INOUYE, GRACE R MD	7/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	47880	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
124743	Fee-for-Service	1205884517	1205884517	1	1	ISCOVICH, ANGEL L MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42205	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
124768	Fee-for-Service	1275581894	1275581894	1	1	IMPERIAL VALLEY FAMILY	5/10/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	CARE MEDICAL GROUP	1550 N IMPERIAL AVE	None	EL CENTRO	CA	92243	6304	13	06025	32.80696546	-115.5702795	Imperial County
124859	Fee-for-Service	1427605948	1427605948	1	1	INGMAN, NICKLAUS PT	10/28/2019	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
124997	Fee-for-Service	1598728040	1598728040	1	1	IMPERIAL VALLEY EMERG	11/1/1992	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	PHYSICIANS MED GROUP	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
125021	Fee-for-Service	1255581245	1255581245	1	1	INTAL, JORGE I LAC	12/29/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
125055	Fee-for-Service	1275581894	1275581894	1	1	IMPERIAL VALLEY FAMILY	5/10/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	CARE MEDICAL GROUP	1550 N IMPERIAL AVE	None	EL CENTRO	CA	92243	6304	13	06025	32.80696546	-115.5702795	Imperial County
125093	Fee-for-Service	1275581894	1275581894	1	7	IMPERIAL VALLEY FAMILY	12/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CARE MEDICAL GROUP APC	516 W ATEN RD	STE 1	IMPERIAL	CA	92251	9805	13	06025	32.82558069	-115.5814237	Imperial County
125119	Fee-for-Service	1306840186	1306840186	1	2	IMADA, DIXIE H	6/8/2015	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	24111 SNIPE LANE	None	LAGUNA NIGUEL	CA	92677	1313	30	06059	33.54051203	-117.7096366	Orange County
125147	Fee-for-Service	1790772572	1790772572	1	1	ISAIAS, AGNELA TERESA MD	6/7/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82912	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
125262	Fee-for-Service	1306332051	1306332051	1	1	IGNACIO, DANIEL A LMFT	1/1/2023	390200000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	305 NORTH HARBOR BOULEVA	#202	FULLERTON	CA	92832	1901	30	06059	33.872697	-117.924428	Orange County
125348	Fee-for-Service	1811983232	1811983232	1	1	IBRAHEEM, LAJA I MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66124	01	General Practice	0	In state provider	RENEW BEHAVIORL HLTH INC	4000 LONG BEACH BLVD	STE 228	LONG BEACH	CA	90807	2617	19	06037	33.830928	-118.189321	Los Angeles County
125382	Fee-for-Service	1275581894	1275581894	1	7	IMPERIAL VALLEY FAMILY	12/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	CARE MEDICAL GROUP APC	516 W ATEN RD	STE 1	IMPERIAL	CA	92251	9805	13	06025	32.82558069	-115.5814237	Imperial County
125477	Fee-for-Service	1437667094	1437667094	1	1	INLAND EMPIRE PHARMACY	3/6/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1535 E HIGHLAND AVE	STE A	SAN BERNARDINO	CA	92404	4682	36	06071	34.13583151	-117.253485	San Bernardino County
125638	Fee-for-Service	1811983232	1811983232	1	1	IBRAHEEM, LAJA I MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66124	36	Psychiatry	0	In state provider	RENEW BEHAVIORL HLTH INC	4000 LONG BEACH BLVD	STE 228	LONG BEACH	CA	90807	2617	19	06037	33.830928	-118.189321	Los Angeles County
125667	Fee-for-Service	1275581894	1275581894	1	7	IMPERIAL VALLEY FAMILY	12/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	CARE MEDICAL GROUP APC	516 W ATEN RD	STE 1	IMPERIAL	CA	92251	9805	13	06025	32.82558069	-115.5814237	Imperial County
125672	Fee-for-Service	1063105161	1063105161	1	1	ISIP, JOSEPHINE PT	6/21/2023	225100000X	NA	Physical Therapist	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
125698	Fee-for-Service	1821033622	1821033622	1	1	IYENGAR, GEETA V MD	4/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103202	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
125729	Fee-for-Service	1598722233	1598722233	1	1	IVAN WILMOT, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3333 BURNET AVE	None	CINCINNATI	OH	45229	3026	00	None	39.14105892	-84.50040782	Hamilton County
125886	Fee-for-Service	1013947712	1013947712	1	1	INFECTIOUS DISEASE CONSU	10/26/1981	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	MEDICAL GROUP	435 ARDEN AVE	STE 350	GLENDALE	CA	91203	4018	19	06037	34.15848148	-118.2628845	Los Angeles County
125907	Fee-for-Service	1083325625	1083325625	1	1	ISH GULATI MD INC	11/22/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	1830 FLOWER STREET	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
126395	Fee-for-Service	1376983429	1376983429	1	1	IRVINE, LESLIE E MD	5/21/2018	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	125702	04	Otology, Laryngology, Rhinology	0	In state provider	None	222 W PUEBLO ST	SUITE A	SANTA BARBARA	CA	93105	3805	42	06083	34.43099377	-119.7214822	Santa Barbara County
126400	Fee-for-Service	1801178843	1801178843	1	2	IZADI, FARANAK F	12/20/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7921 KINGSWOOD DR	A2-C	CITRUS HEIGHTS	CA	95610	7710	34	06067	38.670192	-121.2705855	Sacramento County
126507	Fee-for-Service	1649473695	1649473695	1	2	IMPERIAL VALLEY MEDICAL	12/6/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	200 S 5TH ST	None	EL CENTRO	CA	92243	3013	13	06025	32.791482	-115.554748	Imperial County
126627	Fee-for-Service	1285791954	1285791954	1	1	INTEGRATED THERAPIES, A FAMI	1/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LY COUNSELING CORPORAT	20601 US HIGHWAY 18	STE 158	APPLE VALLEY	CA	92307	3567	36	06071	34.52356839	-117.217061	San Bernardino County
126772	Fee-for-Service	1295117299	1295117299	1	1	INLAND FACULTY SPECIALIST A	5/27/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4153 RUBIDOUX AVENUE	None	RIVERSIDE	CA	92506	1717	33	06065	33.96186386	-117.3969958	Riverside County
127016	Fee-for-Service	1891790705	1891790705	1	1	INCERPI, MARC H MD	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77155	01	General Practice	0	In state provider	None	2701 W ALAMEDA AVE	STE 308	BURBANK	CA	91505	4408	19	06037	34.15751343	-118.3303715	Los Angeles County
127025	Fee-for-Service	1992760821	1992760821	1	1	IZUEGBUNAM, GODWIN C MD	10/19/2004	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2735 SILVER CREEK RD	None	BULLHEAD CITY	AZ	86442	7924	00	None	35.110926	-114.5552445	Mohave County
127069	Fee-for-Service	1699767400	1699767400	1	1	ITSARA, SUDJAI MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	38082	40	Pediatrics	0	In state provider	None	305 E GRANGER AVE	STE 201	MODESTO	CA	95350	4344	50	06099	37.66729751	-120.9891555	Stanislaus County
127305	Fee-for-Service	1891790705	1891790705	1	1	INCERPI, MARC H MD	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77155	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2701 W ALAMEDA AVE	STE 308	BURBANK	CA	91505	4408	19	06037	34.15751343	-118.3303715	Los Angeles County
127709	Fee-for-Service	1487167748	1487167748	1	1	ISRAEL, RACHEL L CNM	3/20/2018	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
127854	Fee-for-Service	1750325098	1750325098	1	1	INGLEWOOD FAMILY MEDICAL	4/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	61290	08	Family Practice	0	In state provider	CLINIC	3215 W IMPERIAL HWY	None	INGLEWOOD	CA	90303	2810	19	06037	33.93103349	-118.3290615	Los Angeles County
128141	Fee-for-Service	1750325098	1750325098	1	1	INGLEWOOD FAMILY MEDICAL	4/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	61290	66	Emergency Medicine (Urgent Care)	0	In state provider	CLINIC	3215 W IMPERIAL HWY	None	INGLEWOOD	CA	90303	2810	19	06037	33.93103349	-118.3290615	Los Angeles County
128192	Fee-for-Service	1982954871	1982954871	1	1	INNOVATIVE DIALYSIS CENTERS	9/5/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	OF LA JOLLA LLC	2082 OTAY LAKES RD	SUITE A1	CHULA VISTA	CA	91915	1367	37	06073	32.64495607	-116.9729801	San Diego County
128285	Fee-for-Service	1679531990	1679531990	1	1	INFOSINO, ANDREW MD	11/30/1991	207L00000X	NA	Other	026	PHYSICIANS	74606	05	Anesthesiology	0	In state provider	S.F.I.A. MEDICAL GROUP	SF INTERNATIONAL AIRPORT	None	SAN FRANCISCO	CA	94128	0000	38	06075	0	0	None
128528	Fee-for-Service	1255979233	1255979233	1	1	INNOVATIVE CARE PARTNERS	3/7/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1307 WESTWOOD BLVD	#203B	LOS ANGELES	CA	90024	4984	19	06037	34.0568799	-118.4428066	Los Angeles County
128568	Fee-for-Service	1679531990	1679531990	1	1	INFOSINO, ANDREW MD	11/30/1991	207L00000X	NA	Other	026	PHYSICIANS	74606	01	General Practice	0	In state provider	S.F.I.A. MEDICAL GROUP	SF INTERNATIONAL AIRPORT	None	SAN FRANCISCO	CA	94128	0000	38	06075	0	0	None
128635	Fee-for-Service	1316086739	1316086739	1	1	INLAND VALLEY DRUG AND	11/13/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ALCOHOL RECOVERY SERVICE	934 N MOUNTAIN AVE	SUITE A,B,C,D	UPLAND	CA	91786	3659	36	06071	34.105644	-117.670191	San Bernardino County
128639	Fee-for-Service	1396099800	1396099800	1	1	INADOMI, SUZAN C OD	8/14/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3772 HOWE ST	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
128771	Fee-for-Service	1740271832	1740271832	2	1	ITO, SARAH K OD	8/27/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2605 LINCOLN BLVD	None	SANTA MONICA	CA	90405	4619	19	06037	34.00650909	-118.4756227	Los Angeles County
128797	Fee-for-Service	1922775709	1922775709	1	1	ICAZA, ANDREA AU	1/27/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	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
128804	Fee-for-Service	1932125044	1932125044	1	1	ISHIYAMA, AKIRA MD	3/31/1996	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	74490	84	Surgery-Head and Neck	0	In state provider	None	200 MEDICAL PLAZA	STE 550	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
128840	Fee-for-Service	1205911716	1205911716	1	1	INTERVENTIONAL PAIN	5/13/2005	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER OF MERCED	1390 E YOSEMITE AVE	STE C	MERCED	CA	95340	8221	24	06047	37.33211251	-120.452175	Merced County
128849	Fee-for-Service	1245735786	1245735786	1	1	INFINITY HOMECARE AGENCY INC	12/17/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7050 OWENSMOUTH AVE	STE 210	CANOGA PARK	CA	91303	4228	19	06037	34.19870174	-118.6015313	Los Angeles County
128863	Fee-for-Service	1447671185	1447671185	1	1	IMAGIWILL MED CO	3/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	109527	36	Psychiatry	0	In state provider	None	7850 VISTA HILL AVE	None	SAN DIEGO	CA	92123	2717	37	06073	32.79493052	-117.155268	San Diego County
128935	Fee-for-Service	1871267005	1871267005	1	1	IBAY, MAIKO D OT	10/15/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1085 W EL CAMINO REAL	None	SUNNYVALE	CA	94087	1030	43	06085	37.37270741	-122.0517412	Santa Clara County
129349	Fee-for-Service	1225036742	1225036742	1	1	IJAZ, TAHIR MD	6/26/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	52748	78	Neoplastic Diseases/Oncology	0	In state provider	None	2466 1ST AVE	# B	SAN DIEGO	CA	92101	1408	37	06073	32.731137	-117.1639695	San Diego County
129453	Fee-for-Service	1740059088	1740059088	1	1	INLAND VALLEY DRUG AND ALCOH	3/21/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ER	1076 S SANTO ANTONIO DR	BC&D	COLTON	CA	92324	8103	36	06071	34.05132194	-117.3108309	San Bernardino County
129636	Fee-for-Service	1225036742	1225036742	1	1	IJAZ, TAHIR MD	6/26/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	52748	30	Radiology	0	In state provider	None	2466 1ST AVE	# B	SAN DIEGO	CA	92101	1408	37	06073	32.731137	-117.1639695	San Diego County
129719	Fee-for-Service	1740711589	1740711589	1	1	ICHWAN, DANIEL J MD	5/14/2020	207P00000X	NA	Other	026	PHYSICIANS	157952	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5250 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91601	3186	19	06037	34.1665161	-118.3755868	Los Angeles County
129757	Fee-for-Service	1023060811	1023060811	1	1	IQBAL, JAVED MD	3/15/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	72647	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
129854	Fee-for-Service	1962089573	1962089573	1	1	ITOH, RYAN MD	10/17/2023	207P00000X	NA	Other	026	PHYSICIANS	187158	None	None	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
129875	Fee-for-Service	1922006188	1922006188	1	1	IZENBERG, ROBERT A MD	6/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	58288	02	General Surgery	0	In state provider	None	1001 POTRERO AVE	RM 3A37	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
130070	Fee-for-Service	1235684879	1235684879	1	1	IBARRA, JOSEPH A OD	9/12/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15330 AMAR RD	STE A	LA PUENTE	CA	91744	2001	19	06037	34.03714077	-117.9509701	Los Angeles County
130167	Fee-for-Service	1902639925	1902639925	1	1	INWARD HEALING THERAPY LICEN	10/18/2024	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	5252 BALBOA AVE	STE 801	SAN DIEGO	CA	92117	6970	37	06073	32.81892468	-117.1833243	San Diego County
130188	Fee-for-Service	1164516944	1164516944	1	1	IWAI, DINA M MD	9/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71762	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
130356	Fee-for-Service	1326115205	1326115205	1	1	ISSAKHANIAN, MARIKA MD	5/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	61511	13	Neurology (M.D. only)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
130454	Fee-for-Service	1902639925	1902639925	1	1	INWARD HEALING THERAPY LICEN	10/18/2024	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	5252 BALBOA AVE	STE 801	SAN DIEGO	CA	92117	6970	37	06073	32.81892468	-117.1833243	San Diego County
130509	Fee-for-Service	1235239385	1235239385	1	1	INOUYE, LIANNE C OD	11/30/1991	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3450 PALMER DR	STE 5	CAMERON PARK	CA	95682	8273	09	06017	38.66241514	-120.9675195	El Dorado County
130655	Fee-for-Service	1700246360	1700246360	2	1	IMGRX SALUD, INC	9/17/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	500B JEFFERSON BLVD	SUITE 181	WEST SACRAMENTO	CA	95605	2349	57	06113	38.58811316	-121.5270471	Yolo County
130705	Fee-for-Service	1598008344	1598008344	1	1	IRIANA, SENTIA MD	9/14/2022	207R00000X	NA	Other	026	PHYSICIANS	136769	None	None	0	In state provider	None	25775 MCBEAN PKWY	202, 215	VALENCIA	CA	91355	3702	19	06037	34.40042013	-118.5511416	Los Angeles County
130901	Fee-for-Service	1679551436	1679551436	1	1	ISRAELIT,ARNOLD H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5314 NE IRVING STREET	None	PORTLAND	OR	97213	0000	00	None	45.52818061	-122.6081458	Multnomah County
130904	Fee-for-Service	1245458959	1245458959	1	1	IBARRA, PEGGY C MD	1/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97468	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
131007	Fee-for-Service	1356305551	1356305551	1	1	ISAACSON, JOSEPH M MD	1/1/1982	207RR0500X	NA	Other	026	PHYSICIANS	40276	03	Allergy	0	In state provider	None	3002 LEIGH AVE	STE 100	SAN JOSE	CA	95124	2202	43	06085	37.26639	-121.9223435	Santa Clara County
131101	Fee-for-Service	1134947583	1134947583	1	1	IBARRA, XOCHITL N PT	12/23/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3191 MISSION INN AVE	B	RIVERSIDE	CA	92507	4187	33	06065	33.98015514	-117.3677324	Riverside County
131295	Fee-for-Service	1356305551	1356305551	1	1	ISAACSON, JOSEPH M MD	1/1/1982	207RR0500X	NA	Other	026	PHYSICIANS	40276	83	Rheumatology	0	In state provider	None	3002 LEIGH AVE	STE 100	SAN JOSE	CA	95124	2202	43	06085	37.26639	-121.9223435	Santa Clara County
131424	Fee-for-Service	1619313400	1619313400	1	1	IRELAND, LAURA M MD	4/30/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	159823	08	Family Practice	0	In state provider	None	3130 DEL MONTE BLVD	None	MARINA	CA	93933	3047	27	06053	36.68590557	-121.8010492	Monterey County
131584	Fee-for-Service	1356305551	1356305551	1	1	ISAACSON, JOSEPH M MD	1/1/1982	207RR0500X	NA	Other	026	PHYSICIANS	40276	41	Internal Medicine	0	In state provider	None	3002 LEIGH AVE	STE 100	SAN JOSE	CA	95124	2202	43	06085	37.26639	-121.9223435	Santa Clara County
131607	Fee-for-Service	1013213842	1013213842	1	1	IMMITT, JESSICA C LCSW	4/29/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3990 WALNUT DR	None	EUREKA	CA	95503	6257	12	06023	40.77005113	-124.1430432	Humboldt County
131620	Fee-for-Service	1265038863	1265038863	1	1	INFLUENTIAL HOME HEALTH INC	4/22/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	19634 VENTURA BLVD	STE 215	TARZANA	CA	91356	7139	19	06037	34.17264197	-118.5613482	Los Angeles County
131695	Fee-for-Service	1114307923	1114307923	2	1	INJOY RX LLC	8/23/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	14676 PIPELINE AVE	SUITE M	CHINO HILLS	CA	91709	1918	36	06071	33.98681089	-117.7152991	San Bernardino County
131765	Fee-for-Service	1972553618	1972553618	1	1	INAMDAR, MADHURI	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77828	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
131798	Fee-for-Service	1629748272	1629748272	1	1	IMPACT COUNSELING GROUP INC	11/11/2023	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	355 GRAND AVE	2450	LOS ANGELES	CA	90071	1560	19	06037	34.05193094	-118.2524437	Los Angeles County
132083	Fee-for-Service	1629748272	1629748272	1	1	IMPACT COUNSELING GROUP INC	11/11/2023	193200000X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	355 GRAND AVE	2450	LOS ANGELES	CA	90071	1560	19	06037	34.05193094	-118.2524437	Los Angeles County
132096	Fee-for-Service	1639487374	1639487374	1	1	INOMAA-BUSTILLOS, ELISABETH	6/13/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYD	29995 TECHNOLOGY DR	STE 103	MURRIETA	CA	92563	2633	33	06065	33.56041691	-117.1370428	Riverside County
132140	Fee-for-Service	1154594885	1154594885	1	2	IKEDA, ALAN	11/5/2024	2080P0207X	NA	Hematology	026	PHYSICIANS	91914	40	Pediatrics	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
132428	Fee-for-Service	1154594885	1154594885	1	2	IKEDA, ALAN	11/5/2024	2080P0207X	NA	Hematology	026	PHYSICIANS	91914	68	Hematology	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
132571	Fee-for-Service	1154763720	1154763720	1	1	INSORIO, ALDRIN T MD	4/22/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	160052	40	Pediatrics	0	In state provider	None	500 40TH STREET	None	BAKERSFIELD	CA	93301	1224	15	06029	35.39619932	-119.0074457	Kern County
132659	Fee-for-Service	1649245366	1649245366	1	1	IHNAT, DANIEL 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	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
133139	Fee-for-Service	1528143401	1528143401	1	1	IMPROVEMENT PROGRAMS INC	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	SOUTH OF MARKET HLTH CTR	229 7TH STREET	None	SAN FRANCISCO	CA	94103	4003	38	06075	37.77745513	-122.4086852	San Francisco County
133211	Fee-for-Service	1881253680	1881253680	1	1	ISHIDA, HEATHER LCSW	4/18/2022	104100000X	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
133285	Fee-for-Service	1508295502	1508295502	1	1	IMPERIAL VALLEY FAMILY CARE	5/8/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP APC	608 G STREET	STE 1-A	BRAWLEY	CA	92227	2567	13	06025	32.97749255	-115.5318435	Imperial County
133310	Fee-for-Service	1962611897	1962611897	1	1	INFANTE, SERGIO MD	11/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98495	47	Miscellaneous	0	In state provider	LIMITED PARTNERSHIP	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
133424	Fee-for-Service	1255759981	1255759981	1	1	ISSA, REDA MD	3/4/2021	207WX0107X	NA	Ophthalmology	026	PHYSICIANS	170817	None	None	0	In state provider	None	41900 WINCHESTER RD	SUITE 201	TEMECULA	CA	92590	3403	33	06065	33.51467986	-117.1703489	Riverside County
133571	Fee-for-Service	1750348033	1750348033	1	1	IMPERIAL VALLEY FAMILY	1/1/1997	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	CARE MEDICAL GROUP	516 W ATEN RD	STE 3	IMPERIAL	CA	92251	9805	13	06025	32.82558069	-115.5814237	Imperial County
133573	Fee-for-Service	1508295502	1508295502	1	1	IMPERIAL VALLEY FAMILY CARE	5/8/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP APC	608 G STREET	STE 1-A	BRAWLEY	CA	92227	2567	13	06025	32.97749255	-115.5318435	Imperial County
133671	Fee-for-Service	1174803431	1174803431	1	1	ISHIKAWA, KARA Y MD	11/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125507	01	General Practice	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
134076	Fee-for-Service	1871685867	1871685867	1	1	IVERSON, LEIGH I MD	2/1/1984	208G00000X	NA	General Surgery	026	PHYSICIANS	14929	01	General Practice	0	In state provider	None	3120 WEBSTER ST	None	OAKLAND	CA	94609	3421	01	06001	37.8200052	-122.2631081	Alameda County
134482	Fee-for-Service	1992063358	1992063358	1	1	IRANMAHBOOB, AMIR K MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147677	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
134584	Fee-for-Service	1477549608	1477549608	1	1	ISBELL, MAY Y OD	9/23/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1749	19	06037	34.0696407	-118.3836988	Los Angeles County
134608	Fee-for-Service	1245767102	1245767102	1	1	IDEAL URGENT CARE A MEDICAL	5/7/2020	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	CORPORATION	4182 N 1ST ST STE 105	None	FRESNO	CA	93726	4300	10	06019	36.79423917	-119.7720356	Fresno County
134813	Fee-for-Service	1700583440	1700583440	1	2	INSPIRE MEDICAL GROUP OF CAL	11/7/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	IFORNIA PC	2730 WILSHIRE BOULEVARD	SUITE 425	SANTA MONICA	CA	90403	4747	19	06037	34.037223	-118.4759177	Los Angeles County
134870	Fee-for-Service	1992856934	1992856934	1	1	ITO, THOMAS	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
134899	Fee-for-Service	1245767102	1245767102	1	1	IDEAL URGENT CARE A MEDICAL	5/7/2020	261QU0200X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	4182 N 1ST ST STE 105	None	FRESNO	CA	93726	4300	10	06019	36.79423917	-119.7720356	Fresno County
134997	Fee-for-Service	1285205526	1285205526	1	1	INTENSE HOME HEALTH INC	8/10/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	640 S HILL ST	STE 561	LOS ANGELES	CA	90014	4701	19	06037	34.04633381	-118.2540393	Los Angeles County
135013	Fee-for-Service	1467427377	1467427377	1	1	INSIGHT HEALTH CORP.	4/25/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NG CENTER	21828 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.829101	-118.299183	Los Angeles County
135042	Fee-for-Service	1245873140	1245873140	1	1	IHS PHARMACY LLC	11/18/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4401 S MAIN ST	None	LOS ANGELES	CA	90037	2731	19	06037	34.003368	-118.2740375	Los Angeles County
135103	Fee-for-Service	1700583440	1700583440	1	2	INSPIRE MEDICAL GROUP OF CAL	11/7/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	IFORNIA PC	2730 WILSHIRE BOULEVARD	SUITE 425	SANTA MONICA	CA	90403	4747	19	06037	34.037223	-118.4759177	Los Angeles County
135390	Fee-for-Service	1700583440	1700583440	1	2	INSPIRE MEDICAL GROUP OF CAL	11/7/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	IFORNIA PC	2730 WILSHIRE BOULEVARD	SUITE 425	SANTA MONICA	CA	90403	4747	19	06037	34.037223	-118.4759177	Los Angeles County
135476	Fee-for-Service	1700536315	1700536315	1	1	INSPIREMD, INC.	1/9/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	1300 N VERMONT AVE	SUITE 506	LOS ANGELES	CA	90027	0000	19	06037	34.0956033	-118.2916918	Los Angeles County
135494	Fee-for-Service	1497991848	1497991848	1	1	ILDIKO,HRABOVSZKY 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	4500 SANDS POINT WAY	NE STE 100	SEATTLE	WA	98105	0000	00	None	47.66165594	-122.2864502	King County
135546	Fee-for-Service	1245671684	1245671684	2	1	INTERGALACTIC HEALTHCARE INC	7/8/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	15211 VANOWEN ST	SUITE 110	VAN NUYS	CA	91405	3606	19	06037	34.19395411	-118.4642527	Los Angeles County
136200	Fee-for-Service	1679658280	1679658280	1	1	ISHIHARA, KENT K MD	3/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106368	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	1418	34	06067	38.552211	-121.449429	Sacramento County
136243	Fee-for-Service	1023450947	1023450947	1	1	INTERVENTIONAL ANESTHESIA	10/21/2013	207LP2900X	NA	Other	026	PHYSICIANS	89836	05	Anesthesiology	0	In state provider	& PAIN MANAGEMENT CLINIC	1575 N LAKE AVE	STE 100	PASADENA	CA	91104	2340	19	06037	34.17298885	-118.1321076	Los Angeles County
136249	Fee-for-Service	1770063554	1770063554	1	1	IMRAN, MAHA	7/18/2022	208M00000X	NA	Other	026	PHYSICIANS	173694	None	None	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
136319	Fee-for-Service	1285626036	1285626036	1	1	IQBAL, NADEEM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1650 BEAM AVE	STE 200	MAPLEWOOD	MN	55109	1147	00	None	45.02792493	-93.03090563	Ramsey County
136335	Fee-for-Service	1255835096	1255835096	1	1	IMO, OGOCHUKWU A MD	5/17/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	174393	None	None	0	In state provider	None	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	15	06029	35.3687456	-119.1106561	Kern County
136488	Fee-for-Service	1679658280	1679658280	1	1	ISHIHARA, KENT K MD	3/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106368	67	Endocrinology	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	1418	34	06067	38.552211	-121.449429	Sacramento County
136559	Fee-for-Service	1710596762	1710596762	1	1	IYAMU, ROBERTA NP	5/6/2024	363LP0808X	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
136891	Fee-for-Service	1598271991	1598271991	1	1	INGRIM, CHELSEA J AU	7/22/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
136934	Fee-for-Service	1780629493	1780629493	1	1	IP, TZE MD	1/12/2025	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	67002	20	Orthopedic Surgery	0	In state provider	None	22 CORPORATE PLAZA DR	None	NEWPORT BEACH	CA	92660	7985	30	06059	33.607602	-117.876852	Orange County
136971	Fee-for-Service	1629394267	1629394267	1	1	IVAN, YARON MD	2/6/2023	2080P0204X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	657 TOWN CENTER	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
137023	Fee-for-Service	1285096495	1285096495	1	1	ISMAIL, KHADIJA MD	5/14/2020	207P00000X	NA	Other	026	PHYSICIANS	152016	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
137193	Fee-for-Service	1801123690	1801123690	1	1	IYENGAR, JAICHARAN J MD	9/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107127	20	Orthopedic Surgery	0	In state provider	None	2488 N CALIFORNIA ST	None	STOCKTON	CA	95204	5508	39	06077	37.97587328	-121.2911856	San Joaquin County
137376	Fee-for-Service	1417608449	1417608449	1	1	IDYLLIC HOME HEALTH SERVICES	5/20/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2220 W BURBANK BLVD	STE 101	BURBANK	CA	91506	1234	19	06037	34.17959893	-118.3353603	Los Angeles County
137619	Fee-for-Service	1497919641	1497919641	1	1	ISHIMITSU, DAVID N MD	2/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	99383	None	None	0	In state provider	None	8700 BEVERLY BLVD	M 335	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
137710	Fee-for-Service	1477722726	1477722726	1	2	ISALES, CARMELO LMFT	5/10/2023	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	29970 TECHNOLOGY DRIVE	STE 105 B	MURRIETA	CA	92563	5855	33	06065	33.5604702	-117.1370275	Riverside County
137767	Fee-for-Service	1518987825	1518987825	1	1	IM, CAROL Y MD	7/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80693	40	Pediatrics	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
137876	Fee-for-Service	1841379997	1841379997	1	1	ISHII, TOYOHISA T MD	10/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	27949	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
137968	Fee-for-Service	1811135866	1811135866	1	1	I-ADARP, INC	8/29/2016	193400000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	8330 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91605	1615	19	06037	34.2217725	-118.3873405	Los Angeles County
137997	Fee-for-Service	1659858090	1659858090	1	1	IECMG INC	2/25/2020	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	ICAL GROUP INC	7101 MAGNOLIA AVE	A	RIVERSIDE	CA	92504	3843	33	06065	33.94582085	-117.4021968	Riverside County
138192	Fee-for-Service	1679138382	1679138382	1	1	ISOLA, PATRICK MD	9/9/2024	207L00000X	NA	Other	026	PHYSICIANS	180981	05	Anesthesiology	0	In state provider	None	5530 BIRDCAGE ST	STE 145	CITRUS HEIGHTS	CA	95610	7690	34	06067	38.667744	-121.273758	Sacramento County
138552	Fee-for-Service	1437527348	1437527348	1	1	INDUKURI, SUSHMA MD	3/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137942	40	Pediatrics	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
138600	Fee-for-Service	1508979519	1508979519	1	1	IKELHEIMER, DOUGLAS M MD	2/21/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	163816	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
138758	Fee-for-Service	1255421319	1255421319	1	1	ITO, CARL J	10/28/2008	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8939 LA MESA BLVD	SUITE 1	LA MESA	CA	91941	4057	37	06073	32.77474557	-117.0045237	San Diego County
138801	Fee-for-Service	1902403926	1902403926	1	1	INNERHEALTH LABORATORY, INC	3/1/2020	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	30151B AVENIDA DE LAS BA	100	RANCHO SANTA MARG	CA	92688	2114	30	06059	33.63333941	-117.604244	Orange County
138926	Fee-for-Service	1245737709	1245737709	1	1	IBRAHIM, TIMOTHY M MD	8/24/2021	207P00000X	NA	Other	026	PHYSICIANS	164351	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
139012	Fee-for-Service	1639549645	1639549645	1	1	INLAND VALLEY PHARMACY, INC	5/10/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3349 W FLORIDA AVE	None	HEMET	CA	92545	3513	33	06065	33.7473147	-117.0073302	Riverside County
139083	Fee-for-Service	1881312338	1881312338	1	1	IDEAL CHOICE HOME HEALTH	11/14/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE	16161 ROSCOE BLVD	STE 204	NORTH HILLS	CA	91343	6234	19	06037	34.22135353	-118.484667	Los Angeles County
139168	Fee-for-Service	1912669920	1912669920	1	1	IRIBE, JAVIER J OT	10/29/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	15325 FAIRFIELD RANCH RD	STE. 150	CHINO HILLS	CA	91709	8834	36	06071	33.9729714	-117.6918388	San Bernardino County
139311	Fee-for-Service	1902050792	1902050792	1	1	IHDE, LAUREN L MD	6/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	105929	30	Radiology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
139816	Fee-for-Service	1841853330	1841853330	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	2372 STERLING AVE	None	SAN BERNARDINO	CA	92404	4624	36	06071	34.13682	-117.243687	San Bernardino County
139831	Fee-for-Service	1104904853	1104904853	1	1	ISAKSON, GORDON MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	52880	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
139903	Fee-for-Service	1598827495	1598827495	1	1	INNOVATIVE SENIOR	3/18/2011	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	REHABILITATION	2220 W KETTLEMAN LN	None	LODI	CA	95242	4347	39	06077	38.11535848	-121.301487	San Joaquin County
140101	Fee-for-Service	1841853330	1841853330	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	2372 STERLING AVE	None	SAN BERNARDINO	CA	92404	4624	36	06071	34.13682	-117.243687	San Bernardino County
140131	Fee-for-Service	1326275975	1326275975	1	1	ISMAWAN, JOHANES M MD	1/5/2021	207L00000X	NA	Other	026	PHYSICIANS	113980	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
140234	Fee-for-Service	1578294195	1578294195	1	1	IMED HOSPICE	1/11/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	22543 VENTURA BLVD	SUITE 223	WOODLAND HILLS	CA	91364	1451	19	06037	34.16774548	-118.6179242	Los Angeles County
140345	Fee-for-Service	1437400488	1437400488	1	1	INFINITE 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	16200 VENTURA BLVD	SUITE 211	VAN NUYS	CA	91426	2202	19	06037	34.15659457	-118.485532	Los Angeles County
140391	Fee-for-Service	1841853330	1841853330	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC.	2372 STERLING AVE	None	SAN BERNARDINO	CA	92404	4624	36	06071	34.13682	-117.243687	San Bernardino County
140517	Fee-for-Service	1790011310	1790011310	1	1	IVORY HOSPICE INC	2/4/2012	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	233 E POMONA BLVD	SUITE A	MONTEREY PARK	CA	91755	7226	19	06037	34.03362475	-118.1280669	Los Angeles County
140525	Fee-for-Service	1578294195	1578294195	1	1	IMED HOSPICE	1/11/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	22543 VENTURA BLVD	SUITE 223	WOODLAND HILLS	CA	91364	1451	19	06037	34.16774548	-118.6179242	Los Angeles County
140623	Fee-for-Service	1497101216	1497101216	1	1	ISRAEL, TRAVIS R DO	10/14/2021	208600000X	NA	General Surgery	026	PHYSICIANS	18796	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
140628	Fee-for-Service	1659337467	1659337467	1	1	IMPERIAL, EUTIQUIO D MD	4/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84359	05	Anesthesiology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
140633	Fee-for-Service	1437400488	1437400488	1	1	INFINITE HOSPICE CARE INC	5/23/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	16200 VENTURA BLVD	SUITE 211	VAN NUYS	CA	91426	2202	19	06037	34.15659457	-118.485532	Los Angeles County
140676	Fee-for-Service	1043220650	1043220650	1	1	IHC HEALTH SERVICES INC	2/1/1993	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INTERMOUNTAIN MED CTR	5121 SOUTH COTTONWOOD ST	None	MURRAY	UT	84107	5701	00	None	40.659588	-111.891798	Salt Lake County
140678	Fee-for-Service	1841853330	1841853330	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC.	2372 STERLING AVE	None	SAN BERNARDINO	CA	92404	4624	36	06071	34.13682	-117.243687	San Bernardino County
140691	Fee-for-Service	1649455841	1649455841	1	1	IMLER, ERIN L MD	12/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115524	01	General Practice	0	In state provider	None	881 ALMA REAL DRIVE	SUITE 214	PACIFIC PALISADES	CA	90272	3750	19	06037	34.04487687	-118.5250831	Los Angeles County
140803	Fee-for-Service	1790011310	1790011310	1	1	IVORY HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	233 E POMONA BLVD	SUITE A	MONTEREY PARK	CA	91755	7226	19	06037	34.03362475	-118.1280669	Los Angeles County
140962	Fee-for-Service	1043220650	1043220650	1	1	IHC HEALTH SERVICES INC	2/1/1993	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INTERMOUNTAIN MED CTR	5121 SOUTH COTTONWOOD ST	None	MURRAY	UT	84107	5701	00	None	40.659588	-111.891798	Salt Lake County
140965	Fee-for-Service	1841853330	1841853330	1	1	INLAND PSYCHIATRIC MEDICAL G	1/14/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC.	2372 STERLING AVE	None	SAN BERNARDINO	CA	92404	4624	36	06071	34.13682	-117.243687	San Bernardino County
141044	Fee-for-Service	1245630557	1245630557	1	3	INTEGRATIVE SPORTS AND SPINE	6/5/2024	208100000X	NA	Physical Medicine and Rehabilitation	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	INC	7039 ALONDRA BLVD	None	PARAMOUNT	CA	90723	3925	19	06037	33.88919451	-118.175787	Los Angeles County
141319	Fee-for-Service	1558976761	1558976761	1	1	IMGRX SLO, INC.	3/1/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1330 LAS TABLAS	140	TEMPLETON	CA	93465	9758	40	06079	35.55442548	-120.723759	San Luis Obispo County
141425	Fee-for-Service	1972602720	1972602720	1	2	ISACESCU, VALENTIN MD	10/3/2022	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	68103	-	NOT APPLICABLE	0	In state provider	None	1100 SPORTFISHER DRIVE	None	OCEANSIDE	CA	92054	2550	37	06073	33.20107607	-117.3773312	San Diego County
141493	Fee-for-Service	1245630557	1245630557	1	2	INTEGRATIVE SPORTS AND SPINE	6/5/2024	208100000X	NA	Physical Medicine and Rehabilitation	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	INC	401 ADA AVE	None	GLENDORA	CA	91741	4241	19	06037	34.13242449	-117.869571	Los Angeles County
141719	Fee-for-Service	1417375528	1417375528	1	1	ITSARA, MELISSA MD	11/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140042	41	Internal Medicine	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
141922	Fee-for-Service	1710358882	1710358882	1	1	IRANIAN JEWISH SENIOR CENTER	1/1/2016	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1019 S WOOSTER	None	LOS ANGELES	CA	90035	1503	19	06037	34.05870104	-118.3824925	Los Angeles County
141992	Fee-for-Service	1891758231	1891758231	1	1	IMAI, KENT MD	1/10/1996	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	31704	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
142001	Fee-for-Service	1316025984	1316025984	1	1	INGRAHAM, AUBREY O MD	8/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87005	01	General Practice	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
142223	Fee-for-Service	1194085290	1194085290	1	1	ISHAQUE, BRANDON M MD	7/17/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	126413	30	Radiology	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
142598	Fee-for-Service	1962493700	1962493700	2	1	INTEGRATED HEALTH CONCEPTS	9/30/2013	332B00000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	720 AEROVISTA PLACE	SUITE A	SAN LUIS OBISPO	CA	93401	8726	40	06079	35.24137336	-120.6429131	San Luis Obispo County
142616	Fee-for-Service	1477890291	1477890291	1	1	INNOVATIVE DIALYSIS CENTER	1/1/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	OF NORTHRIDGE LLC	18546 ROSCOE BLVD	SUITE 108	NORTHRIDGE	CA	91324	4667	19	06037	34.22069869	-118.537684	Los Angeles County
142654	Fee-for-Service	1912180969	1912180969	1	1	IBARRA, FERNANDO MD INC	11/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	38493	41	Internal Medicine	0	In state provider	None	850 S ATLANTIC BLVD	STE 101	MONTEREY PARK	CA	91754	6700	19	06037	34.05097684	-118.1379979	Los Angeles County
142880	Fee-for-Service	1831377795	1831377795	1	1	IDE, JASMINE YEH MD	7/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101182	41	Internal Medicine	0	In state provider	None	2001 FOURTH AVENUE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
142922	Fee-for-Service	1518124718	1518124718	1	1	IRIELE, CLIFFORD I MD	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	102130	36	Psychiatry	0	In state provider	None	18546 ROSCOE BLVD	STE 210	NORTHRIDGE	CA	91324	4663	19	06037	34.22069869	-118.537684	Los Angeles County
142944	Fee-for-Service	1912180969	1912180969	1	1	IBARRA, FERNANDO MD INC	11/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	38493	08	Family Practice	0	In state provider	None	850 S ATLANTIC BLVD	STE 101	MONTEREY PARK	CA	91754	6700	19	06037	34.05097684	-118.1379979	Los Angeles County
143021	Fee-for-Service	1144537317	1144537317	1	1	IRSHAD, WAJIHA MD	6/23/2014	207R00000X	NA	Other	026	PHYSICIANS	123425	41	Internal Medicine	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
143245	Fee-for-Service	1972123412	1972123412	1	1	INFINITE CARE HOSPICE INC	3/8/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2151 MICHELSON DR	STE 263	IRVINE	CA	92612	1374	30	06059	33.67693093	-117.8571312	Orange County
143311	Fee-for-Service	1023424850	1023424850	1	1	INABNIT, CHRISTOPHER MD	8/23/2019	207P00000X	NA	Other	026	PHYSICIANS	161099	66	Emergency Medicine (Urgent Care)	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2854	56	06111	34.2746295	-119.2573399	Ventura County
143336	Fee-for-Service	1942384862	1942384862	1	1	INLAND HEART AND VASCULAR	9/1/2002	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	MEDICAL ASSOCIATES APC	399 E HIGHLAND AVE	STE 110	SAN BERNARDINO	CA	92404	3842	36	06071	34.1358627	-117.2757898	San Bernardino County
143343	Fee-for-Service	1376566323	1376566323	1	1	IBARRA, RODOLFO MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	57516	41	Internal Medicine	0	In state provider	None	911 E SAN ANTONIO DR	STE 1	LONG BEACH	CA	90807	2204	19	06037	33.83829601	-118.1824972	Los Angeles County
143388	Fee-for-Service	1760503486	1760503486	1	1	IDRISS, SAMER I DO	5/9/2016	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	9225 N 3RD ST	STE 304	PHOENIX	AZ	85020	2466	00	None	33.57054	-112.0692465	Maricopa County
143529	Fee-for-Service	1922198779	1922198779	1	1	INTEGRATED PAIN MANAGEMENT M	2/13/2019	2081P2900X	NA	Physical Medicine and Rehabilitation	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EDICAL GROUP, INC.	450 N WIGET LN	None	WALNUT CREEK	CA	94598	2408	07	06013	37.92922203	-122.0292116	Contra Costa County
143532	Fee-for-Service	1972123412	1972123412	1	1	INFINITE CARE HOSPICE INC	3/8/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2151 MICHELSON DR	STE 263	IRVINE	CA	92612	1374	30	06059	33.67693093	-117.8571312	Orange County
143687	Fee-for-Service	1851646566	1851646566	1	1	ILLINGWORTH, KENNETH D MD	9/2/2017	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	147674	20	Orthopedic Surgery	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
143688	Fee-for-Service	1760989891	1760989891	1	1	IRONNAH, ALMIGHTY C DO	8/21/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	23124	30	Radiology	0	In state provider	None	9320 BASELINE RD	STE C	RANCHO CUCAMONGA	CA	91701	5829	36	06071	34.12156453	-117.6018255	San Bernardino County
143732	Fee-for-Service	1801837208	1801837208	1	1	IKEMIYASHIRO, DANIEL F	3/1/1998	207RN0300X	NA	Nephrology	026	PHYSICIANS	54201	41	Internal Medicine	0	In state provider	None	1100 OLIVEWOOD DR	None	MERCED	CA	95348	1210	24	06047	37.31799103	-120.4869437	Merced County
144019	Fee-for-Service	1801837208	1801837208	1	1	IKEMIYASHIRO, DANIEL F	3/1/1998	207RN0300X	NA	Nephrology	026	PHYSICIANS	54201	45	Nephrology (Renal-Kidney)	0	In state provider	None	1100 OLIVEWOOD DR	None	MERCED	CA	95348	1210	24	06047	37.31799103	-120.4869437	Merced County
144259	Fee-for-Service	1619918182	1619918182	1	1	IOFEL, AVIVA MD INC	2/19/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53495	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6234 FOUNTAIN AVE	UNIT B	LOS ANGELES	CA	90028	8214	19	06037	34.094347	-118.3252354	Los Angeles County
144323	Fee-for-Service	1164209821	1164209821	1	1	IN HOME CARE CENTER INC	10/24/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	9023 GAVIOTA AVENUE	None	NORTH HILLS	CA	91343	3012	19	06037	34.23454762	-118.4829006	Los Angeles County
144558	Fee-for-Service	1831870393	1831870393	1	1	INFINITE BLESSINGS CARE HOME	9/12/2024	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INC	23711 PROSPECT VALLEY DR	None	DIAMOND BAR	CA	91765	1637	19	06037	34.02408904	-117.805232	Los Angeles County
144638	Fee-for-Service	1407269145	1407269145	1	1	IMAKYURE, JOSHUA MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140391	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J STREET	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
144687	Fee-for-Service	1992791230	1992791230	1	1	INTERNATIONAL REHABILITATIVE	2/10/2012	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	14001 SE 1ST ST	None	VANCOUVER	WA	98684	3513	00	None	45.62127	-122.5278405	Clark County
144702	Fee-for-Service	1225197825	1225197825	1	1	IANCU, LUIZA C MD	5/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80425	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
144875	Fee-for-Service	1861026916	1861026916	1	1	INSIGHT WELLNESS CENTER	1/21/2025	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2821 CROW CANYON RD	STE 202	SAN RAMON	CA	94583	1659	07	06013	37.77494135	-121.9805388	Contra Costa County
144963	Fee-for-Service	1154824514	1154824514	1	1	INGRAM'S PHARMACY, LLC	7/27/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1703 27TH	None	BAKERSFIELD	CA	93301	2807	15	06029	35.38382908	-119.0214725	Kern County
145093	Fee-for-Service	1336211044	1336211044	1	1	ITAGAKI, STACY	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
145137	Fee-for-Service	1720400971	1720400971	1	1	IMPARATO, ANDREW J MD	12/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144500	01	General Practice	0	In state provider	None	2151 N HARBOR BLVD	None	FULLERTON	CA	92835	3801	30	06059	33.89443025	-117.9288328	Orange County
145163	Fee-for-Service	1861026916	1861026916	1	1	INSIGHT WELLNESS CENTER	3/9/2021	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2821 CROW CANYON RD	STE 202	SAN RAMON	CA	94583	1659	07	06013	37.77494135	-121.9805388	Contra Costa County
145335	Fee-for-Service	1396931309	1396931309	1	1	IWATA, SHUNPEI MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95845	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
145363	Fee-for-Service	1528105012	1528105012	3	1	INF CORP	10/4/2019	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6735 VALJEAN AVE	None	VAN NUYS	CA	91406	5819	19	06037	34.19275482	-118.4859378	Los Angeles County
145376	Fee-for-Service	1922523034	1922523034	1	1	IPPOLITO, LISA CNP	2/8/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
145381	Fee-for-Service	1255728036	1255728036	1	1	IKJAE ACUPUNCTURE & HERBS	5/5/2015	261QP2300X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	CLINIC	3545 WILSHIRE BLVD	SUITE 355	LOS ANGELES	CA	90010	2389	19	06037	34.0617575	-118.301985	Los Angeles County
145538	Fee-for-Service	1255480646	1255480646	1	1	IMAGINATIVE HORIZONS INC	11/1/1976	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1889 NATIONAL CITY BLVD	None	NATIONAL CITY	CA	91950	5599	37	06073	32.66663251	-117.1032704	San Diego County
145547	Fee-for-Service	1689913873	1689913873	1	2	ILLUM, BENJAMIN MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	129002	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
145553	Fee-for-Service	1699279166	1699279166	1	1	ISIKBAY, MASIS MD	7/16/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	165353	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
145670	Fee-for-Service	1508095654	1508095654	1	1	ISAAK, SANDRA J CNP	6/15/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
145803	Fee-for-Service	1962148882	1962148882	1	1	INLAND ANESTHESIA PARTNERS,	6/21/2022	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	210 W SAN BERNARDINO RD	None	COVINA	CA	91723	1515	19	06037	34.088004	-117.893475	Los Angeles County
145819	Fee-for-Service	1811004476	1811004476	1	1	IYENGAR, RAJASHRI S MD	9/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	84762	03	Allergy	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
145907	Fee-for-Service	1508815556	1508815556	1	1	ISLAND DERMATOLOGY INC	4/10/2009	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	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
145997	Fee-for-Service	1598130833	1598130833	1	1	IGNELL, STEVEN P MD	7/3/2023	207P00000X	NA	Other	026	PHYSICIANS	178406	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
146034	Fee-for-Service	1194812263	1194812263	1	1	IDRIES, SHAHEEN IQBAL MD	4/28/1999	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	50795	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
146506	Fee-for-Service	1053499582	1053499582	1	1	INADOMI, DONALD W MD	10/31/1991	207R00000X	NA	Other	026	PHYSICIANS	42789	41	Internal Medicine	0	In state provider	None	20911 EARL ST	STE 320	TORRANCE	CA	90503	4354	19	06037	33.840459	-118.3580985	Los Angeles County
146933	Fee-for-Service	1588370415	1588370415	1	1	IRIS GLUZMAN MD INC	3/22/2023	208M00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
147024	Fee-for-Service	1184978637	1184978637	1	1	INLAND VALLEY SURGERY CENTER	8/1/2013	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	41900 WINCHESTER RD	SUITE 102	TEMECULA	CA	92590	3403	33	06065	33.51467986	-117.1703489	Riverside County
147122	Fee-for-Service	1558724716	1558724716	1	1	IVS HOSPICE INC	10/6/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7034 VAN NUYS BLVD	STE F	VAN NUYS	CA	91405	3061	19	06037	34.19812463	-118.4487475	Los Angeles County
147409	Fee-for-Service	1558724716	1558724716	1	1	IVS HOSPICE INC	10/6/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7034 VAN NUYS BLVD	STE F	VAN NUYS	CA	91405	3061	19	06037	34.19812463	-118.4487475	Los Angeles County
147433	Fee-for-Service	1255668786	1255668786	3	1	IDAMED INC	1/10/2017	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	17660 NEWHOPE ST	STE F	FOUNTAIN VALLEY	CA	92708	4296	30	06059	33.70618446	-117.9290043	Orange County
147510	Fee-for-Service	1154852002	1154852002	1	1	ISHINO, ALLYSE S MD	2/9/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	159266	None	None	0	In state provider	None	3000 LAS POSITAS	None	LIVERMORE	CA	94551	9627	01	06001	37.69960369	-121.7628917	Alameda County
147846	Fee-for-Service	1023295920	1023295920	1	1	ISLA VISTA NEIGHBORHOOD	11/21/2005	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CLINIC	970 EMBARCADERO DEL MAR	None	ISLA VISTA	CA	93117	4869	42	06083	34.411707	-119.857011	Santa Barbara County
148308	Fee-for-Service	1467893933	1467893933	1	1	IHM, JAHYEOK MD	10/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145037	41	Internal Medicine	0	In state provider	None	290 NORTH WAYTE LANE	None	FRESNO	CA	93710	2124	10	06019	36.74643429	-119.7837416	Fresno County
148366	Fee-for-Service	1861449522	1861449522	1	1	INDIAN HEALTH COUNCIL, INC	1/16/2007	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	50100 GOLSH RD	None	VALLEY CENTER	CA	92082	5338	37	06073	33.27715948	-116.9618201	San Diego County
148436	Fee-for-Service	1487465845	1487465845	1	1	IGNO, KENNETH PT	1/28/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7050 BROADWAY	None	LEMON GROVE	CA	91945	1406	37	06073	32.74262091	-117.0461356	San Diego County
148439	Fee-for-Service	1598834632	1598834632	1	1	IWACH, ANDREW G MD	4/1/1995	207W00000X	NA	Ophthalmology	026	PHYSICIANS	56142	18	Ophthalmology	0	In state provider	GLAUCOMA ASSOCIATES	55 STEVENSON ST	None	SAN FRANCISCO	CA	94105	2936	38	06075	37.78967198	-122.3997208	San Francisco County
148593	Fee-for-Service	1477745545	1477745545	1	1	IMAI, TARYNE A MD	10/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98091	02	General Surgery	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
148626	Fee-for-Service	1174760953	1174760953	1	1	INLAND HEALTH CARE GROUP	1/26/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	AMC	17051 SIERRA LAKES PKWY	SUITE 101	FONTANA	CA	92336	1274	36	06071	34.13797332	-117.4324372	San Bernardino County
148651	Fee-for-Service	1861449522	1861449522	1	1	INDIAN HEALTH COUNCIL, INC	6/28/2024	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	50100 GOLSH RD	None	VALLEY CENTER	CA	92082	5338	37	06073	33.27715948	-116.9618201	San Diego County
148706	Fee-for-Service	1144794108	1144794108	1	1	ISEYEMI, OLUWATOYIN CNP	9/20/2021	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
148878	Fee-for-Service	1083044275	1083044275	1	1	ISAIA, MARGIANNE LPCC	12/27/2021	106H00000X	NA	Mental Health Outpatient Services	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1845 CHICAGO AVE	B	RIVERSIDE	CA	92507	2366	33	06065	33.994269	-117.3485375	Riverside County
148912	Fee-for-Service	1174760953	1174760953	1	1	INLAND HEALTH CARE GROUP	1/26/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AMC	17051 SIERRA LAKES PKWY	SUITE 101	FONTANA	CA	92336	1274	36	06071	34.13797332	-117.4324372	San Bernardino County
148937	Fee-for-Service	1861449522	1861449522	1	1	INDIAN HEALTH COUNCIL, INC	7/7/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	50100 GOLSH RD	None	VALLEY CENTER	CA	92082	5338	37	06073	33.27715948	-116.9618201	San Diego County
148988	Fee-for-Service	1053830950	1053830950	2	1	IMGRX SJ VALLEY, INC	6/21/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY SANGER	2502 JENSEN AVE	None	SANGER	CA	93657	2447	10	06019	36.70680549	-119.572011	Fresno County
149061	Fee-for-Service	1003838079	1003838079	1	1	ISENBERG, ELLIOTT S PHD	6/1/1999	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3819 23RD ST	None	SAN FRANCISCO	CA	94114	3320	38	06075	37.75323503	-122.4280916	San Francisco County
149204	Fee-for-Service	1174760953	1174760953	1	1	INLAND HEALTH CARE GROUP	1/26/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	AMC	17051 SIERRA LAKES PKWY	SUITE 101	FONTANA	CA	92336	1274	36	06071	34.13797332	-117.4324372	San Bernardino County
149223	Fee-for-Service	1639568363	1639568363	1	1	IMOTO, LISA C NP	10/30/2017	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
149227	Fee-for-Service	1861449522	1861449522	1	1	INDIAN HEALTH COUNCIL, INC	1/1/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	50100 GOLSH RD	None	VALLEY CENTER	CA	92082	5338	37	06073	33.27715948	-116.9618201	San Diego County
149296	Fee-for-Service	1609838333	1609838333	1	1	INBA-VAZHVU, M.N. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6507 PROFESSIONAL PL	None	RIVERDALE	GA	30274	4941	00	None	33.57726874	-84.396186	Clayton County
149499	Fee-for-Service	1487140927	1487140927	1	1	INCE, RHONDA LMFT	8/19/2024	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
149514	Fee-for-Service	1861449522	1861449522	1	1	INDIAN HEALTH COUNCIL, INC	11/1/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	50100 GOLSH RD	None	VALLEY CENTER	CA	92082	5338	37	06073	33.27715948	-116.9618201	San Diego County
149575	Fee-for-Service	1427093277	1427093277	1	1	INLAND FAMILY HEALTHCARE	10/21/2014	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	7234	01	General Practice	0	In state provider	CENTERS INC	300 N EUCLID AVE	STE B	UPLAND	CA	91786	8322	36	06071	34.097508	-117.6509735	San Bernardino County
149706	Fee-for-Service	1366417123	1366417123	1	1	INSIGHT HEALTH CORP	4/29/2005	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	1180 POST ST	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
149802	Fee-for-Service	1225287881	1225287881	1	1	IQBAL, MUHAMMAD N MD	7/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144912	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	4234 RIVERWALK PKWY	STE 230	RIVERSIDE	CA	92505	3312	33	06065	33.90290859	-117.4941562	Riverside County
149855	Fee-for-Service	1992181143	1992181143	1	1	INGA SIMONIAN PHD PSYCHOLOGY	10/9/2015	305R00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11026 VENTURA BLVD	STE 12	STUDIO CITY	CA	91604	4635	19	06037	34.14072778	-118.370947	Los Angeles County
149893	Fee-for-Service	1497881007	1497881007	1	1	INLAND GLAUCOMA SERVICE	9/9/2014	207W00000X	NA	Ophthalmology	026	PHYSICIANS	51441	18	Ophthalmology	0	In state provider	MEDICAL CORPORATION	11320 MOUNTAIN VIEW AVE	SUITE B	LOMA LINDA	CA	92354	3860	36	06071	34.0472495	-117.2436911	San Bernardino County
149948	Fee-for-Service	1851798383	1851798383	1	1	IBARRA, JOHN LMFT	1/10/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28494 WESTINGHOUSE PL	SUITE 213	VALENCIA	CA	91355	0930	19	06037	34.44221561	-118.5989564	Los Angeles County
149997	Fee-for-Service	1912917345	1912917345	1	1	IGNACIO, KATHLYN R MD	12/31/1988	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	46520	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
150249	Fee-for-Service	1760583140	1760583140	1	1	IAN JAMES HEATH M.D	10/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	701 PARK AVE	None	MINNEAPOLIS	MN	55415	1623	00	None	44.97241797	-93.26300044	Hennepin County
150479	Fee-for-Service	1265010615	1265010615	1	1	IANCU, DANIEL	6/28/2024	208M00000X	NA	Other	026	PHYSICIANS	184206	41	Internal Medicine	0	In state provider	None	23625 WR HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
150531	Fee-for-Service	1154612885	1154612885	1	1	IYER, ANAND V MD	8/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122818	36	Psychiatry	0	In state provider	None	375 LAGUNA HONDA BLVD	RM B200	SAN FRANCISCO	CA	94116	1411	38	06075	37.74791027	-122.4587116	San Francisco County
150643	Fee-for-Service	1063481331	1063481331	1	1	IBARRA, JOSE L MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	73482	08	Family Practice	0	In state provider	None	5561 E KINGS CANYON RD	None	FRESNO	CA	93727	4528	10	06019	36.73593119	-119.7021702	Fresno County
150673	Fee-for-Service	1326115320	1326115320	1	1	INGBER, CRAIG F MD	7/28/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	32578	84	Surgery-Head and Neck	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
150685	Fee-for-Service	1861449522	1861449522	1	3	INDIAN HEALTH COUNCIL, INC	7/7/2021	No Taxonomy Provided	NA	None	096	TRIBAL FQHC PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	H CENTER	110 1/2 SCHOOL HOUSE CAN	None	SANTA YSABEL	CA	92070	0001	37	06073	33.14616255	-116.6540406	San Diego County
150963	Fee-for-Service	1326115320	1326115320	1	1	INGBER, CRAIG F MD	7/28/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	32578	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
150970	Fee-for-Service	1861449522	1861449522	1	3	INDIAN HEALTH COUNCIL, INC	4/2/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	H CENTER	110 1/2 SCHOOL HOUSE CAN	None	SANTA YSABEL	CA	92070	0001	37	06073	33.14616255	-116.6540406	San Diego County
150999	Fee-for-Service	1154541019	1154541019	1	1	IRENE, SUNDAY O MD	4/11/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	98496	08	Family Practice	0	In state provider	None	815 DR MARTIN LUTHER KIN	None	BAKERSFIELD	CA	93307	1365	15	06029	35.3655	-118.985202	Kern County
151010	Fee-for-Service	1659336964	1659336964	1	1	ISAINTS, ARMEN MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	61592	41	Internal Medicine	0	In state provider	None	55 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3954	19	06037	34.13582278	-118.1491634	Los Angeles County
151013	Fee-for-Service	1841468063	1841468063	1	1	INMAN, JARED C MD	10/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	94766	04	Otology, Laryngology, Rhinology	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
151045	Fee-for-Service	1780655548	1780655548	1	1	IQBAL, VASEEM MD	5/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	88289	30	Radiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
151106	Fee-for-Service	1972734267	1972734267	1	1	INLAND ARTIFICIAL	8/11/2009	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	LIMB & BRACE	6840 INDIANA AVE	STE 120	RIVERSIDE	CA	92506	4259	33	06065	33.94246965	-117.3926366	Riverside County
151150	Fee-for-Service	1164862850	1164862850	1	1	ILEJAY, MARIBEL D L R NP	9/18/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	SUITE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
151161	Fee-for-Service	1548344641	1548344641	1	1	ILARDE, JEANETTE S MD	8/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	49030	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	STE 365 420 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
151185	Fee-for-Service	1679816920	1679816920	1	1	ISHIHARA, DAN MD	8/15/2024	2085R0001X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	4500 MORNING DR	SUITE 105	BAKERSFIELD	CA	93306	7276	15	06029	35.39343836	-118.9166214	Kern County
151322	Fee-for-Service	1750367298	1750367298	1	1	ITALIANE, JAMES R L	2/8/2015	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	24022 CALLE DE LA PLATA	STE 415	LAGUNA HILLS	CA	92653	3630	30	06059	33.6104493	-117.7110924	Orange County
151445	Fee-for-Service	1548344641	1548344641	1	1	ILARDE, JEANETTE S MD	8/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	49030	77	Infectious Disease	0	In state provider	None	200 MED PLAZA	STE 365 420 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
151571	Fee-for-Service	1265155212	1265155212	1	2	ITRANSIT INC	5/31/2023	347C00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	333 UNIVERSITY AVE	SUITE 200, ROOM 72	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
151707	Fee-for-Service	1144296807	1144296807	1	1	INSIGHT HEALTH CORP	11/19/2003	293D00000X	NA	Other	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	39055 HASTINGS ST	STE 106	FREMONT	CA	94538	1518	01	06001	37.55249404	-121.983385	Alameda County
152419	Fee-for-Service	1063583854	1063583854	1	1	ITO, KAREN MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	66216	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	801 E MOUNTAIN VIEW ST	STE C	BARSTOW	CA	92311	3052	36	06071	34.89324445	-117.0177579	San Bernardino County
152679	Fee-for-Service	1437553971	1437553971	1	1	INFECTIOUS DISEASE CLINIC IN	12/10/2019	207RI0200X	NA	HIV/AIDS/Infectious Disease	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	C	216 S CITRUS ST	SUITE 395	WEST COVINA	CA	91791	2144	19	06037	34.06931527	-117.8900563	Los Angeles County
152684	Fee-for-Service	1174729933	1174729933	1	1	IFTIKAR, SHAWN J MD	2/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108249	25	Physical Medicine and Rehabilitation	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
152817	Fee-for-Service	1326347113	1326347113	1	1	ILLANGASEKARE, TUSHANI D MD	3/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123931	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
152832	Fee-for-Service	1962897520	1962897520	1	1	ISALES, MARIA MD	6/22/2020	207ND0900X	NA	Dermatology	026	PHYSICIANS	160479	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
153013	Fee-for-Service	1841930286	1841930286	1	1	IMPROVE U FAMILY COUNSELING	6/22/2022	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	INC.	8175 LIMONITE AVE	SUITE A	JURUPA VALLEY	CA	92509	6120	33	06065	33.97766618	-117.4616906	Riverside County
153330	Fee-for-Service	1649473695	1649473695	1	1	IMPERIAL VALLEY MEDICAL	1/27/2006	261QM2800X	NA	Other	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	CLINIC INC	200 S 5TH STREET	None	EL CENTRO	CA	92243	3013	13	06025	32.791482	-115.554748	Imperial County
153368	Fee-for-Service	1578931606	1578931606	1	1	IPHARMACY INC	2/8/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12916 CENTRAL AVE	None	CHINO	CA	91710	4121	36	06071	34.01766	-117.6894065	San Bernardino County
153377	Fee-for-Service	1154412963	1154412963	1	1	IKHISEMOJIE, AUGUSTA U MD	9/8/2004	207L00000X	NA	Other	026	PHYSICIANS	67133	05	Anesthesiology	0	In state provider	APMC	438 W LAS TUNAS DRIVE	None	SAN GABRIEL	CA	91776	1216	19	06037	34.10243051	-118.105902	Los Angeles County
153379	Fee-for-Service	1093585036	1093585036	1	1	IMAGE ONE A MEDICAL CORPORAT	9/18/2024	261QR0206X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	ION	8707 COMPLEX DRIVE	None	SAN DIEGO	CA	92123	1401	37	06073	32.83008553	-117.139662	San Diego County
153503	Fee-for-Service	1245764539	1245764539	1	1	INGEBRITSEN, JOANNA MD	10/15/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	159862	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
153953	Fee-for-Service	1275111544	1275111544	1	1	INFOCUS PATHOLOGY GROUP	5/18/2021	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3113	30	06059	33.80318353	-118.0666665	Orange County
154106	Fee-for-Service	1013792670	1013792670	1	1	ITOH, AYANO NP	6/8/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1145 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3528	19	06037	33.89242734	-118.2947128	Los Angeles County
154200	Fee-for-Service	1225139165	1225139165	2	1	ISHA INC	1/15/2008	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2100 N ARROWHEAD AVE	None	SAN BERNARDINO	CA	92405	4002	36	06071	34.133931	-117.289686	San Bernardino County
154207	Fee-for-Service	1568721991	1568721991	1	1	ISRAEL, DANIEL J MD	7/22/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	152351	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
154369	Fee-for-Service	1255730222	1255730222	1	1	INSTITUTE ON AGING	2/23/2015	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	701 GATEWAY BLVD	None	S SAN FRANCISCO	CA	94080	0701	41	06081	37.6596526	-122.3967792	San Mateo County
154531	Fee-for-Service	1306240551	1306240551	1	1	IROQUOIS DIALYSIS LLC	10/1/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3660 PARK SIERRA DR	SUITE 108	RIVERSIDE	CA	92505	3071	33	06065	33.90330693	-117.4707039	Riverside County
154634	Fee-for-Service	1265588750	1265588750	1	1	ISMAIL, MOHAMMAD MD INC	8/28/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	16415 COLORADO AVE	STE 207	PARAMOUNT	CA	90723	5054	19	06037	33.8853075	-118.1614695	Los Angeles County
154655	Fee-for-Service	1255730222	1255730222	1	1	INSTITUTE ON AGING	2/23/2015	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	None	701 GATEWAY BLVD	None	S SAN FRANCISCO	CA	94080	0701	41	06081	37.6596526	-122.3967792	San Mateo County
154897	Fee-for-Service	1386009306	1386009306	1	1	IDEAL CARE CENTERS INC	7/14/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	3618 W DAYTON AVE	None	FRESNO	CA	93722	4704	10	06019	36.78277148	-119.8581806	Fresno County
154917	Fee-for-Service	1184666570	1184666570	1	1	INDROJ MEDICAL GROUP INC	10/29/2018	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	58471 29 PALMS HWY	STE 201	YUCCA VALLEY	CA	92284	5818	36	06071	34.13270029	-116.3881647	San Bernardino County
155020	Fee-for-Service	1679004592	1679004592	1	1	IZUCHUKWU OKPARA MD INC	4/4/2018	193400000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	10880 WILSHIRE BLVD	1101	LOS ANGELES	CA	90024	4112	19	06037	34.05897499	-118.4431123	Los Angeles County
155204	Fee-for-Service	1184666570	1184666570	1	1	INDROJ MEDICAL GROUP INC	4/26/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	58471 29 PALMS HWY	STE 201	YUCCA VALLEY	CA	92284	5818	36	06071	34.13270029	-116.3881647	San Bernardino County
155378	Fee-for-Service	1508452376	1508452376	1	1	IDEAL CHOICE HOME HEALTH	9/17/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14852 VENTURA BLVD	SUITE 207	SHERMAN OAKS	CA	91403	5949	19	06037	34.15225574	-118.4570166	Los Angeles County
155503	Fee-for-Service	1598893455	1598893455	1	1	IMPERIAL PRIMARY CARE MEDICA	8/21/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	L GROUP	15625 IMPERIAL HWY	None	LA MIRADA	CA	90638	1627	19	06037	33.91736145	-117.9981225	Los Angeles County
155703	Fee-for-Service	1417911314	1417911314	1	1	I-KONARAKI, ZARMEN MD	9/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	56455	67	Endocrinology	0	In state provider	None	801 S CHEVY CHASE DR	STE 102	GLENDALE	CA	91205	4437	19	06037	34.136757	-118.2396195	Los Angeles County
155751	Fee-for-Service	1114461043	1114461043	1	1	INTERCOMMUNITY DIALYSIS	12/6/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER - LA MIRADA, INC	15060 IMPERIAL HWY	None	LA MIRADA	CA	90638	1301	19	06037	33.91708154	-118.0096441	Los Angeles County
155787	Fee-for-Service	1598893455	1598893455	1	1	IMPERIAL PRIMARY CARE MEDICA	8/21/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	L GROUP	15625 IMPERIAL HWY	None	LA MIRADA	CA	90638	1627	19	06037	33.91736145	-117.9981225	Los Angeles County
155990	Fee-for-Service	1417911314	1417911314	1	1	I-KONARAKI, ZARMEN MD	9/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	56455	41	Internal Medicine	0	In state provider	None	801 S CHEVY CHASE DR	STE 102	GLENDALE	CA	91205	4437	19	06037	34.136757	-118.2396195	Los Angeles County
156191	Fee-for-Service	1508251422	1508251422	1	1	IAFE, TIMOTHY MD	3/23/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	146525	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
156325	Fee-for-Service	1710046560	1710046560	1	1	ITALIA, ABIGAL	11/26/2012	No Taxonomy Provided	NA	None	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
156571	Fee-for-Service	1831108497	1831108497	1	1	IHC HEALTH SERVICES, INC	7/5/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LOGAN REGIONAL HOSP	1400 N 500 E	None	LOGAN	UT	84341	2455	00	None	41.75658895	-111.821161	Cache County
156632	Fee-for-Service	1558363739	1558363739	1	1	ITSARA, KRIENGSAK MD	6/25/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	33103	41	Internal Medicine	0	In state provider	None	1400 FLORIDA AVE	STE 112	MODESTO	CA	95350	4422	50	06099	37.66410995	-120.996159	Stanislaus County
156725	Fee-for-Service	1972821494	1972821494	1	1	INTERCARE MEDICAL GROUP INC	8/24/2010	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL GROUP INC	1111 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.64171	-117.669847	Kern County
156859	Fee-for-Service	1831108497	1831108497	1	1	IHC HEALTH SERVICES, INC	9/1/1999	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LOGAN REGIONAL HOSP	1400 N 500 E	None	LOGAN	UT	84341	2455	00	None	41.75658895	-111.821161	Cache County
156920	Fee-for-Service	1558363739	1558363739	1	1	ITSARA, KRIENGSAK MD	6/25/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	33103	45	Nephrology (Renal-Kidney)	0	In state provider	None	1400 FLORIDA AVE	STE 112	MODESTO	CA	95350	4422	50	06099	37.66410995	-120.996159	Stanislaus County
156996	Fee-for-Service	1508828195	1508828195	1	1	IMAM, KHURSHEED MD	7/31/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	52011	30	Radiology	0	In state provider	None	2820 N ONTARIO ST	None	BURBANK	CA	91504	2015	19	06037	34.20335077	-118.3443845	Los Angeles County
157436	Fee-for-Service	1821168766	1821168766	2	1	I.V. FAMILY PHARMACY, INC.	5/9/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	420 HEFFERNAN AVE	A	CALEXICO	CA	92231	4718	13	06025	32.6691	-115.494863	Imperial County
157619	Fee-for-Service	1639706252	1639706252	1	1	IGOU, TORRI A DO	10/31/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20818	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
157639	Fee-for-Service	1245493881	1245493881	1	1	IYENGAR, JAIDEEP J MD	3/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	103986	20	Orthopedic Surgery	0	In state provider	None	2585 SUMARITAN DRIVE	None	SAN JOSE	CA	95124	4107	43	06085	37.25083752	-121.9503884	Santa Clara County
157659	Fee-for-Service	1689600363	1689600363	1	1	IRANMANESH, REZA MD	11/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102425	18	Ophthalmology	0	In state provider	None	622 ABBOTT STREET	None	SALINAS	CA	93901	4315	27	06053	36.66170619	-121.6412319	Monterey County
157664	Fee-for-Service	1730542515	1730542515	1	1	IFTIKHAR, SYED F MD	6/18/2021	207R00000X	NA	Other	026	PHYSICIANS	160234	None	None	0	In state provider	None	1415 ROSS AVENUE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
157752	Fee-for-Service	1285625376	1285625376	2	1	IPLAZA PHARMACY INC	10/4/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3400 LOMITA BLVD	STE 102	TORRANCE	CA	90505	4911	19	06037	33.81309744	-118.3448635	Los Angeles County
157945	Fee-for-Service	1700277647	1700277647	1	1	IMPERIAL VALLEY MULTI-	4/18/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	SPECIALTY MEDICAL GROUP	2061 ROSS AVE	SUITE A	EL CENTRO	CA	92243	3687	13	06025	32.7814167	-115.579257	Imperial County
157968	Fee-for-Service	1326403130	1326403130	1	1	INFECTIOUS DISEASE	3/18/2016	193400000X	NA	Other	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	ASSOCIATES OF ORANGE COU	999 N TUSTIN AVE	SUITE #109	SANTA ANA	CA	92705	6501	30	06059	33.754167	-117.834191	Orange County
158059	Fee-for-Service	1255963781	1255963781	1	1	ISLAND CREEK HOLDINGS LLC	3/1/2020	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	788 HOLMES ST	None	LIVERMORE	CA	94550	4229	01	06001	37.6731021	-121.7803262	Alameda County
158119	Fee-for-Service	1003004169	1003004169	1	1	IVEY, SUSAN L MD	8/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	43335	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
158136	Fee-for-Service	1730627050	1730627050	1	2	INTEGRATED ELDER CARE INC	5/4/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	217 N GROVE ST	None	REDLANDS	CA	92374	6000	36	06071	34.05786426	-117.1605151	San Bernardino County
158233	Fee-for-Service	1700277647	1700277647	1	1	IMPERIAL VALLEY MULTI-	4/18/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	SPECIALTY MEDICAL GROUP	2061 ROSS AVE	SUITE A	EL CENTRO	CA	92243	3687	13	06025	32.7814167	-115.579257	Imperial County
158335	Fee-for-Service	1043473903	1043473903	1	1	ISHAK, AMY L NP	3/9/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
158369	Fee-for-Service	1902470859	1902470859	1	1	IMAM, DANYAL MD	8/1/2024	207R00000X	NA	Other	026	PHYSICIANS	None	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
158520	Fee-for-Service	1700277647	1700277647	1	1	IMPERIAL VALLEY MULTI-	4/18/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	SPECIALTY MEDICAL GROUP	2061 ROSS AVE	SUITE A	EL CENTRO	CA	92243	3687	13	06025	32.7814167	-115.579257	Imperial County
158595	Fee-for-Service	1376978742	1376978742	1	1	IQBAL, SAQIB LCSW	3/2/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17215 STUDEBAKER ROAD	SUITE 110	CERRITOS	CA	90703	2521	19	06037	33.874686	-118.0998595	Los Angeles County
158604	Fee-for-Service	1902321383	1902321383	1	1	IRON POINT HOME HEALTH CARE	3/20/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	1837 IRON POINT ROAD	SUITE 160	FOLSOM	CA	95690	8781	34	06067	38.643381	-121.146309	Sacramento County
158624	Fee-for-Service	1003964321	1003964321	1	1	INGLEWOOD UNIFIED SD	12/4/1994	251300000X	NA	Other	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	401 S INGLEWOOD AVE	None	INGLEWOOD	CA	90301	2599	19	06037	33.9587247	-118.3617601	Los Angeles County
158639	Fee-for-Service	1659786721	1659786721	1	1	INLAND BEHAVIORAL AND HEALTH	6/3/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	SERVICES, INC.	1070 E RAMSEY ST	STE C	BANNING	CA	92220	5924	33	06065	33.92534349	-116.8644555	Riverside County
158692	Fee-for-Service	1023625423	1023625423	1	1	I KNOW HOSPICE INC	1/10/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	18425 BURBANK BLVD	STE 401	TARZANA	CA	91356	2806	19	06037	34.17226853	-118.5348151	Los Angeles County
158743	Fee-for-Service	1528235553	1528235553	1	1	IBRAHIM, FAYAZ A MD	5/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	115161	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
158834	Fee-for-Service	1326294844	1326294844	1	1	INGLISH, DANIEL J DO	3/24/2015	No Taxonomy Provided	NA	None	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
158981	Fee-for-Service	1023625423	1023625423	1	1	I KNOW HOSPICE INC	1/10/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	18425 BURBANK BLVD	STE 401	TARZANA	CA	91356	2806	19	06037	34.17226853	-118.5348151	Los Angeles County
159167	Fee-for-Service	1487290854	1487290854	1	1	ISSA, CHRISTINA OD	7/6/2021	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
159168	Fee-for-Service	1902235393	1902235393	1	1	INSUNZA ESPINOZA, IRENE G LM	9/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	1916 ORANGE TREE LANE	SUITE 450G	REDLANDS	CA	92374	4520	36	06071	34.06785848	-117.2189386	San Bernardino County
159255	Fee-for-Service	1144517632	1144517632	1	1	ISOZAKI, VERONICA L OD	10/31/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1450 SAN PABLO STREET	STE 4000	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
159561	Fee-for-Service	1124647011	1124647011	1	1	INNOVA PHARMACY II	4/21/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 J ST	101	SACRAMENTO	CA	95816	5542	34	06067	38.571237	-121.4566245	Sacramento County
159586	Fee-for-Service	1255762373	1255762373	1	1	IVORY, KEVIN H	4/1/2015	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	8263 GROVE AVE	STE 203	RANCHO CUCAMONGA	CA	91730	3107	36	06071	34.10436536	-117.6285141	San Bernardino County
159640	Fee-for-Service	1932522505	1932522505	1	1	IHEALTH MAX	7/31/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9713 BASELINE ROAD	None	RANCHO CUCAMONGA	CA	91730	1408	36	06071	34.12151451	-117.5930955	San Bernardino County
159696	Fee-for-Service	1720270184	1720270184	1	1	IMANI, FARZIN MD	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96285	42	Nuclear Medicine	0	In state provider	None	10833 LE CONTE AVE	BLDG AR130	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
159738	Fee-for-Service	1205252368	1205252368	1	1	INDEPENDENT ANESTHESIA	7/29/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
159829	Fee-for-Service	1194708099	1194708099	1	1	IRANI, HORMUZ MD	9/20/2002	208600000X	NA	General Surgery	026	PHYSICIANS	41148	02	General Surgery	0	In state provider	None	6001D TRUXTUN AVE	STE 420	BAKERSFIELD	CA	93309	0611	15	06029	35.36254873	-119.0727158	Kern County
159987	Fee-for-Service	1841232279	1841232279	1	1	INLAND VALLEY PARTNERS, LLC	10/1/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	250 W ARTESIA ST	None	POMONA	CA	91768	1807	19	06037	34.07733923	-117.7543529	Los Angeles County
160212	Fee-for-Service	1386732253	1386732253	1	1	IM, JAMES J MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60431	08	Family Practice	0	In state provider	None	9500 STOCKDALE HWY	STE 104	BAKERSFIELD	CA	93311	3621	15	06029	35.35452448	-119.1074625	Kern County
160238	Fee-for-Service	1912387010	1912387010	1	1	IRONSIDE, ERICA F PSYD	7/12/2021	101Y00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	906 G ST	None	SACRAMENTO	CA	95814	1800	34	06067	38.583468	-121.49289	Sacramento County
160355	Fee-for-Service	1104582345	1104582345	1	1	INDEPENDENT COLLECTIONS GROU	11/18/2021	344600000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	10859 SHERMAN WAY	None	SUN VALLEY	CA	91352	4829	19	06037	34.20123037	-118.3678228	Los Angeles County
160507	Fee-for-Service	1114019544	1114019544	1	1	IM, STEVE S MD	7/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	75924	05	Anesthesiology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
160535	Fee-for-Service	1083215792	1083215792	1	1	ITHERAPY, A SPEECH PATHOLOGY	10/5/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	955 WALNUT AVE	None	VALLEJO	CA	94592	1021	48	06095	38.0960736	-122.2701348	Solano County
160631	Fee-for-Service	1104876275	1104876275	1	1	ITO, BRIAN T DC	3/1/2007	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	4247 TELEGRAPH RD	None	VENTURA	CA	93003	3705	56	06111	34.27467044	-119.2378629	Ventura County
160653	Fee-for-Service	1275630287	1275630287	1	1	INTIMATE IMAGE	6/24/1998	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	22941 VENTURA BLVD	STE M	WOODLAND HILLS	CA	91364	1242	19	06037	34.1650484	-118.6264997	Los Angeles County
160808	Fee-for-Service	1497148456	1497148456	2	4	IHS RADIOLOGY MEDICAL GROUP,	12/3/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	12620 MONTE VISTA ROAD	SUITE A	POWAY	CA	92064	2531	37	06073	32.99536145	-117.056826	San Diego County
160969	Fee-for-Service	1962643718	1962643718	1	1	IN HOME HEALTHCARE INC	2/8/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1280 E COOLEY DRIVE	SUITE 7	COLTON	CA	92324	3919	36	06071	34.05447547	-117.3069855	San Bernardino County
160976	Fee-for-Service	1124359443	1124359443	1	1	IOANNIS BERIOS, 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	520 MADISON OAK DR	None	SAN ANTONIO	TX	78258	3913	00	None	29.62127927	-98.49119067	Bexar County
161280	Fee-for-Service	1457754731	1457754731	3	1	IMGRX HEALDSBURG, INC	2/9/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1381 UNIVERSITY ST.	A	HEALDSBURG	CA	95448	3314	49	06097	38.62729851	-122.8637785	Sonoma County
161324	Fee-for-Service	1225113996	1225113996	1	1	IYER, SHAMBHAVI MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65771	01	General Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94598	2419	01	06001	37.55102172	-121.9759026	Alameda County
161541	Fee-for-Service	1013933324	1013933324	1	1	INDER, TERRIE E MD	3/28/2023	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	181463	None	None	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
161611	Fee-for-Service	1225113996	1225113996	1	1	IYER, SHAMBHAVI MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65771	41	Internal Medicine	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94598	2419	01	06001	37.55102172	-121.9759026	Alameda County
161725	Fee-for-Service	1790826774	1790826774	1	1	ISTRATE, SIMONA CNM	2/8/2015	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	SIMONA NATURAL BIRTH CEN	9209 COLIMA RD	STE 4100	WHITTIER	CA	90605	1826	19	06037	33.9505367	-118.0054552	Los Angeles County
162118	Fee-for-Service	1093750747	1093750747	2	1	INTEGRITY HEALTHCARE	4/25/2008	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SOLUTIONS INC	425 W 5TH AVE	STE 101	ESCONDIDO	CA	92025	4843	37	06073	33.11571006	-117.0834795	San Diego County
162210	Fee-for-Service	1730627050	1730627050	1	1	INTEGRATED ELDER CARE INC	12/4/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5850 MANZANITA AVE	None	ANGELUS OAKS	CA	92305	1190	36	06071	34.14733716	-116.9816052	San Bernardino County
162240	Fee-for-Service	1326115163	1326115163	1	1	INOCENCIO-DIAZ, JERRELYN	4/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94332	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	J MD	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
162393	Fee-for-Service	1972021152	1972021152	1	1	IBANEZ, SERGIO LCSW	7/6/2023	101YM0800X	NA	Other	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
162495	Fee-for-Service	1013193101	1013193101	1	1	ITAGAKI, BRANDON K MD	5/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	99873	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
163369	Fee-for-Service	1134906159	1134906159	1	1	IRUNGU, EUNICE MUMBUA	9/26/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1134 FONTANA DRIVE	None	ALAMEDA	CA	94502	6576	01	06001	37.73453194	-122.2485349	Alameda County
163561	Fee-for-Service	1710535968	1710535968	1	1	INLAND PSYCHIATRIC MEDICAL G	3/19/2021	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC	11306 MOUNTAIN VIEW	A	LOMA LINDA	CA	92354	3832	36	06071	34.047513	-117.243647	San Bernardino County
163636	Fee-for-Service	1902169196	1902169196	1	1	IKPEAMAEZE, LILIAN NP	8/2/2023	163W00000X	NA	Other	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
163659	Fee-for-Service	1134906159	1134906159	1	1	IRUNGU, EUNICE MUMBUA	9/26/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1134 FONTANA DRIVE	None	ALAMEDA	CA	94502	6576	01	06001	37.73453194	-122.2485349	Alameda County
163707	Fee-for-Service	1346263670	1346263670	1	1	IWAOKA, KEN RAY	8/31/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	48630	08	Family Practice	0	In state provider	None	130 CEDAR RD	None	VISTA	CA	92083	5102	37	06073	33.18682732	-117.2839184	San Diego County
163711	Fee-for-Service	1902014145	1902014145	1	1	INSTITUTE OF ADVANCED STUDIE	9/28/2015	251V00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	STUDIES INC	56970 YUCCA TRL	104	YUCCA VALLEY	CA	92284	7910	36	06071	34.12059645	-116.420985	San Bernardino County
163713	Fee-for-Service	1912562877	1912562877	1	1	INSIDE OUT COUNSELING SERVIC	2/7/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ES INC	2522 CHAMBERS ROAD	125	TUSTIN	CA	92780	6962	30	06059	33.71785088	-117.8076329	Orange County
163845	Fee-for-Service	1710535968	1710535968	1	1	INLAND PSYCHIATRIC MEDICAL G	3/19/2021	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	11306 MOUNTAIN VIEW	A	LOMA LINDA	CA	92354	3832	36	06071	34.047513	-117.243647	San Bernardino County
163988	Fee-for-Service	1669716932	1669716932	1	1	ISAACS, SHERYL A	7/23/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5523 SCOTTS VALLEY DR	STE 106	SCOTTS VALLEY	CA	95066	3450	44	06087	37.06045683	-122.0087837	Santa Cruz County
164006	Fee-for-Service	1548311202	1548311202	1	1	INTERCOMMUNITY DIALYSIS	6/17/1991	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	12291 E WASHINGTON BLVD	STE 410	WHITTIER	CA	90606	3815	19	06037	33.96734104	-118.0508773	Los Angeles County
164137	Fee-for-Service	1710535968	1710535968	1	1	INLAND PSYCHIATRIC MEDICAL G	11/14/2023	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	11306 MOUNTAIN VIEW	A	LOMA LINDA	CA	92354	3832	36	06071	34.047513	-117.243647	San Bernardino County
164283	Fee-for-Service	1861628026	1861628026	1	1	INTERNATIONAL HEALTHCARE	4/1/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	PRODUCTS INC	18625 SHERMAN WAY	SUITE 106	RESEDA	CA	91335	4186	19	06037	34.20121398	-118.5393529	Los Angeles County
164426	Fee-for-Service	1710535968	1710535968	1	1	INLAND PSYCHIATRIC MEDICAL G	3/19/2021	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC	11306 MOUNTAIN VIEW	A	LOMA LINDA	CA	92354	3832	36	06071	34.047513	-117.243647	San Bernardino County
164430	Fee-for-Service	1235166729	1235166729	1	1	INFINITI MEDICAL SUPPLY	8/12/1998	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	KARAGEOZYAN, ARAM	5863 IMPERIAL HWY	STE E	SOUTH GATE	CA	90280	7626	19	06037	33.92957741	-118.1648701	Los Angeles County
164466	Fee-for-Service	1326253881	1326253881	1	1	IBRAHIM, YOMNA A MD	12/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92639	40	Pediatrics	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
164508	Fee-for-Service	1538703756	1538703756	1	1	IE NON-EMERGENCY MEDICAL TRA	7/5/2023	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	NSPORTATION INC	595 N LA CADENA DR	E	COLTON	CA	92324	9998	36	06071	34.07103778	-117.3234989	San Bernardino County
164529	Fee-for-Service	1023771375	1023771375	1	1	ITZEP, BRIANA E PT	8/21/2024	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
164598	Fee-for-Service	1356474530	1356474530	1	1	ISCHANDER, MARIAM M MD	3/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88054	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
164913	Fee-for-Service	1265588909	1265588909	1	1	INLAND PSYCHIATRIC MEDICAL G	7/16/2019	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	8710 MONROE CT	SUITE 150	RANCHO CUCAMONGA	CA	91730	4883	36	06071	34.09544496	-117.5747968	San Bernardino County
165028	Fee-for-Service	1992785422	1992785422	1	1	ILKO,IVANOV 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
165153	Fee-for-Service	1306165857	1306165857	1	1	IZADPANAH GUNN, NAZANIN MD	9/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127410	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365	LOS ANGELES	CA	90045	5631	19	06037	34.06527974	-118.4462792	Los Angeles County
165203	Fee-for-Service	1265588909	1265588909	1	1	INLAND PSYCHIATRIC MEDICAL G	7/16/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC	8710 MONROE CT	SUITE 150	RANCHO CUCAMONGA	CA	91730	4883	36	06071	34.09544496	-117.5747968	San Bernardino County
165216	Fee-for-Service	1881856458	1881856458	1	1	IHIAGARAJAH, CHITTA MD A	3/14/2011	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	PROFESSIONAL MED CORP	44725 10TH ST W	STE 110	LANCASTER	CA	93534	3051	19	06037	34.695693	-118.1480965	Los Angeles County
165417	Fee-for-Service	1356372601	1356372601	1	1	INLAND CARDIOTHORACIC	9/30/1990	174400000X	NA	Other	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	SURGICAL ASSOCIATES	401 E HIGHLAND AVE	STE 251	SAN BERNARDINO	CA	92404	3800	36	06071	34.1358627	-117.2757778	San Bernardino County
165489	Fee-for-Service	1265588909	1265588909	1	1	INLAND PSYCHIATRIC MEDICAL G	7/16/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC	8710 MONROE CT	SUITE 150	RANCHO CUCAMONGA	CA	91730	4883	36	06071	34.09544496	-117.5747968	San Bernardino County
165588	Fee-for-Service	1629003157	1629003157	2	1	IMPULSE AMBULANCE INC	5/23/2008	3416L0300X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	12531 VANOWEN ST	None	NORTH HOLLYWOOD	CA	91605	5321	19	06037	34.1939765	-118.4064525	Los Angeles County
165688	Fee-for-Service	1790886869	1790886869	1	2	IQBAL,RAZA MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	53318	41	Internal Medicine	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
165701	Fee-for-Service	1356372601	1356372601	1	1	INLAND CARDIOTHORACIC	9/30/1990	174400000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	SURGICAL ASSOCIATES	401 E HIGHLAND AVE	STE 251	SAN BERNARDINO	CA	92404	3800	36	06071	34.1358627	-117.2757778	San Bernardino County
165777	Fee-for-Service	1265588909	1265588909	1	1	INLAND PSYCHIATRIC MEDICAL G	7/16/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC	8710 MONROE CT	SUITE 150	RANCHO CUCAMONGA	CA	91730	4883	36	06071	34.09544496	-117.5747968	San Bernardino County
165780	Fee-for-Service	1124893615	1124893615	1	1	IRC-SUTTER HEALTH JACKSON LL	10/23/2024	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	JACKSON DIALYSIS CENTER	12030 INDUSTRY BLVD	None	JACKSON	CA	95642	9371	03	06005	38.36936365	-120.8019857	Amador County
166064	Fee-for-Service	1265588909	1265588909	1	1	INLAND PSYCHIATRIC MEDICAL G	7/16/2019	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	8710 MONROE CT	SUITE 150	RANCHO CUCAMONGA	CA	91730	4883	36	06071	34.09544496	-117.5747968	San Bernardino County
166101	Fee-for-Service	1851371520	1851371520	1	1	IWATA, CHRIS H OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	595 STANISLAUS	STE C	ANGELS CAMP	CA	95222	0501	05	06009	38.07602766	-120.5503016	Calaveras County
166143	Fee-for-Service	1285865832	1285865832	1	1	IBRAHIM, STEVANUS PT	5/6/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1135 S SUNSET AVE	SUITE 101	WEST COVINA	CA	91790	3938	19	06037	34.06215064	-117.9453997	Los Angeles County
166283	Fee-for-Service	1902935984	1902935984	1	2	ISKANDAR, LUCY R PSYD	8/26/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	18672 FLORIDA ST	#100	HUNTINGTON BEACH	CA	92648	1917	30	06059	33.691185	-117.9910425	Orange County
166368	Fee-for-Service	1982618641	1982618641	1	1	INGRID HERNBERG MD	9/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3015 3RD AVE SE	None	ABERDEEN	SD	57401	5418	00	None	45.46218051	-98.444655	Brown County
166559	Fee-for-Service	1144334368	1144334368	1	1	ISIDRO, MARICEL A CRNA	10/5/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
166561	Fee-for-Service	1225195340	1225195340	1	1	INDIANA UNIVERSITY HEALTH BA	3/16/2022	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ITAL	2401 W UNIVERSITY AVE	None	MUNCIE	IN	47303	3428	00	None	40.19758382	-85.41506596	Delaware County
166599	Fee-for-Service	1285886440	1285886440	1	1	ISACSON, JASON K LMFT	6/10/2022	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
166649	Fee-for-Service	1831684703	1831684703	1	1	IHENACHOR, EZINNE MD	10/14/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	165425	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
166683	Fee-for-Service	1841517620	1841517620	1	1	INNES, LINDSAY M MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123751	41	Internal Medicine	0	In state provider	None	3801 HOWE STREET	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
166850	Fee-for-Service	1225195340	1225195340	1	1	INDIANA UNIVERSITY HEALTH BA	3/16/2022	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	ITAL	2401 W UNIVERSITY AVE	None	MUNCIE	IN	47303	3428	00	None	40.19758382	-85.41506596	Delaware County
166851	Fee-for-Service	1861598419	1861598419	1	1	IRVINE, JOHN W MD	5/20/1987	174400000X	NA	Other	026	PHYSICIANS	23597	41	Internal Medicine	0	In state provider	None	730 HARRIS ST	None	EUREKA	CA	95503	4414	12	06023	40.78034799	-124.1605914	Humboldt County
166974	Fee-for-Service	1255481404	1255481404	1	1	ISRAELS, BARBARA LMFT	4/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3300 TULLY ROAD	C-1	MODESTO	CA	95350	0849	50	06099	37.68597355	-121.012414	Stanislaus County
167362	Fee-for-Service	1154742229	1154742229	1	1	IM-FSR INC	5/30/2014	193400000X	NA	Other	026	PHYSICIANS	125541	41	Internal Medicine	0	In state provider	None	2701 S BRISTOL	None	SANTA ANA	CA	92704	6201	30	06059	33.71114199	-117.8853958	Orange County
167740	Fee-for-Service	1447994298	1447994298	1	1	INGLEWOOD URGENT CARE INC	8/1/2022	261QU0200X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	933 CENTINELA AVENUE	STE B	INGLEWOOD	CA	90302	1501	19	06037	33.97609809	-118.356369	Los Angeles County
167785	Fee-for-Service	1033124730	1033124730	1	1	ISHAQUE, SALEEM MD	9/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	36997	36	Psychiatry	0	In state provider	None	550 WASHINGTON ST	STE 635	SAN DIEGO	CA	92103	2229	37	06073	32.75003652	-117.1603431	San Diego County
168105	Fee-for-Service	1417429648	1417429648	1	1	IMPAKT MEDICAL, LLC	3/29/2019	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	700 FREDERICK STREET	SUITE 301	SANTA CRUZ	CA	95062	2239	44	06087	36.98031434	-122.004438	Santa Cruz County
168268	Fee-for-Service	1316055205	1316055205	1	1	IHC HEALTH SERVICES INC	7/26/2008	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1485 S HIGHWAY 40	None	HEBER CITY	UT	84032	3522	00	None	40.490019	-111.4061895	Wasatch County
168308	Fee-for-Service	1164962882	1164962882	1	1	IPSUM DIAGNOSTICS LLC	7/2/2018	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	8607 ROBERTS DRIVE	SUITE 125	ATLANTA	GA	30350	2205	00	None	33.99107435	-84.34047573	Fulton County
168410	Fee-for-Service	1205452794	1205452794	1	1	INNOVATIVE HEALTHCARE	1/26/2023	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	CONSULTANTS	746 S MAIN AVENUE	SUITE B	FALLBROOK	CA	92028	3352	37	06073	33.37559896	-117.2514256	San Diego County
168557	Fee-for-Service	1316055205	1316055205	1	1	IHC HEALTH SERVICES INC	7/26/2008	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1485 S HIGHWAY 40	None	HEBER CITY	UT	84032	3522	00	None	40.490019	-111.4061895	Wasatch County
168607	Fee-for-Service	1881042034	1881042034	1	1	IGNACIO, ANDREW J	8/14/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
168622	Fee-for-Service	1497917504	1497917504	1	1	IP, JASPER S MD	9/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	103233	41	Internal Medicine	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
168683	Fee-for-Service	1285240622	1285240622	1	1	INFINITE LIFE, INC	8/20/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5958 VINELAND AVE	STE L-2	NORTH HOLLYWOOD	CA	91601	1329	19	06037	34.179174	-118.370272	Los Angeles County
168714	Fee-for-Service	1538752431	1538752431	1	1	ITEN, JESSICA	4/19/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1550 N IMPERIAL AVE	STE 1	EL CENTRO	CA	92243	6304	13	06025	32.80696546	-115.5702795	Imperial County
168741	Fee-for-Service	1093769341	1093769341	1	1	IN HOME HEALTH LLC	5/13/1996	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2005 DE LA CRUZ BLVD	STE 271	SANTA CLARA	CA	95050	3031	43	06085	37.36107355	-121.941418	Santa Clara County
168819	Fee-for-Service	1245284983	1245284983	1	1	INTRIERE, LISA MD	12/2/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	76379	None	None	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
168936	Fee-for-Service	1174791396	1174791396	1	1	IGID SENIOR CARE INC	1/10/2008	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	FABIOLA IGID	38648 CORTINA WAY	None	PALMDALE	CA	93552	4039	19	06037	34.585245	-118.059054	Los Angeles County
168969	Fee-for-Service	1285240622	1285240622	1	1	INFINITE LIFE, INC	8/20/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5958 VINELAND AVE	STE L-2	NORTH HOLLYWOOD	CA	91601	1329	19	06037	34.179174	-118.370272	Los Angeles County
169029	Fee-for-Service	1093769341	1093769341	1	1	IN HOME HEALTH LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2005 DE LA CRUZ BLVD	STE 271	SANTA CLARA	CA	95050	3031	43	06085	37.36107355	-121.941418	Santa Clara County
169080	Fee-for-Service	1134415854	1134415854	1	1	IJADI, JEFFREY MD	5/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126442	01	General Practice	0	In state provider	None	1601 N MONTE VISTA AVE	SUITE 100	CLAREMONT	CA	91711	2914	19	06037	34.112259	-117.698539	Los Angeles County
169210	Fee-for-Service	1790015063	1790015063	1	1	IN HONOR OF OUR PARENTS INC	3/8/2013	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1317 WEST 40TH PLACE	None	LOS ANGELES	CA	90037	1703	19	06037	34.00995024	-118.2987162	Los Angeles County
169436	Fee-for-Service	1497148456	1497148456	2	8	IHS RADIOLOGY MEDICAL GROUP,	12/4/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	3601 VISTA WAY	SUITE 101	OCEANSIDE	CA	92056	4559	37	06073	33.18140858	-117.3093221	San Diego County
169552	Fee-for-Service	1851463483	1851463483	1	24	INDEPENDENT OPTIONS INC	11/7/1996	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SHERWOOD HOUSE	2625 SHERWOOD AVE	None	FULLERTON	CA	92831	1418	30	06059	33.89302657	-117.8828973	Orange County
169597	Fee-for-Service	1568807691	1568807691	1	1	INNOVATIVE SLEEP SOLUTIONS	7/28/2015	261QS1200X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	INC	7974 HAVEN AVENUE	STE 180	RANCHO CUCAMONGA	CA	91730	3052	36	06071	34.10875445	-117.5759905	San Bernardino County
169819	Fee-for-Service	1316455926	1316455926	1	1	IMBERI, JENNY E PHD	4/2/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
169968	Fee-for-Service	1003994757	1003994757	1	1	ISAACS, RICHARD S MD	10/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75756	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	2525 STOCKTON BLVD	STE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
169978	Fee-for-Service	1174131957	1174131957	1	1	INTEGRALIFE FAMILY COUNSELIN	11/12/2021	251S00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	S INSTITUTE	41197 GOLDEN GATE CIRCLE	205	MURRIETA	CA	92562	6999	33	06065	33.53652808	-117.1759195	Riverside County
170010	Fee-for-Service	1053846790	1053846790	1	1	IBRAHIM, MARYANNE R	6/23/2022	207R00000X	NA	Other	026	PHYSICIANS	171435	None	None	0	In state provider	None	18035 BROOKHURST ST	STE 2100	FOUNTAIN VALLEY	CA	92708	6738	30	06059	33.701184	-117.9544385	Orange County
170108	Fee-for-Service	1417995598	1417995598	1	1	INLAND VALLEY INFECTIOUS	8/9/1993	207RI0200X	NA	HIV/AIDS/Infectious Disease	022	PHYSICIANS GROUP	-	None	None	0	In state provider	DISEASE MEDICAL GROUP	255 E BONITA AVE	None	POMONA	CA	91767	1923	19	06037	34.097913	-117.7474635	Los Angeles County
170195	Fee-for-Service	1518009554	1518009554	1	1	IONG-SZETO, ALISON PHD	5/25/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	540 S EREMLAND DR	SUITE E	COVINA	CA	91723	3186	19	06037	34.079904	-117.8863235	Los Angeles County
170533	Fee-for-Service	1033224134	1033224134	1	1	IRVING, WILLIAM H MD	1/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	27033	20	Orthopedic Surgery	0	In state provider	None	123 DI SALVO AVE	STE C	SAN JOSE	CA	95128	1717	43	06085	37.32628785	-121.9371289	Santa Clara County
170551	Fee-for-Service	1467005579	1467005579	1	1	INLAND EMPIRE AUTISM ASSESSM	10/24/2019	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ENT CENTER, A PSYCHOLOGI	1499 S TIPPECANOE AVE	A	SAN BERNARDINO	CA	92408	2920	36	06071	34.073982	-117.259711	San Bernardino County
170580	Fee-for-Service	1760062582	1760062582	1	1	IDEMUDIA, FUNMILAYO MD	9/27/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	188127	08	Family Practice	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
170601	Fee-for-Service	1265504013	1265504013	1	1	IYER, BALA C MD	5/2/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	69287	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
170643	Fee-for-Service	1316216617	1316216617	1	1	IVANCIE. REBECCA A MD	4/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114313	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
170889	Fee-for-Service	1265504013	1265504013	1	1	IYER, BALA C MD	5/2/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	69287	41	Internal Medicine	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
170922	Fee-for-Service	1720474729	1720474729	1	1	IZZO, JOSEPH A MD	7/1/2018	207P00000X	NA	Other	026	PHYSICIANS	154197	66	Emergency Medicine (Urgent Care)	0	In state provider	None	500 WEST HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
170995	Fee-for-Service	1992440986	1992440986	1	1	ILLENCIK, CHRISTINA LMFT	8/11/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1902 ORANGE TREE LN	SUITE 200	REDLANDS	CA	92374	2888	36	06071	34.06785293	-117.2179967	San Bernardino County
171013	Fee-for-Service	1972821494	1972821494	1	2	INTERCARE MEDICAL GROUP INC	11/15/2011	193200000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1555 SHAW AVE	STE 101	CLOVIS	CA	93611	4096	10	06019	36.80870008	-119.687617	Fresno County
171168	Fee-for-Service	1902673726	1902673726	1	1	IMAD AKEL MD INC	1/2/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	7950 CHERRY AVE	105	FONTANA	CA	92336	4023	36	06071	34.109892	-117.4887375	San Bernardino County
171218	Fee-for-Service	1588229710	1588229710	1	1	IM, TAYLIN E MD	4/8/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	1920 COLORADO AVENUE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
171464	Fee-for-Service	1447344023	1447344023	1	1	ITKIN, ALEKSANDR M MD	8/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81088	07	Dermatology	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
171494	Fee-for-Service	1083724850	1083724850	1	1	INLAND PHYSICIANS	7/15/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	SERVICES, INC	9089 BASELINE RD	STE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
171617	Fee-for-Service	1801974969	1801974969	1	1	IGRA, VIVIEN K MD	9/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	63247	40	Pediatrics	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
171743	Fee-for-Service	1619206703	1619206703	1	1	INNOVATIVE SENIOR	3/18/2011	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	REHABILITATION	222 W PINE ST	None	LODI	CA	95240	2020	39	06077	38.13426186	-121.2758101	San Joaquin County
171886	Fee-for-Service	1386486397	1386486397	1	1	INLAND LUNG INSTITUTE PROFES	9/13/2024	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	SIONAL CORPORATION	830 MAGNOLIA AVE	1ST FLOOR	CORONA	CA	92879	3128	33	06065	33.86017131	-117.5520534	Riverside County
171966	Fee-for-Service	1265857213	1265857213	1	1	INSIGHT PSYCHOLOGY & ADDICTI	11/21/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	N	4000 BIRCH ST	SUITE 112A	NEWPORT BEACH	CA	92660	2211	30	06059	33.66463772	-117.8698289	Orange County
171969	Fee-for-Service	1639669104	1639669104	1	1	IMPERIO, MICHELLE E MD	7/1/2021	207R00000X	NA	Other	026	PHYSICIANS	163801	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
172020	Fee-for-Service	1801077680	1801077680	1	1	IKEGBU, NNENNA N MD	10/12/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	100808	None	None	0	In state provider	None	22419 KENT AVE	None	TORRANCE	CA	90505	2303	19	06037	33.824448	-118.3564765	Los Angeles County
172098	Fee-for-Service	1750893947	1750893947	1	1	ISMAY, HEATHER M CCC-SLP	5/16/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	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
172102	Fee-for-Service	1841346293	1841346293	1	1	ISON, PAMELA J MD	2/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87353	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
172304	Fee-for-Service	1013024132	1013024132	3	1	IMGRX SJ VALLEY INC	10/8/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY PARLIER	429 E MANNING AVE	BLDG 1	PARLIER	CA	93648	2668	10	06019	36.60472152	-119.5230233	Fresno County
172348	Fee-for-Service	1184684383	1184684383	1	1	IZMIRIAN, GEORGE G MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	71432	05	Anesthesiology	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
172384	Fee-for-Service	1518461391	1518461391	1	1	IDOWU, OLUMUYIWA A MD	9/3/2024	390200000X	NA	Other	026	PHYSICIANS	165545	20	Orthopedic Surgery	0	In state provider	None	2525 ERRINGER RD.	None	SIMI VALLEY	CA	93065	2352	56	06111	34.280838	-118.7614975	Ventura County
173059	Fee-for-Service	1730565524	1730565524	1	1	IQBAL-HOFMEISTER, MALEEHA L	5/8/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CSW	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
173115	Fee-for-Service	1942654231	1942654231	1	1	ITRIAGO ARAUJO, ELENA C MD	4/17/2023	2080N0001X	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
173130	Fee-for-Service	1114373370	1114373370	1	1	IRBY, DANIEL P MD	1/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152488	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
173334	Fee-for-Service	1164499737	1164499737	2	1	INTERNAL MEDICAL GROUP	6/27/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1050 E YORBA LINDA BLVD	STE 103	PLACENTIA	CA	92870	3750	30	06059	33.88824259	-117.8446439	Orange County
173351	Fee-for-Service	1104830074	1104830074	1	1	INTERSCOPE PATHOLOGY MEDICAL	3/1/1980	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	21114 VANOWEN ST	None	CANOGA PARK	CA	91303	2821	19	06037	34.19373808	-118.5935645	Los Angeles County
173604	Fee-for-Service	1578887790	1578887790	1	1	IRVINE GASTROENTEROLOGY	2/1/2011	261QM2500X	NA	Other	026	PHYSICIANS	66256	10	Gastroenterology (M.D. only)	0	In state provider	None	15825 LAGUNA CANYON RD	STE 106	IRVINE	CA	92618	2126	30	06059	33.66406324	-117.7638431	Orange County
173639	Fee-for-Service	1104830074	1104830074	1	1	INTERSCOPE PATHOLOGY MEDICAL	4/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	None	21114 VANOWEN ST	None	CANOGA PARK	CA	91303	2821	19	06037	34.19373808	-118.5935645	Los Angeles County
173798	Fee-for-Service	1831410299	1831410299	1	1	IYER, ASHA	4/9/2025	207T00000X	NA	General Surgery	026	PHYSICIANS	149696	14	Neurological Surgery	0	In state provider	None	2800 L ST	STE 610	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
174150	Fee-for-Service	1689628265	1689628265	1	1	ISRAEL, JOSHUA A MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	68944	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
174382	Fee-for-Service	1174908685	1174908685	1	1	ISNASIOUS, SANDRA MD	8/1/2019	207P00000X	NA	Other	026	PHYSICIANS	146762	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
174481	Fee-for-Service	1841959061	1841959061	1	1	IMANI TRANSPORTATION LLC	8/16/2023	2278P4000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2667 CAMINO DEL RIO S	UNIT 214-98	SAN DIEGO	CA	92108	3707	37	06073	32.76977026	-117.135564	San Diego County
174899	Fee-for-Service	1548331465	1548331465	1	1	INDERIAS, LUZMIN A MD	9/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87776	41	Internal Medicine	0	In state provider	None	1700 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	5115	36	06071	34.130214	-117.2788065	San Bernardino County
175043	Fee-for-Service	1871687590	1871687590	1	2	ISLAM, SHAMIM MD	11/6/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	86834	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
175128	Fee-for-Service	1174682769	1174682769	1	1	IMARAH, JOSEPH E MD	4/1/2003	207L00000X	NA	Other	026	PHYSICIANS	44896	05	Anesthesiology	0	In state provider	ATTN MGA OFFICE	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
175212	Fee-for-Service	1134176225	1134176225	1	1	INLAND REHABILITATION	11/30/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	MEDICAL GROUP INC	400 N PEPPER AVE	RM 6A218A	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
175369	Fee-for-Service	1912227273	1912227273	1	1	IN, GINO K MD	9/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126412	78	Neoplastic Diseases/Oncology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
175638	Fee-for-Service	1053486498	1053486498	1	1	IM, TAEHO MD INC	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	66753	05	Anesthesiology	0	In state provider	None	817 COFFEE ROAD	SUITE C3	MODESTO	CA	95355	4241	50	06099	37.655235	-120.975616	Stanislaus County
175658	Fee-for-Service	1912227273	1912227273	1	1	IN, GINO K MD	9/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126412	68	Hematology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
175806	Fee-for-Service	1558608380	1558608380	1	1	INNOVATIVE DIALYSIS CENTER	1/1/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	OF VERDUGO HILLS LLC	1808 VERDUGO BLVD	STE 200	GLENDALE	CA	91208	3501	19	06037	34.2056211	-118.2154553	Los Angeles County
175888	Fee-for-Service	1154668986	1154668986	1	1	INNOVATIVE DIALYSIS CENTER	1/1/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	OF WEST LOS ANGELES LLC	1801 S LA CIENEGA BLVD	None	LOS ANGELES	CA	90035	4641	19	06037	34.04410198	-118.3768238	Los Angeles County
175898	Fee-for-Service	1851395313	1851395313	1	1	IROMLOO, KHOSRO MD	12/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87126	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	720 PAULARINO AVE	STE 230	COSTA MESA	CA	92626	6920	30	06059	33.68237845	-117.8866035	Orange County
176004	Fee-for-Service	1629529466	1629529466	1	1	ICHINOSE, MEGAN C PHD	8/1/2022	103T00000X	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
176136	Fee-for-Service	1083188221	1083188221	1	1	INNOVATIVE DERMATOLOGY ALLIA	7/6/2024	207ND0101X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	AND WELLNESS	1027 DEMAREE	None	VISALIA	CA	93291	4117	54	06107	36.338382	-119.3333175	Tulare County
176394	Fee-for-Service	1205280971	1205280971	1	1	IWUCHUKWU, CHIJIOKE C MD	5/28/2020	390200000X	NA	Other	026	PHYSICIANS	151515	30	Radiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
176447	Fee-for-Service	1154783397	1154783397	1	1	IBISH, ABDULLAH MD	3/16/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	168155	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
176520	Fee-for-Service	1447273115	1447273115	1	1	IMPERIO, JOSHUA A H MD	1/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	56083	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
176582	Fee-for-Service	1437435724	1437435724	1	1	ISAAC, COURTNEY S	3/15/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3733 SAN DIMAS ST	STE 104	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
176732	Fee-for-Service	1134155336	1134155336	1	1	INLAND URGENT CARE OF SUN	12/19/2013	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	27168 NEWPORT ROAD	SUITE 1	MENIFEE	CA	92584	7383	33	06065	33.68505351	-117.185472	Riverside County
176759	Fee-for-Service	1861854390	1861854390	1	1	IBRAHIM, FADY MD	4/9/2025	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	178856	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
176766	Fee-for-Service	1508027194	1508027194	1	1	IKEI, MICHELLE L LMFT	3/19/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
176782	Fee-for-Service	1316952195	1316952195	1	1	INLAND EMPIRE CARDIOLOGY	10/31/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	FACULTY MEDICAL ASSC INC	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
176792	Fee-for-Service	1164002135	1164002135	1	1	IMBERT MATOS, LICET MD	8/29/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	188439	08	Family Practice	0	In state provider	None	9000 MING AVE	STE L-1B	BAKERSFIELD	CA	93311	1318	15	06029	35.33989328	-119.1034715	Kern County
177016	Fee-for-Service	1902811672	1902811672	1	1	ISLEY, GARY L MD	1/1/1982	207L00000X	NA	Other	026	PHYSICIANS	26125	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
177053	Fee-for-Service	1952305914	1952305914	1	1	IGWE, DANIEL JR MD	10/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	53362	02	General Surgery	0	In state provider	None	1225 E LATHAM AVE	STE A	HEMET	CA	92543	4423	33	06065	33.74937952	-116.959626	Riverside County
177096	Fee-for-Service	1831269125	1831269125	1	1	INTEGRAL ORTHOTICS AND	3/2/1994	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	PROSTHETICS	5900 COYLE AVE	STE B	CARMICHAEL	CA	95608	0429	34	06067	38.6676	-121.3268445	Sacramento County
177164	Fee-for-Service	1114953262	1114953262	1	1	IWANCZYK, LUKASZ J MD	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79334	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
177167	Fee-for-Service	1316981905	1316981905	1	1	INAMDAR, SYEDA R MD	8/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100882	41	Internal Medicine	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
177375	Fee-for-Service	1124296124	1124296124	1	1	ISMAIL, HEBA MD	6/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102593	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	4234 RIVERWALK PKWY	SUITE 236	RIVERSIDE	CA	92505	3312	33	06065	33.90290859	-117.4941562	Riverside County
177382	Fee-for-Service	1922064161	1922064161	1	1	ISHII, ROY T MD	5/20/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	23529	40	Pediatrics	0	In state provider	None	755 S FAIRMONT AVE	STE F	LODI	CA	95240	4643	39	06077	38.125089	-121.285886	San Joaquin County
177456	Fee-for-Service	1316981905	1316981905	1	1	INAMDAR, SYEDA R MD	8/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100882	03	Allergy	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
177598	Fee-for-Service	1730673153	1730673153	1	1	INFINITY KIDS CORPORATION	11/23/2021	225X00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	22691 LAMBERT ST	502	LAKE FOREST	CA	92630	1614	30	06059	33.63321041	-117.7137117	Orange County
177653	Fee-for-Service	1669787123	1669787123	1	2	I&V HOME HEALTH INC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	336 N CENTRAL AVE	SUITE 8	GLENDALE	CA	91203	3128	19	06037	34.15128339	-118.2579015	Los Angeles County
177673	Fee-for-Service	1245587328	1245587328	1	1	INLAND FIRST ASSIST INC	5/16/2013	282N00000X	NA	Hospitals	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3865 JACKSON ST	None	RIVERSIDE	CA	92503	3919	33	06065	33.92617009	-117.4404151	Riverside County
177850	Fee-for-Service	1386911006	1386911006	1	1	INSITE DIGESTIVE HEALTH CARE	2/2/2017	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	50 ALESSANDRO PLACE	SUITE 440	PASADENA	CA	91105	0000	19	06037	34.13101049	-118.151532	Los Angeles County
177884	Fee-for-Service	1730673153	1730673153	1	1	INFINITY KIDS CORPORATION	11/23/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	22691 LAMBERT ST	502	LAKE FOREST	CA	92630	1614	30	06059	33.63321041	-117.7137117	Orange County
177902	Fee-for-Service	1386043065	1386043065	1	2	IMC CARE HOME INC	10/21/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2081 E RYAN LANE	None	FRESNO	CA	93720	4146	10	06019	36.87204181	-119.7456986	Fresno County
178058	Fee-for-Service	1639541758	1639541758	1	1	INTOUCH HOME CARE, INC	12/20/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4701 PATRICK HENRY DR	STE 1107	SANTA CLARA	CA	95054	1868	43	06085	37.397709	-121.984972	Santa Clara County
178171	Fee-for-Service	1730673153	1730673153	1	1	INFINITY KIDS CORPORATION	6/2/2022	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	22691 LAMBERT ST	502	LAKE FOREST	CA	92630	1614	30	06059	33.63321041	-117.7137117	Orange County
178232	Fee-for-Service	1417703323	1417703323	1	1	INSPIRE PSYCHOLOGY SERVICES,	6/5/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PC	2628 VICTOR AVE	STE C	REDDING	CA	96002	1454	45	06089	40.56894199	-122.3392301	Shasta County
178323	Fee-for-Service	1992006720	1992006720	1	1	INSIGHT IMAGING INC	8/29/2011	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	45512	30	Radiology	0	In state provider	None	140 LITTON DR	STE 208	GRASS VALLEY	CA	95945	5079	29	06057	39.23422354	-121.0525426	Nevada County
178442	Fee-for-Service	1063168698	1063168698	1	1	ISMAIEL, NADA MD	6/1/2022	207L00000X	NA	Other	026	PHYSICIANS	168039	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
178779	Fee-for-Service	1205050655	1205050655	1	1	ISMAIL BOKHARI MD	4/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3269 N STOCKTON HILL RD	None	KINGMAN	AZ	86409	3619	00	None	35.220006	-114.0380145	Mohave County
178799	Fee-for-Service	1669811907	1669811907	1	1	INDRAKANTI, SANTOSHI S MD	1/30/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	148322	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
178859	Fee-for-Service	1144828500	1144828500	1	1	IE COMMUNITY HOSPICE, INC	9/9/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	600 N MOUNTAIN AVE	STE B102	UPLAND	CA	91786	4359	36	06071	34.10094187	-117.6700806	San Bernardino County
178993	Fee-for-Service	1205944907	1205944907	1	1	IMANZAHRAI, ASHKAN MD	10/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	55704	01	General Practice	0	In state provider	None	5601 DE SOTO DR	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
179111	Fee-for-Service	1689724585	1689724585	1	1	ISRAEL, STEVEN S OD	12/5/2007	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	COMMUNITY VISION OPT	2068 W AVENUE J	None	LANCASTER	CA	93536	5913	19	06037	34.6893627	-118.1678057	Los Angeles County
179148	Fee-for-Service	1144828500	1144828500	1	1	IE COMMUNITY HOSPICE, INC	9/9/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	600 N MOUNTAIN AVE	STE B102	UPLAND	CA	91786	4359	36	06071	34.10094187	-117.6700806	San Bernardino County
179283	Fee-for-Service	1205944907	1205944907	1	1	IMANZAHRAI, ASHKAN MD	10/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	55704	10	Gastroenterology (M.D. only)	0	In state provider	None	5601 DE SOTO DR	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
179480	Fee-for-Service	1437416179	1437416179	1	1	ISTRATE, LAURENTIU MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	2865 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25240042	-121.7859055	Klamath County
179632	Fee-for-Service	1588978449	1588978449	1	1	IPSON, JASON T MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	69715	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
179708	Fee-for-Service	1972513695	1972513695	2	1	ITURBE, IGNACIO MD	8/24/2022	207RH0003X	NA	Oncology	026	PHYSICIANS	42415	None	None	0	In state provider	None	855 THIRD AVE	STE 3330	CHULA VISTA	CA	91911	1350	37	06073	32.62197574	-117.0723222	San Diego County
179790	Fee-for-Service	1356925911	1356925911	1	1	IVY COTTAGES INC	1/20/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	16840 MT EDEN ST	None	FOUNTAIN VALLEY	CA	92708	2518	30	06059	33.71876883	-117.9301266	Orange County
179976	Fee-for-Service	1245282011	1245282011	1	1	IDETA, RICK W OD	10/31/1986	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1265 E SHAW AVE	STE 102	FRESNO	CA	93710	7801	10	06019	36.80833453	-119.766501	Fresno County
180057	Fee-for-Service	1982272977	1982272977	1	1	IMAM, AREEBA MD	8/1/2024	207P00000X	NA	Other	026	PHYSICIANS	None	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
180093	Fee-for-Service	1578111308	1578111308	1	1	INFUSION AND CLINICAL SERVIC	12/19/2023	1041C0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1311 COLUMBUS ST	None	BAKERSFIELD	CA	93305	2010	15	06029	35.39743852	-118.977435	Kern County
180323	Fee-for-Service	1962431759	1962431759	1	1	IMESON, SHALE MD	4/30/1988	207L00000X	NA	Other	026	PHYSICIANS	62662	05	Anesthesiology	0	In state provider	None	2626 N CALIFORNIA ST	STE G	STOCKTON	CA	95204	5500	39	06077	37.97724966	-121.2917368	San Joaquin County
180367	Fee-for-Service	1669769345	1669769345	1	1	ISAACS, KRISTOPHER T	1/16/2013	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
180458	Fee-for-Service	1487613766	1487613766	2	1	INLAND CENTER MED GRP PC	4/11/2008	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	None	9220 HAVEN AVENUE	SUITE 210	RANCHO CUCAMONGA	CA	91730	8551	36	06071	34.08525	-117.5758875	San Bernardino County
180504	Fee-for-Service	1538153853	1538153853	1	1	IMAI, REN N MD	12/12/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	43837	01	General Practice	0	In state provider	None	1471 N ACACIA AVE	None	REEDLEY	CA	93654	2102	10	06019	36.60940406	-119.4510445	Fresno County
180744	Fee-for-Service	1487613766	1487613766	2	1	INLAND CENTER MED GRP PC	4/11/2008	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	None	9220 HAVEN AVENUE	SUITE 210	RANCHO CUCAMONGA	CA	91730	8551	36	06071	34.08525	-117.5758875	San Bernardino County
180784	Fee-for-Service	1689102261	1689102261	1	1	IKIZLER, HALIL O MD	8/13/2019	111NR0200X	NA	Other	026	PHYSICIANS	162638	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
180900	Fee-for-Service	1437125176	1437125176	1	1	INSIGHT HEALTH CORP	4/2/2004	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	INSIGHT IMAGING ENCINO	5363 BALBOA BLVD	STE 100	ENCINO	CA	91316	2802	19	06037	34.169058	-118.5011265	Los Angeles County
180953	Fee-for-Service	1740391176	1740391176	1	1	IMAHARA, SCOTT D MD	12/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108984	None	None	0	In state provider	None	2950 RESEARCH PARK	None	SOQUEL	CA	95073	2000	44	06087	36.98692657	-121.9685264	Santa Cruz County
180954	Fee-for-Service	1689902512	1689902512	1	1	INTEGRATED PAIN CARE, INC	3/5/2012	193400000X	NA	Other	026	PHYSICIANS	77502	05	Anesthesiology	0	In state provider	None	2299 POST ST	STE 211	SAN FRANCISCO	CA	94115	3473	38	06075	37.78434298	-122.4392033	San Francisco County
181034	Fee-for-Service	1487613766	1487613766	2	1	INLAND CENTER MED GRP PC	2/29/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	9220 HAVEN AVENUE	SUITE 210	RANCHO CUCAMONGA	CA	91730	8551	36	06071	34.08525	-117.5758875	San Bernardino County
181067	Fee-for-Service	1669725834	1669725834	1	1	INTEGRATED INTERVENTION FOR	3/18/2016	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	CHILDREN WITH AUTISM INC	911 BERN COURT	SUITE 130	SAN JOSE	CA	95112	1242	43	06085	37.37594797	-121.8941096	Santa Clara County
181262	Fee-for-Service	1720471097	1720471097	1	1	INTERCEDE HEALTH OF CA PC	5/14/2015	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1680 E 120TH ST	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
181321	Fee-for-Service	1487613766	1487613766	2	1	INLAND CENTER MED GRP PC	4/11/2008	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9220 HAVEN AVENUE	SUITE 210	RANCHO CUCAMONGA	CA	91730	8551	36	06071	34.08525	-117.5758875	San Bernardino County
181344	Fee-for-Service	1154586105	1154586105	1	1	IAN LEONG LIAO MD	9/28/2015	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
181471	Fee-for-Service	1174598072	1174598072	1	1	INSIGHT HEALTH CORP	4/29/2005	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	INSIGHT IMAGING FOLSOM	1354 PRAIRIE CITY RD	None	FOLSOM	CA	95630	9554	34	06067	38.65521642	-121.1687371	Sacramento County
181474	Fee-for-Service	1720449358	1720449358	1	1	ILLESCAS, CINDY NP	4/25/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
181789	Fee-for-Service	1497148456	1497148456	2	11	IHS RADIOLOGY MEDICAL GROUP,	4/1/2021	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	2427 TRANSPORTATION	None	NATIONAL CITY	CA	91950	6664	37	06073	32.66097312	-117.1026092	San Diego County
181898	Fee-for-Service	1568537637	1568537637	1	1	INLAND ARTIFICIAL LIMB &	7/27/2007	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	BRACE INC	41707 WINCHESTER RD	SUITE 102	TEMECULA	CA	92590	4867	33	06065	33.51901547	-117.1674976	Riverside County
181903	Fee-for-Service	1790976066	1790976066	1	1	IRISH, TREVOR K OD	2/24/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	991 E MONTE VISTA AVE	None	TURLOCK	CA	95382	0636	50	06099	37.52188647	-120.83769	Stanislaus County
181930	Fee-for-Service	1659411841	1659411841	1	1	IEVLEVA, YULIA O LMFT	5/22/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	48839	-	NOT APPLICABLE	0	In state provider	None	15519 CRENSHAW BLVD	None	GARDENA	CA	90249	4525	19	06037	33.8896575	-118.3266105	Los Angeles County
182191	Fee-for-Service	1518557552	1518557552	1	1	IZZO MARRIAGE & FAMILY THERA	8/17/2023	261QM0801X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	PY, PC	307 S. B ST.	None	SAN MATEO	CA	94401	4053	41	06081	37.56539871	-122.3222584	San Mateo County
182234	Fee-for-Service	1740900729	1740900729	1	1	I-CARE REGISTERED NURSING PR	3/17/2025	261QM0801X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ACTITIONER, INC	699 W RIALTO AVE	UNIT B	SAN BERNARDINO	CA	92410	3327	36	06071	34.10083253	-117.298431	San Bernardino County
182348	Fee-for-Service	1841496452	1841496452	1	1	IBANEZ, SIR CEDRIC A III MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112484	41	Internal Medicine	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
182358	Fee-for-Service	1104830074	1104830074	1	4	INTERSCOPE PATHOLOGY MEDICAL	2/1/2025	207ZP0102X	NA	Other	026	PHYSICIANS	None	22	Pathology (M.D. only)	0	In state provider	GROUP INC	30700 RUSSELL RANCH RD	SUITE 250, UNIT 235	WESTLAKE VILLAGE	CA	91362	9507	19	06037	34.14987261	-118.7943115	Los Angeles County
182476	Fee-for-Service	1518557552	1518557552	1	1	IZZO MARRIAGE & FAMILY THERA	11/4/2024	261QM0801X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	PY, PC	307 S. B ST.	None	SAN MATEO	CA	94401	4053	41	06081	37.56539871	-122.3222584	San Mateo County
182518	Fee-for-Service	1003071903	1003071903	1	1	IDROVO, JUAN P MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	89	Surgery-Traumatic	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
182520	Fee-for-Service	1740900729	1740900729	1	1	I-CARE REGISTERED NURSING PR	8/29/2023	261QM0801X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ACTITIONER, INC	699 W RIALTO AVE	UNIT B	SAN BERNARDINO	CA	92410	3327	36	06071	34.10083253	-117.298431	San Bernardino County
182532	Fee-for-Service	1497148456	1497148456	2	6	IHS RADIOLOGY MEDICAL GROUP,	12/4/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	1809 NATIONAL AVENUE	SUITE 2104	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
182649	Fee-for-Service	1104830074	1104830074	1	4	INTERSCOPE PATHOLOGY MEDICAL	2/1/2025	207ZP0102X	NA	Other	026	PHYSICIANS	None	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	GROUP INC	30700 RUSSELL RANCH RD	SUITE 250, UNIT 235	WESTLAKE VILLAGE	CA	91362	9507	19	06037	34.14987261	-118.7943115	Los Angeles County
182734	Fee-for-Service	1104830074	1104830074	1	2	INTERSCOPE PATHOLOGY MEDICAL	8/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	MEDICAL GROUP	18321 CLARK ST	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
182759	Fee-for-Service	1265470868	1265470868	1	2	IDEAL HEALTH CARE AND MEDICA	6/6/2006	174400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	L CLINIC, INC	1711 W TEMPLE ST	5606	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
182767	Fee-for-Service	1518557552	1518557552	1	1	IZZO MARRIAGE & FAMILY THERA	8/19/2021	261QM0801X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	PY, PC	307 S. B ST.	None	SAN MATEO	CA	94401	4053	41	06081	37.56539871	-122.3222584	San Mateo County
182891	Fee-for-Service	1194803775	1194803775	1	1	INOKUCHI, SHARON MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	52412	13	Neurology (M.D. only)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
183048	Fee-for-Service	1265470868	1265470868	1	2	IDEAL HEALTH CARE AND MEDICA	6/6/2006	174400000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	L CLINIC, INC	1711 W TEMPLE ST	5606	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
183168	Fee-for-Service	1851348643	1851348643	1	1	INDIO MEDICAL PHARMACY	5/15/1980	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	81893 DR CARREON BLVD	STE 7	INDIO	CA	92201	5592	33	06065	33.7073755	-116.2355895	Riverside County
183178	Fee-for-Service	1194803775	1194803775	1	1	INOKUCHI, SHARON MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	52412	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
183332	Fee-for-Service	1265470868	1265470868	1	2	IDEAL HEALTH CARE AND MEDICA	6/6/2006	174400000X	NA	Other	022	PHYSICIANS GROUP	-	38	Geriatrics	0	In state provider	L CLINIC, INC	1711 W TEMPLE ST	5606	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
183736	Fee-for-Service	1962506535	1962506535	1	1	INTRACOMMUNITY HOME CARE	6/30/1989	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	INC	610 S GLENDALE AVE	None	GLENDALE	CA	91205	2316	19	06037	34.13960614	-118.2506352	Los Angeles County
183783	Fee-for-Service	1942520721	1942520721	1	1	INDEPENDENT LIVING RESOURCE	11/15/2010	251B00000X	NA	Other	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	423 W VICTORIA ST	None	SANTA BARBARA	CA	93101	3619	42	06083	34.41974299	-119.7105873	Santa Barbara County
184045	Fee-for-Service	1376720813	1376720813	1	1	IBRAHIM, WALEED MD INC	1/29/2008	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	77739	10	Gastroenterology (M.D. only)	0	In state provider	None	999 S FAIRMONT AVE	SUITE 115	LODI	CA	95240	5100	39	06077	38.1206163	-121.2858323	San Joaquin County
184058	Fee-for-Service	1689200628	1689200628	1	1	IQBAL, ZARA Q MD	9/26/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	187539	None	None	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
184158	Fee-for-Service	1316575954	1316575954	1	1	INNOVATIVE HEARING CARE & AU	12/9/2020	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	DIOLOGY INC	3975 JACKSON ST	SUITE 204	RIVERSIDE	CA	92503	3948	33	06065	33.92729721	-117.4413503	Riverside County
184702	Fee-for-Service	1245423243	1245423243	1	1	ITALEE OPTOMETRC CTR INC	1/1/1996	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	978 S VERMONT AVE	None	LOS ANGELES	CA	90006	1611	19	06037	34.05302726	-118.2915913	Los Angeles County
184774	Fee-for-Service	1457618522	1457618522	1	1	IQBAL, SADIAH MD	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127801	01	General Practice	0	In state provider	None	2210 DEL PASO RD	None	SACRAMENTO	CA	95834	9676	34	06067	38.655189	-121.5091575	Sacramento County
184875	Fee-for-Service	1740426469	1740426469	1	2	INGARAMO, OSCAR A MD	11/23/2010	No Taxonomy Provided	NA	None	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
185130	Fee-for-Service	1013476852	1013476852	1	1	ISAACSOHN, MAYA J MD	9/20/2022	207R00000X	NA	Other	026	PHYSICIANS	177182	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
185141	Fee-for-Service	1396715793	1396715793	1	1	ISAACSON, MARK S MD	3/4/2014	207L00000X	NA	Other	026	PHYSICIANS	58617	05	Anesthesiology	0	In state provider	None	23625 HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
185145	Fee-for-Service	1275562969	1275562969	1	1	INLAND BEHAVIORAL AND HEALTH	7/1/2000	261QF0050X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	665 N D ST	None	SAN BERNARDINO	CA	92401	1109	36	06071	34.111737	-117.2918735	San Bernardino County
185185	Fee-for-Service	1184077877	1184077877	1	1	INLOW, NICOLE PHD	5/22/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
185228	Fee-for-Service	1568529915	1568529915	3	1	INNOVA PHARMACEUTICALS INC	2/10/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5830 JAMESON CT	None	CARMICHAEL	CA	95608	0896	34	06067	38.650869	-121.3284555	Sacramento County
185256	Fee-for-Service	1487639647	1487639647	1	1	INNOVATIVE PROSTHETIC	4/26/2005	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	SOLUTIONS INC	23641 BIRTCHER DR	None	LAKE FOREST	CA	92630	1770	30	06059	33.6335613	-117.7168312	Orange County
185356	Fee-for-Service	1073745170	1073745170	1	1	INFINITY HEALTHCARE	5/1/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SOLUTIONS INC	14550 ARCHWOOD ST	SUITE 107	VAN NUYS	CA	91405	4604	19	06037	34.19290331	-118.4504678	Los Angeles County
185432	Fee-for-Service	1275562969	1275562969	1	1	INLAND BEHAVIORAL AND HEALTH	7/1/2000	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	665 N D ST	None	SAN BERNARDINO	CA	92401	1109	36	06071	34.111737	-117.2918735	San Bernardino County
185655	Fee-for-Service	1790250264	1790250264	1	1	IBANEZ, DAMIAN RCP	8/21/2024	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
185670	Fee-for-Service	1851463483	1851463483	1	6	INDEPENDENT OPTIONS INC	3/11/1991	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INDEPENDENT OPTIONS, INC	1501 KIOWA CREST DR	None	DIAMOND BAR	CA	91765	3918	19	06037	33.99392774	-117.8323092	Los Angeles County
185718	Fee-for-Service	1275562969	1275562969	1	1	INLAND BEHAVIORAL AND HEALTH	7/1/2000	261QF0050X	NA	Other	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	665 N D ST	None	SAN BERNARDINO	CA	92401	1109	36	06071	34.111737	-117.2918735	San Bernardino County
185994	Fee-for-Service	1881776821	1881776821	1	1	IMTIAZ AHMED MD	1/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 S CRISMON RD	None	MESA	AZ	85209	3767	00	None	33.391494	-111.611862	Maricopa County
186256	Fee-for-Service	1497148456	1497148456	2	7	IHS RADIOLOGY MEDICAL GROUP,	12/4/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	1000 VALE TERRACE DR	None	VISTA	CA	92084	5218	37	06073	33.20904502	-117.2286439	San Diego County
186455	Fee-for-Service	1609302017	1609302017	1	1	ISKANDAR, ANDREW S MD	6/18/2020	208M00000X	NA	Other	026	PHYSICIANS	164727	41	Internal Medicine	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3220	33	06065	33.763572	-116.4056895	Riverside County
186458	Fee-for-Service	1194023994	1194023994	1	1	IZADI, AFSHEEN LMFT	3/5/2024	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
186484	Fee-for-Service	1003805987	1003805987	1	1	IVAN, JUDITH W	10/26/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	10050 N WOLFE RD	SUITE SW1-190	CUPERTINO	CA	95014	2519	43	06085	37.323639	-122.014123	Santa Clara County
186490	Fee-for-Service	1720896129	1720896129	1	1	INNIS, DALLAS AU	3/31/2025	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
186497	Fee-for-Service	1093854176	1093854176	1	2	INLAND HOME HEALTH	2/8/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PROVIDERS, INC	9221 ARICHIBALD AVENUE	None	RANCHO CUCAMONGA	CA	91730	5207	36	06071	34.08580113	-117.5934204	San Bernardino County
186622	Fee-for-Service	1417944224	1417944224	1	1	IREDELL MEMORIAL HOSP INC	3/11/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	557 BROOKDALE DR	None	STATESVILLE	NC	28677	4107	00	None	35.799426	-80.87805	Iredell County
186673	Fee-for-Service	1902817158	1902817158	1	1	ISRAEL, MORTON P	1/1/1979	207W00000X	NA	Ophthalmology	026	PHYSICIANS	19795	None	None	0	In state provider	None	770 MAGNOLIA AVE	STE 1X	CORONA	CA	92879	3122	33	06065	33.85936872	-117.5534605	Riverside County
186802	Fee-for-Service	1538147145	1538147145	1	1	IGNACIO, ROMEO C MD	1/16/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	110729	02	General Surgery	0	In state provider	None	8110 BIRMINGHAM WAY	BLDG 28	SAN DIEGO	CA	92123	2758	37	06073	32.79648424	-117.1521397	San Diego County
186908	Fee-for-Service	1417944224	1417944224	1	1	IREDELL MEMORIAL HOSP INC	3/11/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	557 BROOKDALE DR	None	STATESVILLE	NC	28677	4107	00	None	35.799426	-80.87805	Iredell County
187013	Fee-for-Service	1912725375	1912725375	1	1	INSIGHT THERAPY, A MARRIAGE,	11/15/2024	261QM0801X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	FAMILY, AND CHILD CORP.	26 W MISSION ST	STE. 7	SANTA BARBARA	CA	93101	0403	42	06083	34.42998638	-119.7156355	Santa Barbara County
187039	Fee-for-Service	1285714451	1285714451	1	1	ISRAEL, LESLIE DO	9/22/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	7348	01	General Practice	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
187138	Fee-for-Service	1225245590	1225245590	1	1	IRUVURI, SIREESHA MD	9/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119770	30	Radiology	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
187187	Fee-for-Service	1437184421	1437184421	1	1	ISHIMINE, PAUL T MD	8/12/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79142	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9300 CAMPUS POINT DR	None	LA JOLLA	CA	92037	1300	37	06073	32.877999	-117.225891	San Diego County
187193	Fee-for-Service	1962636811	1962636811	1	1	INES HEALTHCARE INC	7/27/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	INES HEALTHCARE INC	6623 SAN FERNANDO ROAD	SUITE D	GLENDALE	CA	91201	3287	19	06037	34.16934679	-118.2929912	Los Angeles County
187205	Fee-for-Service	1255851895	1255851895	1	1	IRVIN, ANNA S DO	2/1/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	1201 ALHAMBRA BLVD	STE 220	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
187315	Fee-for-Service	1134215684	1134215684	1	1	ILDESA,JOYCE MARIE MD	7/14/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75872	08	Family Practice	0	In state provider	None	278 TOWN CENTER PKWY	None	SANTEE	CA	92071	5800	37	06073	32.8429885	-116.984583	San Diego County
187383	Fee-for-Service	1851468763	1851468763	1	1	ISINHUE, MING C MD	4/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	56020	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
187462	Fee-for-Service	1114944568	1114944568	1	1	ISOLA, VENKATARAO MD	1/19/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	139260	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
187763	Fee-for-Service	1669127346	1669127346	1	1	ILLUMINATE DIAGNOSTICS INC	1/25/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	18331 GRIDLEY RD	STE C	CERRITOS	CA	90703	5438	19	06037	33.86506541	-118.0911068	Los Angeles County
188052	Fee-for-Service	1043385727	1043385727	1	1	ISAACSON, TED M	9/23/2008	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	191 W BURTON MESA BLVD	STE B	LOMPOC	CA	93436	1400	42	06083	34.70401649	-120.4647615	Santa Barbara County
188112	Fee-for-Service	1467996009	1467996009	1	1	IP, EMILEIGH W	5/18/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
188234	Fee-for-Service	1922485085	1922485085	1	2	INSTANT URGENT CARE	7/14/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2435 SAN RAMON VALLEY BL	SUTE 1A	SAN RAMON	CA	94583	1663	07	06013	37.77514445	-121.9774599	Contra Costa County
188321	Fee-for-Service	1497933550	1497933550	1	1	ILSTRUP, DONNA C LMFT	8/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2805 PORTER ST	None	SOQUEL	CA	95073	2422	44	06087	36.986895	-121.9574085	Santa Cruz County
188608	Fee-for-Service	1730480740	1730480740	1	1	IVANCHENKO, MADELINE PSYD	10/6/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
188666	Fee-for-Service	1972586840	1972586840	1	1	IM, RICHARD B MD	11/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86732	41	Internal Medicine	0	In state provider	None	23512 MADERO	None	MISSION VIEJO	CA	92691	2743	30	06059	33.62192373	-117.6765103	Orange County
188695	Fee-for-Service	1093210627	1093210627	1	1	ISHIBASHI, MEGAN A DPM	7/19/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	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
188933	Fee-for-Service	1780751206	1780751206	1	1	INOUYE, FRANKLIN B OD	1/21/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15908 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	9547	36	06071	34.4709788	-117.316553	San Bernardino County
188964	Fee-for-Service	1215511035	1215511035	2	1	IMGRX SJ VALLEY, INC.	7/24/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CY REEDLEY	1790 E MANNING AVE	PHARMACY SUITE	REEDLEY	CA	93654	9467	10	06019	36.60411951	-119.428434	Fresno County
189139	Fee-for-Service	1851463483	1851463483	1	2	INDEPENDENT OPTIONS INC	2/2/1989	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INDEPENDENT OPTIONS, INC	500 JULIAN CT	None	DIAMOND BAR	CA	91765	1497	19	06037	34.02703064	-117.786932	Los Angeles County
189196	Fee-for-Service	1508804006	1508804006	1	1	IMD MEDICAL GROUP INC	3/21/2005	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1234 N VERMONT AVE	None	LOS ANGELES	CA	90029	1704	19	06037	34.093971	-118.2917315	Los Angeles County
189330	Fee-for-Service	1952660482	1952660482	1	1	ISAAC NOYES	10/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1200 E 3900 S	None	SALT LAKE CTY	UT	84124	1300	00	None	40.68703142	-111.857243	Salt Lake County
189394	Fee-for-Service	1457461337	1457461337	1	1	INGERSOLL, JAMES P MD	1/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	58062	08	Family Practice	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
189483	Fee-for-Service	1508804006	1508804006	1	1	IMD MEDICAL GROUP INC	3/21/2005	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1234 N VERMONT AVE	None	LOS ANGELES	CA	90029	1704	19	06037	34.093971	-118.2917315	Los Angeles County
189524	Fee-for-Service	1558052159	1558052159	1	1	IFEMAZI, EMMANUEL	10/24/2023	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
189933	Fee-for-Service	1114950086	1114950086	1	1	INLAND EYE SPECIALISTS	12/1/2000	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	31950 TEMECULA PKWY	STE B7	TEMECULA	CA	92592	9497	33	06065	33.48068345	-117.1005174	Riverside County
190034	Fee-for-Service	1851530984	1851530984	1	1	IHC HEALTH SERVICES	9/1/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	900 ROUND VALLEY DR	None	PARK CITY	UT	84060	7532	00	None	40.68736413	-111.4675063	Summit County
190044	Fee-for-Service	1730560343	1730560343	1	1	IRELAND, COLIN D DO	11/26/2019	207PE0004X	NA	Other	026	PHYSICIANS	17651	66	Emergency Medicine (Urgent Care)	0	In state provider	None	500 WEST HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
190085	Fee-for-Service	1164584058	1164584058	1	1	INNOVATIVE SENIOR	3/18/2011	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	REHABILITATION	3318 BROOKSIDE RD	None	STOCKTON	CA	95219	2343	39	06077	37.98261028	-121.3551552	San Joaquin County
190222	Fee-for-Service	1497148456	1497148456	2	10	IHS RADIOLOGY MEDICAL GROUP,	12/4/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	150 W. WASHINGTON STREET	None	SAN DIEGO	CA	92103	2005	37	06073	32.74999225	-117.1647027	San Diego County
190322	Fee-for-Service	1851530984	1851530984	1	1	IHC HEALTH SERVICES	9/1/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	900 ROUND VALLEY DR	None	PARK CITY	UT	84060	7532	00	None	40.68736413	-111.4675063	Summit County
190334	Fee-for-Service	1851463483	1851463483	1	14	INDEPENDENT OPTIONS INC	9/18/1985	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9653 DERBY DR	None	RIVERSIDE	CA	92509	3524	33	06065	33.999381	-117.494523	Riverside County
190349	Fee-for-Service	1730190745	1730190745	1	1	IHLE, EVA C MD	6/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76406	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
190493	Fee-for-Service	1023767332	1023767332	1	1	ISHIKI, MATTHEW MD	6/3/2024	390200000X	NA	Other	026	PHYSICIANS	189460	None	None	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
190581	Fee-for-Service	1003444886	1003444886	1	1	IQBAL, RABIA DO	8/4/2023	207P00000X	NA	Other	026	PHYSICIANS	20651	None	None	0	In state provider	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
190786	Fee-for-Service	1164940433	1164940433	1	1	IN, SOPHEAR CNP	2/23/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1350 FLORIN RD	None	SACRAMENTO	CA	95822	4202	34	06067	38.495232	-121.505409	Sacramento County
190814	Fee-for-Service	1528539954	1528539954	1	1	ISHIMARU, MILLICENT A RCP	9/10/2020	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2350 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3305	38	06075	37.78305866	-122.4421313	San Francisco County
190849	Fee-for-Service	1851463483	1851463483	1	22	INDEPENDENT OPTIONS INC	3/12/1990	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HARBOR VILLAGE I	2532 SANTA CATALINA DR	APT 101	COSTA MESA	CA	92626	6881	30	06059	33.66640118	-117.9218102	Orange County
190866	Fee-for-Service	1932767381	1932767381	1	2	INTERFAITH COMMUNITY SERVICE	6/10/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	S INC.	1820 SOUTH ESCONDIDO BOU	STE 101	ESCONDIDO	CA	92025	6524	37	06073	33.10274588	-117.0716978	San Diego County
190894	Fee-for-Service	1255811543	1255811543	1	1	IDEAL THERAPY, INC	3/1/2023	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	4342 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3573	30	06059	33.80294143	-118.057265	Orange County
190974	Fee-for-Service	1275626939	1275626939	1	1	IAN R LIVINGSTONE, M.D.	7/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	269 S CANDY LN	None	COTTONWOOD	AZ	86326	4158	00	None	34.735176	-112.0295655	Yavapai County
191183	Fee-for-Service	1255811543	1255811543	1	1	IDEAL THERAPY, INC	3/1/2023	111N00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4342 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3573	30	06059	33.80294143	-118.057265	Orange County
191331	Fee-for-Service	1437346244	1437346244	1	1	IZHAR, MOHAMMED MD	1/1/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	30009	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
191480	Fee-for-Service	1114609401	1114609401	1	1	INNOVATIVE PHARMACY SOLUTION	9/14/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	ING CENTER	17500 RED HILL AVE	STE 250	IRVINE	CA	92614	7600	30	06059	33.69482227	-117.8539174	Orange County
191566	Fee-for-Service	1821001397	1821001397	1	1	IMBASCIANI, VITO D MD	6/1/1990	208800000X	NA	Other	026	PHYSICIANS	69863	34	Urology and Urological Surgery	0	In state provider	None	1711 W TEMPLE ST	None	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
191616	Fee-for-Service	1225401979	1225401979	1	1	IV HOSPICE INC	1/22/2025	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10806 VENTURA BLVD	SUITE 5	STUDIO CITY	CA	91604	3300	19	06037	34.13882717	-118.3661702	Los Angeles County
191771	Fee-for-Service	1376585372	1376585372	1	1	IVESTOR,CHARLES 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	4401 HARRISON BLVD	None	OGDEN	UT	84403	0000	00	None	41.18328	-111.9536955	Weber County
191853	Fee-for-Service	1821001397	1821001397	1	1	IMBASCIANI, VITO D MD	6/1/1990	208800000X	NA	Other	026	PHYSICIANS	69863	01	General Practice	0	In state provider	None	1711 W TEMPLE ST	None	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
191905	Fee-for-Service	1225401979	1225401979	1	1	IV HOSPICE INC	1/22/2025	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10806 VENTURA BLVD	SUITE 5	STUDIO CITY	CA	91604	3300	19	06037	34.13882717	-118.3661702	Los Angeles County
191987	Fee-for-Service	1639433345	1639433345	1	1	IRETON, VIVIAN L	6/12/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
192044	Fee-for-Service	1962954883	1962954883	1	1	INLAND LEADERS CHARTER	7/1/2017	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOLS	12375 CALIFORNIA STREET	None	YUCAIPA	CA	92399	0000	36	06071	34.0282047	-117.0387794	San Bernardino County
192049	Fee-for-Service	1275833162	1275833162	1	1	INGER, LAURA	1/27/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1033 3RD ST	None	SAN RAFAEL	CA	94901	3107	21	06041	37.97209412	-122.5280013	Marin County
192335	Fee-for-Service	1851463483	1851463483	1	29	INDEPENDENT OPTIONS INC	3/11/1988	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	KACHINA HOUSE	5899 KACHINA DR	None	RIVERSIDE	CA	92509	5223	33	06065	33.98829779	-117.4596906	Riverside County
192490	Fee-for-Service	1427446947	1427446947	1	1	IVANOVSKY, ALEXANDRA LCSW	9/11/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2976 ALHAMBRA DR	None	CAMERON PARK	CA	95682	7835	09	06017	38.68873344	-120.9908286	El Dorado County
192675	Fee-for-Service	1003917451	1003917451	2	1	INJETY, SHANNON M	12/27/2007	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1001 E COOLEY DR	STE E	COLTON	CA	92324	3941	36	06071	34.0546353	-117.3110923	San Bernardino County
192694	Fee-for-Service	1902105489	1902105489	1	1	ISAACSON, JARED S MD	1/13/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	140930	30	Radiology	0	In state provider	None	501 PETALUMA AVE	None	SEBASTOPOL	CA	95472	9917	49	06097	38.39674221	-122.8201502	Sonoma County
192706	Fee-for-Service	1699380634	1699380634	1	1	INGMA HOSPICE CARE	9/2/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR STREET	STE 227	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
192743	Fee-for-Service	1063773141	1063773141	1	1	IRAM, FAIZA MD	4/20/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	168755	None	None	0	In state provider	None	504 S SIERRA MADRE BLVD	None	PASADENA	CA	91107	5240	19	06037	34.137603	-118.101464	Los Angeles County
192915	Fee-for-Service	1659552289	1659552289	1	1	INFINITY CARE OF EAST	8/4/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LOS ANGELES	101 S FICKETT ST	None	LOS ANGELES	CA	90033	4017	19	06037	34.04231839	-118.2075342	Los Angeles County
192963	Fee-for-Service	1144054867	1144054867	1	1	INNOV8 NEMT	8/30/2024	No Taxonomy Provided	Both NEMT & NMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3101 ENOS LN	None	BAKERSFIELD	CA	93314	7901	15	06029	35.38820549	-119.2521063	Kern County
192995	Fee-for-Service	1699380634	1699380634	1	1	INGMA HOSPICE CARE	9/2/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR STREET	STE 227	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
193035	Fee-for-Service	1659411841	1659411841	1	2	IEVLEVA, YULIA O LMFT	4/22/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1095 IRVINE BLVD	None	TUSTIN	CA	92780	3526	30	06059	33.74821163	-117.8097851	Orange County
193354	Fee-for-Service	1497148456	1497148456	2	1	IHS RADIOLOGY MEDICAL GROUP,	12/3/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	6386 ALVARADO COURT	121	SAN DIEGO	CA	92120	4905	37	06073	32.77666838	-117.0614255	San Diego County
193578	Fee-for-Service	1043892771	1043892771	1	1	IBRAHIM, SAMIR MD	8/2/2024	207P00000X	NA	Other	026	PHYSICIANS	None	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
193588	Fee-for-Service	1992068373	1992068373	1	1	ISOM, SHUNA E R MD	9/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139855	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
193646	Fee-for-Service	1538508791	1538508791	1	1	IR REHAB HOME HEALTH INC	1/27/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2250 DOUGLAS BLVD	SUITE 140	ROSEVILLE	CA	95661	3860	31	06061	38.74418053	-121.2430005	Placer County
193767	Fee-for-Service	1962949826	1962949826	1	1	INGEMANSSON, CASSANDRA R NP	2/26/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	SUITE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
193797	Fee-for-Service	1497148456	1497148456	2	9	IHS RADIOLOGY MEDICAL GROUP,	12/4/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	333 H STREET	SUITE 1095	CHULA VISTA	CA	91910	5557	37	06073	32.63411233	-117.0783636	San Diego County
193817	Fee-for-Service	1851463483	1851463483	1	15	INDEPENDENT OPTIONS INC	11/17/1989	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	4736 HORSESHOE LN	None	RIVERSIDE	CA	92509	7100	33	06065	34.00333297	-117.4701652	Riverside County
193917	Fee-for-Service	1770917387	1770917387	1	1	IVANOFF, LAUREN M PT	7/14/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	134 SOUTH E ST	None	EXETER	CA	93221	1731	54	06107	36.29571271	-119.1405696	Tulare County
194362	Fee-for-Service	1326185265	1326185265	1	1	ISOLANI, FRANCESCO G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	85394	05	Anesthesiology	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
194391	Fee-for-Service	1205893245	1205893245	1	1	ISMAIL, HABIB A MD	11/30/1996	2084N0402X	NA	Neurology	026	PHYSICIANS	43523	None	None	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
194395	Fee-for-Service	1386043065	1386043065	1	1	IMC CARE HOME INC	3/12/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2103 E RYAN AVE	None	FRESNO	CA	93720	4147	10	06019	36.87206858	-119.7457926	Fresno County
194541	Fee-for-Service	1497148456	1497148456	2	2	IHS RADIOLOGY MEDICAL GROUP,	12/3/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	477 N. EL CAMINO REAL	A102	ENCINITAS	CA	92024	1329	37	06073	33.05700866	-117.262449	San Diego County
194715	Fee-for-Service	1215185251	1215185251	1	1	ITRIAGO, MERCEDES G PSYD	3/29/2021	171M00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
194968	Fee-for-Service	1952758849	1952758849	1	1	INNOVATIVE MINIMALLY INVASIV	2/5/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	E IMAGING & THERAPEUTI	8283 GROVE AVE STE 207A	None	RANCHO CUCAMONGA	CA	91730	3141	36	06071	34.10380433	-117.6285116	San Bernardino County
195092	Fee-for-Service	1013495431	1013495431	1	1	IMAM, KAMRAN H MD	4/12/2022	207R00000X	NA	Other	026	PHYSICIANS	173489	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
195114	Fee-for-Service	1851463483	1851463483	1	11	INDEPENDENT OPTIONS INC	12/26/2000	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3648 RED BLUFF LN	None	BANNING	CA	92220	1400	33	06065	33.93616355	-116.9166285	Riverside County
195256	Fee-for-Service	1952758849	1952758849	1	1	INNOVATIVE MINIMALLY INVASIV	2/5/2024	2085R0202X	NA	Mammography/MRI Provider	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	E IMAGING & THERAPEUTI	8283 GROVE AVE STE 207A	None	RANCHO CUCAMONGA	CA	91730	3141	36	06071	34.10380433	-117.6285116	San Bernardino County
195298	Fee-for-Service	1295289452	1295289452	1	1	IGNACIO, MICHAEL A	4/3/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
195483	Fee-for-Service	1144553207	1144553207	1	1	ITO-STEIDLEY, COLLEEN OD	2/9/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 N D ST	None	PORTERVILLE	CA	93257	3621	54	06107	36.06700265	-119.0184282	Tulare County
195656	Fee-for-Service	1962543397	1962543397	1	1	IM, SOO J MD	8/31/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107024	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
195694	Fee-for-Service	1497148456	1497148456	2	3	IHS RADIOLOGY MEDICAL GROUP,	12/3/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	4150 REGENTS PARK ROW	SUITE 195	LA JOLLA	CA	92037	9139	37	06073	32.87272099	-117.2175656	San Diego County
195796	Fee-for-Service	1891892162	1891892162	1	1	INTERNATIONAL MERCANTILE	2/28/2012	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	ENTERPRISES	19323 COLLIER STREET	None	TARZANA	CA	91356	3010	19	06037	34.16669556	-118.5543915	Los Angeles County
195943	Fee-for-Service	1184008294	1184008294	1	1	IMAMOTO, NANCY T OD PC	9/8/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1713 W ARTESIA BLVD	None	GARDENA	CA	90248	3220	19	06037	33.8730063	-118.3076296	Los Angeles County
196114	Fee-for-Service	1730627050	1730627050	1	3	INTEGRATED ELDER CARE INC	12/24/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1438 PACIFIC ST	None	REDLANDS	CA	92373	6939	36	06071	34.02820504	-117.1717242	San Bernardino County
196133	Fee-for-Service	1154572113	1154572113	1	1	ISAAC OVERHOLT	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
196383	Fee-for-Service	1851463483	1851463483	1	13	INDEPENDENT OPTIONS INC	1/14/2003	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	DONNA HOUSE	680 DONNA DR	None	BEAUMONT	CA	92223	1771	33	06065	33.94535852	-116.973342	Riverside County
196417	Fee-for-Service	1619044146	1619044146	1	1	INGRAM, DAWN M PHD	9/11/2012	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
196472	Fee-for-Service	1063910156	1063910156	1	1	IRELAND, JORDAN	11/4/2024	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
196473	Fee-for-Service	1669443446	1669443446	1	1	ISAACS, ROBERT S. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9901 MEDICAL CENTER DR	None	ROCKVILLE	MD	20850	3357	00	None	39.09683663	-77.19664059	Montgomery County
196491	Fee-for-Service	1811314602	1811314602	1	1	IDEAL LIVING PSYCHOLOGY CENT	6/11/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ER	9220 HAVEN AVE	100	RANCHO CUCAMONGA	CA	91730	8551	36	06071	34.08525	-117.5758875	San Bernardino County
196534	Fee-for-Service	1255408191	1255408191	1	1	INGA-SURAINDER, GLADYS	12/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	71272	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MD	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
196542	Fee-for-Service	1447263066	1447263066	1	1	INLAND HEART DOCTORS MEDICAL	10/1/1998	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	GROUP	2250 S MAIN ST	STE 201	CORONA	CA	92882	2536	33	06065	33.8550661	-117.5695499	Riverside County
196644	Fee-for-Service	1669064366	1669064366	1	1	INLAND PHYSICIANS PULMONARY	8/27/2021	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SERVICES	9525 MONTE VISTA AVE	105	MONTCLAIR	CA	91763	2231	36	06071	34.080777	-117.698234	San Bernardino County
196665	Fee-for-Service	1851350797	1851350797	1	1	ISHO, LUBNA DO	12/21/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	8305	08	Family Practice	0	In state provider	None	420 W ROWLAND ST	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
196672	Fee-for-Service	1851463483	1851463483	1	30	INDEPENDENT OPTIONS INC	11/20/1990	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HARBOR VILLAGE III	2525 SANTA CATALINA DR	APT 105	COSTA MESA	CA	92626	6862	30	06059	33.66608015	-117.9221384	Orange County
196824	Fee-for-Service	1700031242	1700031242	1	1	INLAND VALLEY HEMATOLOGY	6/29/2009	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONCOLOGY ASSOCIATES APMC	1910 ROYALTY DRIVE	None	POMONA	CA	91767	3021	19	06037	34.07871356	-117.7454184	Los Angeles County
196860	Fee-for-Service	1962561530	1962561530	1	1	ISRAEL, STUART R MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65151	07	Dermatology	0	In state provider	ATTN MGA OFFICE	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
197215	Fee-for-Service	1376283077	1376283077	1	1	INSPIRATIONS HOME CARE IV	6/3/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LLC	1540 HEARTLAND WAY	None	CORONA	CA	92881	4179	33	06065	33.83571053	-117.5408215	Riverside County
197293	Fee-for-Service	1467433292	1467433292	1	1	INFORM DIAGNOSTICS INC	10/11/2018	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	6655 N MACARTHUR BLVD	None	IRVING	TX	75039	2443	00	None	32.90011788	-96.95893678	Dallas County
197322	Fee-for-Service	1770550667	1770550667	1	1	INSKO, ERIK K MD	1/4/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	173764	None	None	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
197686	Fee-for-Service	1134890080	1134890080	1	1	IRAHETA, SANDRA I	3/1/2024	176B00000X	NA	Licensed Midwife	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	42	06083	0	0	None
197698	Fee-for-Service	1710154794	1710154794	1	1	IM, MICHAEL Y MD	7/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119769	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
197757	Fee-for-Service	1528238961	1528238961	1	1	INLAND HEALTHCARE GROUP AMC	3/9/2010	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	2150 N WATERMAN AVE	SUITE 303	SAN BERNARDINO	CA	92404	4811	36	06071	34.134705	-117.2787865	San Bernardino County
197821	Fee-for-Service	1306022934	1306022934	1	1	INGALLINERA, TRISTYN LMFT	2/10/2025	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
198117	Fee-for-Service	1073755484	1073755484	1	1	INMAN, BRYCE C MD	4/1/2019	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	1775 THOMPSON ROAD	None	COOS BAY	OR	97420	2125	00	None	43.383456	-124.2330435	Coos County
198159	Fee-for-Service	1831506724	1831506724	1	1	IBE, IFEGWU O MD	5/22/2018	390200000X	NA	Other	026	PHYSICIANS	142966	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
198209	Fee-for-Service	1962478347	1962478347	1	1	ISKIKIAN, JOHN A MD	4/13/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	49027	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	969 PLUMAS ST	STE 200	YUBA CITY	CA	95991	4011	51	06101	39.14263634	-121.6176593	Sutter County
198502	Fee-for-Service	1063416949	1063416949	1	1	ISOM, HEATHER 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
198857	Fee-for-Service	1447270459	1447270459	1	1	INGEGNO, MICHAEL D MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68202	None	None	0	In state provider	None	13851 E 14TH ST	STE 201	SAN LEANDRO	CA	94578	2627	01	06001	37.71458918	-122.1418781	Alameda County
198956	Fee-for-Service	1205522000	1205522000	1	1	INTEGRAL TRANSIT LLC	6/21/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	555 1ST ST	STE 302	BENICIA	CA	94510	3280	48	06095	38.04877526	-122.1593437	Solano County
199044	Fee-for-Service	1184668782	1184668782	1	1	IRINA RYBALSKY, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3333 BURNET AVE	None	CINCINNATI	OH	45229	3026	00	None	39.14105892	-84.50040782	Hamilton County
199060	Fee-for-Service	1235357104	1235357104	1	1	INGALLS, NICHOLE K MD	10/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	3006 S MARYLAND PKWY	STE 315	LAS VEGAS	NV	89109	6205	00	None	36.135288	-115.1368705	Clark County
199161	Fee-for-Service	1801804208	1801804208	1	1	INTERVALLEY ANESTHESIA	9/23/2011	193400000X	NA	Other	026	PHYSICIANS	25137	05	Anesthesiology	0	In state provider	MEDICAL CORPORATION	1805 MEDICAL CENTER DR	None	SAN BERNARDINO	CA	92411	1217	36	06071	34.131303	-117.3225325	San Bernardino County
199240	Fee-for-Service	1841970647	1841970647	1	1	IVY PHARMA INC	10/13/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16854 IVY AVE	STE C	FONTANA	CA	92335	1504	36	06071	34.10487353	-117.436896	San Bernardino County
199254	Fee-for-Service	1790425494	1790425494	1	1	INSPIRATIONS HOME CARE IV	6/3/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LLC	1507 CHESTNUT CIRCLE	None	CORONA	CA	92881	4169	33	06065	33.83697636	-117.5407243	Riverside County
199349	Fee-for-Service	1609227875	1609227875	1	1	IDEAL PALLIATIVE AND HOSPICE	4/22/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE, INC	420 N MONTEBELLO BLVD	STE 200	MONTEBELLO	CA	90640	4274	19	06037	34.01651383	-118.1060207	Los Angeles County
199446	Fee-for-Service	1093711681	1093711681	1	1	INLAND CHRISTIAN HOME	2/16/1979	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1950 S MOUNTAIN AVE	None	ONTARIO	CA	91762	6723	36	06071	34.03827	-117.6705045	San Bernardino County
199474	Fee-for-Service	1851463483	1851463483	1	18	INDEPENDENT OPTIONS INC	1/28/1992	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MARK LANE II	2516 MARK LN	None	COSTA MESA	CA	92626	6701	30	06059	33.66576701	-117.9216369	Orange County
199477	Fee-for-Service	1528403516	1528403516	1	1	ISKAROUS, JOY DO	7/6/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	14033	36	Psychiatry	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
199555	Fee-for-Service	1407052244	1407052244	1	1	IBRAHIM, WALEED A MD	3/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	77739	None	None	0	In state provider	None	1514 FLORIDA AVE	SUITE 200	MODESTO	CA	95350	4438	50	06099	37.66582423	-120.9961796	Stanislaus County
199639	Fee-for-Service	1609227875	1609227875	1	1	IDEAL PALLIATIVE AND HOSPICE	4/22/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE, INC	420 N MONTEBELLO BLVD	STE 200	MONTEBELLO	CA	90640	4274	19	06037	34.01651383	-118.1060207	Los Angeles County
199975	Fee-for-Service	1598261240	1598261240	1	1	IYENGAR, MANGALA S MD	9/14/2021	208M00000X	NA	Other	026	PHYSICIANS	173695	None	None	0	In state provider	None	1450 SAN PABLO ST	STE 4000	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
200102	Fee-for-Service	1306125778	1306125778	1	1	INTEGRATED LABS LLC	1/13/2014	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	2020 8TH AVENUE	STE 200	WEST LINN	OR	97068	4657	00	None	45.34541876	-122.6539261	Clackamas County
200514	Fee-for-Service	1548367113	1548367113	1	1	IOTA-HERBEI, CLAUDIA MD	6/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85905	41	Internal Medicine	0	In state provider	None	2905 TELEGRAPH AVE	None	BERKELEY	CA	94705	2063	01	06001	37.85736641	-122.2594952	Alameda County
200663	Fee-for-Service	1851463483	1851463483	1	28	INDEPENDENT OPTIONS INC	1/11/2005	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HARBOR VILLAGE VI	2541 SANTA CATALINA DR	STE 105	COSTA MESA	CA	92626	6890	30	06059	33.66738367	-117.9216713	Orange County
200715	Fee-for-Service	1245880087	1245880087	1	1	IZADI, SHANETTE M LCSW	4/11/2024	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
200800	Fee-for-Service	1548367113	1548367113	1	1	IOTA-HERBEI, CLAUDIA MD	6/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85905	45	Nephrology (Renal-Kidney)	0	In state provider	None	2905 TELEGRAPH AVE	None	BERKELEY	CA	94705	2063	01	06001	37.85736641	-122.2594952	Alameda County
200985	Fee-for-Service	1740243104	1740243104	1	1	ISKANDER, ISIS S MD	1/17/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	37114	None	None	0	In state provider	None	1505 WILSON TER	STE 150	GLENDALE	CA	91206	4076	19	06037	34.14960934	-118.2313491	Los Angeles County
201311	Fee-for-Service	1083638100	1083638100	1	1	ILANO, MARIA D MD	1/22/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	47981	-	NOT APPLICABLE	0	In state provider	None	6765 GREEN VALLEY RD	None	PLACERVILLE	CA	95667	8672	09	06017	38.72039732	-120.8664353	El Dorado County
201327	Fee-for-Service	1659026805	1659026805	1	1	INLOES, ALLISON OT	7/18/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3687 MT DIABLO	SUITE 100	LAFAYETTE	CA	94549	3717	07	06013	37.8898926	-122.1304235	Contra Costa County
201359	Fee-for-Service	1659442564	1659442564	1	1	IINUMA, JAY KEN	8/1/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	77312	01	General Practice	0	In state provider	None	5411 VALLEY BLVD	STE D	LOS ANGELES	CA	90032	3518	19	06037	34.07433404	-118.1656038	Los Angeles County
201368	Fee-for-Service	1316446644	1316446644	1	1	IMPERIAL VALLEY HOSPITALIST	9/17/2018	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INC	207 W LEGION RD	None	BRAWLEY	CA	92227	7750	13	06025	32.95809	-115.5537045	Imperial County
201767	Fee-for-Service	1376501171	1376501171	1	1	IRELAND, JAMES MD	11/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	91-239 FORT WEAVER 108	None	EWA BEACH	HI	96706	0000	00	None	21.31381617	-157.9976444	Honolulu County
201820	Fee-for-Service	1326064759	1326064759	1	1	INDIO EMERGENCY MED.GRP.	11/30/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
201823	Fee-for-Service	1366543555	1366543555	1	1	ISERO, ERIC G	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	140 S EL CAMINO REAL	None	MILLBRAE	CA	94030	3121	41	06081	37.597093	-122.3857675	San Mateo County
201956	Fee-for-Service	1407868417	1407868417	1	1	INGLEWOOD IMAG CTR LLC	7/31/2007	261QR0200X	NA	Mammography/MRI Provider	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	211 N PRAIRIE AVE	STE E	INGLEWOOD	CA	90301	1412	19	06037	33.965136	-118.3439955	Los Angeles County
202088	Fee-for-Service	1932203072	1932203072	1	1	IKOLA, DAVID JOHN	3/31/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	45711	40	Pediatrics	0	In state provider	None	1430 E MAIN ST	STE 201	SANTA MARIA	CA	93454	4832	42	06083	34.9528467	-120.4127301	Santa Barbara County
202246	Fee-for-Service	1942487848	1942487848	1	1	ISLA VISTA NEIGHBORHOOD	7/17/2005	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CLINIC	970 EMBARCADERO DEL MAR	None	ISLA VISTA	CA	93117	4869	42	06083	34.411707	-119.857011	Santa Barbara County
202304	Fee-for-Service	1770238222	1770238222	1	1	INTRIERI, MARIA CCC-SLP	10/12/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8265 WHITE OAK AVE	None	RANCHO CUCAMONGA	CA	91730	7671	36	06071	34.10330723	-117.5642502	San Bernardino County
202327	Fee-for-Service	1689128936	1689128936	1	2	IMGRX SLO INC	3/1/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2800 RIVERSIDE AVE.	150	PASO ROBLES	CA	93446	1311	40	06079	35.64351546	-120.6888699	San Luis Obispo County
202361	Fee-for-Service	1497435606	1497435606	1	1	INNER STRENGTH MEDICAL AND W	4/8/2024	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	ELLNESS PC	1522 STATE ST # A	None	SANTA BARBARA	CA	93101	2514	42	06083	34.42671923	-119.7090229	Santa Barbara County
202492	Fee-for-Service	1497148456	1497148456	2	5	IHS RADIOLOGY MEDICAL GROUP,	12/4/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	TS	3939 RUFFIN RD	102	SAN DIEGO	CA	92123	1802	37	06073	32.8139371	-117.121269	San Diego County
202645	Fee-for-Service	1063999340	1063999340	1	1	IQBAL, MOHAMMED F MD	8/2/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165662	08	Family Practice	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
202873	Fee-for-Service	1063451771	1063451771	1	1	IBRAHIM, MAHMOUD A MD	1/31/1988	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	42803	40	Pediatrics	0	In state provider	None	7974 HAVEN AVE	SUITE 290	RANCHO CUCAMONGA	CA	91730	3052	36	06071	34.10875445	-117.5759905	San Bernardino County
203302	Fee-for-Service	1265582084	1265582084	1	1	IANCU, DACIANA I MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70894	41	Internal Medicine	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
203404	Fee-for-Service	1578007902	1578007902	1	1	ICURE HOME HEALTH INC	5/2/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1415 E COLORADO ST	UNIT 207	GLENDALE	CA	91205	1541	19	06037	34.14279663	-118.2333245	Los Angeles County
203504	Fee-for-Service	1225488455	1225488455	1	1	IGENOMEDX INC.	8/24/2020	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	4115 MEDICAL DR	210	SAN ANTONIO	TX	78229	5657	00	None	29.51564309	-98.56572796	Bexar County
203580	Fee-for-Service	1669829628	1669829628	3	1	IMGRX SALUD, INC.	6/23/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3104 PONTE MORINO DR	100	CAMERON PARK	CA	95682	8282	09	06017	38.66304719	-120.9667044	El Dorado County
203732	Fee-for-Service	1851463483	1851463483	1	16	INDEPENDENT OPTIONS INC	9/18/1985	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INDEPENDENT OPTIONS, INC	4614 VILLA WOODS DR	None	RIVERSIDE	CA	92509	7119	33	06065	34.00415863	-117.4643733	Riverside County
203767	Fee-for-Service	1649053299	1649053299	1	1	INN HOME CARE LLC	9/6/2023	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	11632 MOUNT WAVERLY CT	None	RANCHO CUCAMONGA	CA	91737	7904	36	06071	34.14122857	-117.5505815	San Bernardino County
203933	Fee-for-Service	1326652371	1326652371	1	1	IMPERIAL BEACH PHARMACY LLC	2/14/2021	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1530 PALM AVE	None	SAN DIEGO	CA	92154	1016	37	06073	32.58396649	-117.10053	San Diego County
203997	Fee-for-Service	1245816198	1245816198	1	1	INLAND PSYCHIATRIC MEDICAL G	2/10/2022	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ROUP, INC.	500 W BADILLO ST	None	COVINA	CA	91722	3762	19	06037	34.0862325	-117.899253	Los Angeles County
204010	Fee-for-Service	1215291463	1215291463	1	1	IDDRISS, ADAM MD	3/30/2023	208600000X	NA	General Surgery	026	PHYSICIANS	171375	None	None	0	In state provider	None	1225 E LATHAM AVE	SUITE A	HEMET	CA	92543	4423	33	06065	33.74937952	-116.959626	Riverside County
204114	Fee-for-Service	1336115427	1336115427	1	1	ISSEROFF, ROSLYN R MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43459	07	Dermatology	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
204521	Fee-for-Service	1710465372	1710465372	1	1	ISHII-KIM, KELLIE-ANNE C OD	4/14/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	425 W BONITA AVE	STE 110B	SAN DIMAS	CA	91773	2541	19	06037	34.10669347	-117.814932	Los Angeles County
204555	Fee-for-Service	1023006988	1023006988	1	1	IAFRATE, GREGORY MD	10/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	435 LEWIS AVE	None	MERIDEN	CT	06451	2101	00	None	41.549166	-72.8008605	South Central Connecticut Planning Region
204618	Fee-for-Service	1487205506	1487205506	1	1	INLAND PSYCHIATRIC MEDICAL G	3/24/2021	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	4049 BROCKTON AVE	None	RIVERSIDE	CA	92501	3440	33	06065	33.98177617	-117.3807605	Riverside County
204777	Fee-for-Service	1982056040	1982056040	1	1	IANNACCONE, ELIZABETH A LMFT	3/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8385 BRENTWOOD BLVD	SUITE A	BRENTWOOD	CA	94513	1381	07	06013	37.93224883	-121.6963177	Contra Costa County
204905	Fee-for-Service	1487205506	1487205506	1	1	INLAND PSYCHIATRIC MEDICAL G	3/24/2021	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC.	4049 BROCKTON AVE	None	RIVERSIDE	CA	92501	3440	33	06065	33.98177617	-117.3807605	Riverside County
205138	Fee-for-Service	1023179447	1023179447	1	1	IGNATOVA, ANNA NP	10/18/2023	363LG0600X	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
205192	Fee-for-Service	1487205506	1487205506	1	1	INLAND PSYCHIATRIC MEDICAL G	3/24/2021	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC.	4049 BROCKTON AVE	None	RIVERSIDE	CA	92501	3440	33	06065	33.98177617	-117.3807605	Riverside County
205481	Fee-for-Service	1487205506	1487205506	1	1	INLAND PSYCHIATRIC MEDICAL G	3/24/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC.	4049 BROCKTON AVE	None	RIVERSIDE	CA	92501	3440	33	06065	33.98177617	-117.3807605	Riverside County
205663	Fee-for-Service	1487606695	1487606695	1	1	ISHIMORI, MARIKO L MD	5/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79050	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
205770	Fee-for-Service	1487205506	1487205506	1	1	INLAND PSYCHIATRIC MEDICAL G	3/24/2021	103TC0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC.	4049 BROCKTON AVE	None	RIVERSIDE	CA	92501	3440	33	06065	33.98177617	-117.3807605	Riverside County
205852	Fee-for-Service	1588737720	1588737720	1	1	IONESCU-TIBA, VIVIANA T MD	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99311	08	Family Practice	0	In state provider	None	18460 ROSCOE BLVD	None	NORTHRIDGE	CA	91324	4107	19	06037	34.22071454	-118.5357375	Los Angeles County
205954	Fee-for-Service	1487606695	1487606695	1	1	ISHIMORI, MARIKO L MD	5/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79050	83	Rheumatology	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
206226	Fee-for-Service	1659813012	1659813012	1	1	ISOM, JORDAN L PT	5/10/2019	273Y00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1255 LIBERTY STREET	None	REDDING	CA	96001	0814	45	06089	40.58769807	-122.3879041	Shasta County
206236	Fee-for-Service	1265888663	1265888663	1	1	INDURU, SPANDANA R MD	8/8/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	186727	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
206483	Fee-for-Service	1285829804	1285829804	1	1	INLAND URGENT CARE A MEDICAL	1/25/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	29738 RANCHO CALIFORNIA	STE B	TEMECULA	CA	92591	5322	33	06065	33.50612116	-117.1438774	Riverside County
206705	Fee-for-Service	1699925255	1699925255	1	1	IKEDA, SADAKATSU MD	10/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132380	68	Hematology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
206727	Fee-for-Service	1922017516	1922017516	1	1	INSTANT DIAGNOSTIC SYSTEMS	10/5/2010	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	2	Out of state provider	INCORPORATED	1740 4TH AVENUE SE	STE A	DECATUR	AL	35601	5900	00	None	34.57890307	-86.98309266	Morgan County
206967	Fee-for-Service	1295921773	1295921773	1	1	ISAO IWATA	5/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 ROBERT WOOD JOHNSON PL	None	NEW BRUNSWICK	NJ	08901	1928	00	None	40.49580805	-74.45050729	Middlesex County
206993	Fee-for-Service	1699925255	1699925255	1	1	IKEDA, SADAKATSU MD	10/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132380	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
206996	Fee-for-Service	1114249026	1114249026	1	1	IRISH, TREVOR K OD INC	6/22/2011	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	991 E MONTE VISTA AVE	None	TURLOCK	CA	95382	0636	50	06099	37.52188647	-120.83769	Stanislaus County
207020	Fee-for-Service	1790865038	1790865038	1	1	IZADI, HOMEIRA MD	8/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86985	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
207255	Fee-for-Service	1831220714	1831220714	1	2	INOVA HEALTHCARE SERVICES	11/12/2019	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3300 GALLOWS RD	None	FALLS CHURCH	VA	22042	3307	00	None	38.858193	-77.226426	City of Fairfax
207398	Fee-for-Service	1356428205	1356428205	1	1	INSERRA, MICHELLE M MD	3/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73027	84	Surgery-Head and Neck	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
207443	Fee-for-Service	1376832212	1376832212	1	1	INIZIO INTERVENTIONS INC	6/22/2018	103K00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1433 FOOTHILL BLVD	None	LA CANADA	CA	91011	2109	19	06037	34.20872227	-118.20946	Los Angeles County
207542	Fee-for-Service	1831220714	1831220714	1	2	INOVA HEALTHCARE SERVICES	11/12/2019	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3300 GALLOWS RD	None	FALLS CHURCH	VA	22042	3307	00	None	38.858193	-77.226426	City of Fairfax
207748	Fee-for-Service	1871318865	1871318865	1	1	INTEGRATED REHABILITATION CO	1/7/2025	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	25	Physical Medicine and Rehabilitation	0	In state provider	NSULTANTS PC	15120 KENSINGTON PARK DR	None	TUSTIN	CA	92782	1801	30	06059	33.71335852	-117.8170952	Orange County
208015	Fee-for-Service	1952860900	1952860900	1	1	IANTORNO, STEFANO A MD	5/1/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	177369	29	Pulmonary Diseases (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
208043	Fee-for-Service	1265164321	1265164321	1	1	IN R GREAT HANDS LLC	9/29/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1261 MONTEVIDEO AVENUE	None	PLACENTIA	CA	92870	3908	30	06059	33.88584212	-117.84118	Orange County
208065	Fee-for-Service	1821047580	1821047580	1	1	INNOVATIVE PHYSICAL THERAPY	3/11/2014	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	5030 CAMINO DE LA SIESTA	STE 220	SAN DIEGO	CA	92108	3118	37	06073	32.76484572	-117.1602073	San Diego County
208172	Fee-for-Service	1831125376	1831125376	1	1	IBANEZ, JULIUS A MD	4/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	47962	66	Emergency Medicine (Urgent Care)	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
208230	Fee-for-Service	1326065210	1326065210	1	1	IKRAMULLAH, SULTANA MD	4/30/1992	2084P0800X	NA	Psychiatry	026	PHYSICIANS	41576	36	Psychiatry	0	In state provider	None	315 N 3RD AVE	STE 300	COVINA	CA	91723	1916	19	06037	34.08873786	-117.8923869	Los Angeles County
208242	Fee-for-Service	1386751626	1386751626	1	1	INOUYE, TAKESHI MD	8/31/1992	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	70969	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	PENINSULA GYN/0B MED GRP	2660 GRANT RD	STE D	MOUNTAIN VIEW	CA	94040	4315	43	06085	37.36653288	-122.0778348	Santa Clara County
208304	Fee-for-Service	1952860900	1952860900	1	1	IANTORNO, STEFANO A MD	5/1/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	177369	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
208509	Fee-for-Service	1952690737	1952690737	1	1	IRISH-ZELENER, SUSAN PSYD	11/8/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	255 TERRACINA BLVD	SUITE 204	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
208618	Fee-for-Service	1063589083	1063589083	1	1	IVERY, GAYLA P MD	1/1/1998	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	81415	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
208722	Fee-for-Service	1073144762	1073144762	1	1	INTEGRATED NEUROLOGY & PAIN	7/25/2023	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MANAGEMENT, PC	155 GLEN COVE MARINA RD	SUITE 100	VALLEJO	CA	94591	7284	48	06095	38.07026311	-122.2123223	Solano County
208788	Fee-for-Service	1770905663	1770905663	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC	12555 CENTRAL AVE	STE C	CHINO	CA	91710	3569	36	06071	34.025247	-117.6892645	San Bernardino County
209076	Fee-for-Service	1770905663	1770905663	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	12555 CENTRAL AVE	STE C	CHINO	CA	91710	3569	36	06071	34.025247	-117.6892645	San Bernardino County
209082	Fee-for-Service	1801910724	1801910724	1	1	ITO, SARAH K O D	3/23/2010	193400000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A PROFESSIONAL CORP	2605 LINCOLN BLVD	None	SANTA MONICA	CA	90405	4619	19	06037	34.00650909	-118.4756227	Los Angeles County
209363	Fee-for-Service	1770905663	1770905663	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC	12555 CENTRAL AVE	STE C	CHINO	CA	91710	3569	36	06071	34.025247	-117.6892645	San Bernardino County
209364	Fee-for-Service	1134528342	1134528342	1	1	IMHOTEP INC	8/22/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	337 N VINEYARD AVE	STE 341	ONTARIO	CA	91764	7931	36	06071	34.066728	-117.611622	San Bernardino County
209435	Fee-for-Service	1407412828	1407412828	1	1	INTEGNA HOME HEALTH LLC	2/18/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6131 ORANGETHORPE AVE	STE 106	BUENA PARK	CA	92868	4633	30	06059	33.8588521	-118.0243537	Orange County
209654	Fee-for-Service	1770905663	1770905663	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC	12555 CENTRAL AVE	STE C	CHINO	CA	91710	3569	36	06071	34.025247	-117.6892645	San Bernardino County
209761	Fee-for-Service	1003513110	1003513110	1	1	INNOVA PHARMACY OF ARDEN-ARC	2/13/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	ADE	2400 GLENDALE LN	A	SACRAMENTO	CA	95825	2431	34	06067	38.597355	-121.405212	Sacramento County
209941	Fee-for-Service	1770905663	1770905663	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	12555 CENTRAL AVE	STE C	CHINO	CA	91710	3569	36	06071	34.025247	-117.6892645	San Bernardino County
209992	Fee-for-Service	1538654330	1538654330	1	1	IYER, RAJAN MD	10/18/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	180997	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
210110	Fee-for-Service	1962461541	1962461541	1	1	ICHIUJI, JUDY L OD	11/12/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	18013 CHATSWORTH STREET	None	GRANADA HILLS	CA	91344	5608	19	06037	34.2648826	-118.5250089	Los Angeles County
210135	Fee-for-Service	1790761005	1790761005	1	1	IWASAKI, PAMELA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66677	08	Family Practice	0	In state provider	None	510 W CYPRESS AVE	None	REEDLEY	CA	93654	2096	10	06019	36.60787131	-119.4521808	Fresno County
210203	Fee-for-Service	1942265939	1942265939	1	1	INLAND SURGERY CENTER	4/9/1987	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LTD	1620 LAUREL AVE	None	REDLANDS	CA	92373	4838	36	06071	34.03791255	-117.2041736	San Bernardino County
210370	Fee-for-Service	1952403909	1952403909	1	1	IKEDA, NAOKO DO	10/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9574	08	Family Practice	0	In state provider	None	155 SOLANO ST	None	CORNING	CA	96021	3511	52	06103	39.92779745	-122.1687508	Tehama County
210518	Fee-for-Service	1609153436	1609153436	1	1	INTEGRATED COMMUNITY HEALTH	2/9/2015	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CARE SOLUTIONS	1505 E 17TH ST	STE 209	SANTA ANA	CA	92705	8506	30	06059	33.75993551	-117.846954	Orange County
210528	Fee-for-Service	1730496688	1730496688	2	1	INLAND EMPIRE EMERGENCY	8/22/2011	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL GROUP INC	150 W ROUTE 66	None	GLENDORA	CA	91740	6207	19	06037	34.12866152	-117.86535	Los Angeles County
210710	Fee-for-Service	1841236320	1841236320	1	1	IDOWU, OLAJIRE MD	7/24/2000	2086S0120X	NA	General Surgery	026	PHYSICIANS	33345	85	Surgery-Pediatric	0	In state provider	None	744 52ND ST	STE 4100	OAKLAND	CA	94609	1810	01	06001	37.83734299	-122.2677613	Alameda County
210718	Fee-for-Service	1407906597	1407906597	1	1	IRVINE ADULT DAY HEALTH	7/6/1994	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	SERVICES	20 LAKE RD	None	IRVINE	CA	92604	4567	30	06059	33.67680215	-117.8037911	Orange County
210814	Fee-for-Service	1821490061	1821490061	1	1	INGRAM, TARA PHD	3/8/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2200 L ST	None	SACRAMENTO	CA	95816	4927	34	06067	38.573523	-121.4780805	Sacramento County
211220	Fee-for-Service	1356604094	1356604094	1	1	IMOTO, BRYAN T OD	8/26/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11436 ARTESIA BLVD	STE D	ARTESIA	CA	90701	3859	19	06037	33.87290578	-118.0898206	Los Angeles County
211311	Fee-for-Service	1326225186	1326225186	1	1	INLAND NEUROLOGICAL	3/15/2010	2084N0400X	NA	Neurology	026	PHYSICIANS	9169	13	Neurology (M.D. only)	0	In state provider	None	1148 SAN BERNARDINO	STE C101	UPLAND	CA	91786	4961	36	06071	34.10140903	-117.6359301	San Bernardino County
211477	Fee-for-Service	1366742140	1366742140	1	1	INLAND PSYCHIATRIC MEDICAL G	1/14/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ROUP, INC	73700 DINAH SHORE DR	STE 106	PALM DESERT	CA	92211	0813	33	06065	33.79748917	-116.3786855	Riverside County
211510	Fee-for-Service	1851463483	1851463483	1	17	INDEPENDENT OPTIONS INC	11/12/1991	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2500 MARK LN	None	COSTA MESA	CA	92626	6701	30	06059	33.66538803	-117.9208268	Orange County
211602	Fee-for-Service	1326225186	1326225186	1	1	INLAND NEUROLOGICAL	3/15/2010	2084N0400X	NA	Neurology	026	PHYSICIANS	9169	36	Psychiatry	0	In state provider	None	1148 SAN BERNARDINO	STE C101	UPLAND	CA	91786	4961	36	06071	34.10140903	-117.6359301	San Bernardino County
211632	Fee-for-Service	1548498157	1548498157	1	1	INNA V ANDREWS	3/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	747 BROADWAY	None	SEATTLE	WA	98122	4379	00	None	47.608326	-122.3207985	King County
211658	Fee-for-Service	1265093108	1265093108	1	1	IBRAHIM, ZULIANNA MD	11/17/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180378	None	None	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
211663	Fee-for-Service	1801150636	1801150636	1	1	I 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	3633 INLAND EMPIRE BLVD	SUITE 895	ONTARIO	CA	91764	4922	36	06071	34.069941	-117.570492	San Bernardino County
211672	Fee-for-Service	1740451079	1740451079	1	1	ISMAEL, OUSAMA MD	8/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100770	None	None	0	In state provider	None	555 E TACHEVAH DR	3W105	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
211766	Fee-for-Service	1366742140	1366742140	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ROUP, INC	73700 DINAH SHORE DR	STE 106	PALM DESERT	CA	92211	0813	33	06065	33.79748917	-116.3786855	Riverside County
211852	Fee-for-Service	1912585100	1912585100	1	1	IRVINE, KRYSTLE MD	9/27/2022	390200000X	NA	Other	026	PHYSICIANS	181979	None	None	0	In state provider	None	3855 ALAMO ST	None	SIMI VALLEY	CA	93063	2104	56	06111	34.28644751	-118.721655	Ventura County
211947	Fee-for-Service	1801150636	1801150636	1	1	I CARE HOSPICE INC	2/24/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3633 INLAND EMPIRE BLVD	SUITE 895	ONTARIO	CA	91764	4922	36	06071	34.069941	-117.570492	San Bernardino County
211952	Fee-for-Service	1275543605	1275543605	1	1	IMLER, GREGORY P MD	4/1/1995	208600000X	NA	General Surgery	026	PHYSICIANS	54636	02	General Surgery	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
212055	Fee-for-Service	1366742140	1366742140	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ROUP, INC	73700 DINAH SHORE DR	STE 106	PALM DESERT	CA	92211	0813	33	06065	33.79748917	-116.3786855	Riverside County
212228	Fee-for-Service	1730715889	1730715889	1	1	INTEGRAL HOSPICE INC	3/16/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10623 SHERMAN GROVE AVE	UNIT C	SUNLAND	CA	91040	2703	19	06037	34.262181	-118.3201565	Los Angeles County
212234	Fee-for-Service	1801150636	1801150636	1	1	I CARE HOSPICE INC	7/7/2022	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	None	3633 INLAND EMPIRE BLVD	SUITE 895	ONTARIO	CA	91764	4922	36	06071	34.069941	-117.570492	San Bernardino County
212243	Fee-for-Service	1275543605	1275543605	1	1	IMLER, GREGORY P MD	4/1/1995	208600000X	NA	General Surgery	026	PHYSICIANS	54636	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
212342	Fee-for-Service	1366742140	1366742140	1	1	INLAND PSYCHIATRIC MEDICAL G	7/26/2019	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ROUP, INC	73700 DINAH SHORE DR	STE 106	PALM DESERT	CA	92211	0813	33	06065	33.79748917	-116.3786855	Riverside County
212519	Fee-for-Service	1730715889	1730715889	1	1	INTEGRAL HOSPICE INC	3/16/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10623 SHERMAN GROVE AVE	UNIT C	SUNLAND	CA	91040	2703	19	06037	34.262181	-118.3201565	Los Angeles County
212718	Fee-for-Service	1801450127	1801450127	1	1	IBRAHEEM, HAYAN D MD	8/21/2023	208M00000X	NA	Other	026	PHYSICIANS	188117	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
212760	Fee-for-Service	1114336229	1114336229	1	1	IDEAL CARE, LLC	8/11/2014	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	15977 AVENIDA VILLAHA	UNIT 18	SAN DIEGO	CA	92128	3146	37	06073	33.00504478	-117.060318	San Diego County
212817	Fee-for-Service	1316949506	1316949506	2	1	INSIGHT VISION CENTER	2/28/2013	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1360 E HERNDON AVE	STE 201	FRESNO	CA	93270	3326	10	06019	36.83744648	-119.7646425	Fresno County
212915	Fee-for-Service	1770998031	1770998031	1	1	IKLE, JENNIFER M MD	9/3/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	169971	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
213016	Fee-for-Service	1235684960	1235684960	1	1	INTERGRATIVE URGENT CARE INC	3/20/2017	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	148 NORTH GRAND AVENUE	None	GLENDORA	CA	91741	2434	19	06037	34.13786301	-117.8724781	Los Angeles County
213095	Fee-for-Service	1174716583	1174716583	1	1	IBRAHIMI, WAHEED S MD	1/1/2016	207R00000X	NA	Other	026	PHYSICIANS	128575	None	None	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
213103	Fee-for-Service	1316949506	1316949506	2	1	INSIGHT VISION CENTER	2/28/2013	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	MEDICAL GROUP INC	1360 E HERNDON AVE	STE 201	FRESNO	CA	93270	3326	10	06019	36.83744648	-119.7646425	Fresno County
213304	Fee-for-Service	1225108673	1225108673	1	1	IGOR FISHKIN	5/17/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	506 LENOX AVE	None	NEW YORK	NY	10037	1802	00	None	40.814352	-73.94031	New York County
213516	Fee-for-Service	1992041081	1992041081	1	1	IRVINE, GRACE M LMFT	12/30/2018	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
213519	Fee-for-Service	1063488872	1063488872	1	1	IHDE, JANET MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	38144	02	General Surgery	0	In state provider	None	1733 N PALM CANYON DR	STE C	PALM SPRINGS	CA	92262	2957	33	06065	33.845418	-116.546788	Riverside County
213732	Fee-for-Service	1376741389	1376741389	1	1	IPPEN, CHANDRA M PHD	12/2/2021	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
213805	Fee-for-Service	1063488872	1063488872	1	1	IHDE, JANET MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	38144	78	Neoplastic Diseases/Oncology	0	In state provider	None	1733 N PALM CANYON DR	STE C	PALM SPRINGS	CA	92262	2957	33	06065	33.845418	-116.546788	Riverside County
213906	Fee-for-Service	1346271533	1346271533	1	1	INLAND CARDIOTHORACIC	1/1/1999	174400000X	NA	Other	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	SURGICAL ASSOCIATES MED	16051 KASOTA RD	STE 900	APPLE VALLEY	CA	92307	2209	36	06071	34.543368	-117.2667825	San Bernardino County
214099	Fee-for-Service	1861552291	1861552291	1	1	IBRAHIM, RIM S MD	11/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	111466	26	Psychiatry (child)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
214195	Fee-for-Service	1346271533	1346271533	1	1	INLAND CARDIOTHORACIC	1/1/1999	174400000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	SURGICAL ASSOCIATES MED	16051 KASOTA RD	STE 900	APPLE VALLEY	CA	92307	2209	36	06071	34.543368	-117.2667825	San Bernardino County
214440	Fee-for-Service	1043256738	1043256738	1	1	INWARDS-BRELAND, DAVID J MD	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68214	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
214990	Fee-for-Service	1861819104	1861819104	1	1	IRIBARNE, DANIELA MD	12/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148908	41	Internal Medicine	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
215010	Fee-for-Service	1730487083	1730487083	1	1	INTERVENTIONAL SPINE CENTER	8/27/2018	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	1110 W LA PALMA AVE	None	ANAHEIM	CA	92801	2804	30	06059	33.84712953	-117.9320355	Orange County
215019	Fee-for-Service	1255536165	1255536165	1	1	ISRAEL LANDA MD	3/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2700 WAYNE MEMORIAL DR	None	GOLDSBORO	NC	27534	9494	00	None	35.398593	-77.952294	Wayne County
215151	Fee-for-Service	1487002614	1487002614	1	1	IHEJIRIKA-LOMEDICO, RIVKA M	6/21/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	185582	None	None	0	In state provider	D	511 BATH ST	None	SANTA BARBARA	CA	93101	3403	42	06083	34.41386476	-119.6993335	Santa Barbara County
215356	Fee-for-Service	1730269622	1730269622	1	1	IMPERIAL VALLEY MEDICAL	12/1/1977	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CLINIC INC	535 RIVER ROAD	None	CALEXICO	CA	92231	0000	13	06025	32.684958	-115.5141698	Imperial County
215390	Fee-for-Service	1548339039	1548339039	1	1	I & G PHARMACY INC	4/24/1996	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	815 E COLORADO ST	STE A	GLENDALE	CA	91205	1293	19	06037	34.14268219	-118.2448037	Los Angeles County
215556	Fee-for-Service	1023755006	1023755006	1	1	IWUAGWU, CHINYERE NP	2/6/2024	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
215601	Fee-for-Service	1851463483	1851463483	1	4	INDEPENDENT OPTIONS INC	2/2/1989	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	24218 SILVER SPRAY DR	None	DIAMOND BAR	CA	91765	1833	19	06037	34.02579107	-117.7964771	Los Angeles County
215908	Fee-for-Service	1538693262	1538693262	1	1	ISTRATE, LAURA E MD	1/3/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	158381	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
215934	Fee-for-Service	1043237977	1043237977	1	1	INTERNAL MED ASSOCS OF	1/1/1979	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FRESNO LAB AND RADIO	1379 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83694289	-119.7636839	Fresno County
215988	Fee-for-Service	1326458324	1326458324	1	1	ISKANDER, SHERIF MD	11/22/2019	207QH0002X	NA	Adult Primary Care	026	PHYSICIANS	144032	38	Geriatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
216064	Fee-for-Service	1639463573	1639463573	1	1	IDAKOJI, IBRAHIM A MD	7/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123106	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
216134	Fee-for-Service	1851463483	1851463483	1	8	INDEPENDENT OPTIONS INC	2/12/2000	310500000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1289 N 3RD AVE	None	UPLAND	CA	91786	3227	36	06071	34.110477	-117.6462695	San Bernardino County
216285	Fee-for-Service	1932736766	1932736766	1	1	IVANOVA, VARSHA DPM	1/29/2024	390200000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1800 SULLIVAN AVE	RM 106	DALY CITY	CA	94015	2227	41	06081	37.68077723	-122.4728941	San Mateo County
216317	Fee-for-Service	1407964489	1407964489	1	1	IDYLLWILD HEALTH CENTER	4/27/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	54910 PINECREST DRIVE	None	IDYLLWILD	CA	92549	0000	33	06065	33.7525352	-116.7068573	Riverside County
216380	Fee-for-Service	1851921373	1851921373	1	1	INTEGRAL HOME HEALTH CARE	5/9/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14547 TITUS ST	STE 203	PANORAMA CITY	CA	91402	4928	19	06037	34.21973977	-118.4503255	Los Angeles County
217117	Fee-for-Service	1902822745	1902822745	1	2	IKUTA, PAMELA K DO	7/2/2021	207P00000X	NA	Other	026	PHYSICIANS	7643	None	None	0	In state provider	None	1950 ROSALINE AVE	SUITE A	REDDING	CA	96001	2543	45	06089	40.57330004	-122.3943613	Shasta County
217227	Fee-for-Service	1841958162	1841958162	1	1	INNOVATIVE HOME HEALTH INC	2/29/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1220 W GLENOAKS BLVD	SUITE 104A	GLENDALE	CA	91201	2231	19	06037	34.16551419	-118.2821828	Los Angeles County
217279	Fee-for-Service	1326427014	1326427014	1	1	IVANOV, MARGARET MD	7/23/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	156352	45	Nephrology (Renal-Kidney)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
217457	Fee-for-Service	1811412018	1811412018	1	1	ICARE HOSPICE SERVICES, INC	11/12/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12011 VICTORY BLVD	STE 100	NORTH HOLLWOOD	CA	91606	3330	19	06037	34.18670845	-118.394784	Los Angeles County
217490	Fee-for-Service	1073200697	1073200697	1	1	ISHKA LLC	5/23/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	303 W NAPA ST	None	SONOMA	CA	95476	6516	49	06097	38.29248664	-122.4638317	Sonoma County
217505	Fee-for-Service	1982846242	1982846242	1	1	IANNUZZI, JAMES C MD	7/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156530	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
217577	Fee-for-Service	1669015772	1669015772	1	1	ISHII, MOTOKO NP	2/5/2020	363LA2200X	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
217664	Fee-for-Service	1427791607	1427791607	1	1	INNOVATE RECOVERY LLC	11/6/2024	261QR0405X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	14718 KESWICK ST	None	VAN NUYS	CA	91405	1205	19	06037	34.21024549	-118.4537092	Los Angeles County
217742	Fee-for-Service	1770586232	1770586232	1	1	ISAEFF, WAYNE B MD	12/6/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	8927	18	Ophthalmology	0	In state provider	None	1900 E WASHINGTON ST	None	COLTON	CA	92324	4614	36	06071	34.04839685	-117.2950602	San Bernardino County
217747	Fee-for-Service	1811412018	1811412018	1	1	ICARE HOSPICE SERVICES, INC	11/12/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12011 VICTORY BLVD	STE 100	NORTH HOLLWOOD	CA	91606	3330	19	06037	34.18670845	-118.394784	Los Angeles County
217837	Fee-for-Service	1417727157	1417727157	1	1	INDIGENOUS WELLNESS ALLIANCE	9/15/2024	251V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	INC	409 TALMAGE RD	None	UKIAH	CA	95482	5956	23	06045	39.13615493	-123.2007385	Mendocino County
217855	Fee-for-Service	MSS00006F	None	1	1	INSTITUTE ON AGING	7/1/1998	No Taxonomy Provided	NA	None	074	MULTIPURPOSE SENIOR SERVICES PROGRAM	-	-	NOT APPLICABLE	0	In state provider	ON AGING	3575 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3212	38	06075	37.78122373	-122.4579478	San Francisco County
217870	Fee-for-Service	1114303849	1114303849	1	1	IRWIN, GAIL M LMFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	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
218022	Fee-for-Service	1669547733	1669547733	1	1	INLAND ARTIFICIAL LIMB & BRA	4/4/2007	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CE	1700 E. LINCOLN AVE	101	ANAHEIM	CA	92805	4346	30	06059	33.84008418	-117.8937053	Orange County
218300	Fee-for-Service	1447604525	1447604525	1	2	INFUSION EXPRESS OF CALIFORN	2/5/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	IA, INC.	43360 MISSION BLVD	100	FREMONT	CA	94539	5899	01	06001	37.53249631	-121.9198141	Alameda County
218355	Fee-for-Service	1962642579	1962642579	1	1	ISHIDA, JULIE H MD	5/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106442	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
218371	Fee-for-Service	1750506713	1750506713	1	1	INHOUS ORTHOPEDICS	7/1/1996	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	15571 BROOKHURST ST	None	WESTMINSTER	CA	92683	7554	30	06059	33.73633159	-117.9548222	Orange County
218375	Fee-for-Service	1366514499	1366514499	1	1	IQBAL, SHAHEEN MD	3/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38557	08	Family Practice	0	In state provider	None	609 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	3623	19	06037	34.0168264	-118.1043661	Los Angeles County
218380	Fee-for-Service	1205127941	1205127941	1	1	INLAND EMPIRE DIAGNOSTICS IN	3/14/2019	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	C	77711 FLORA ROAD	STE 110	PALM DESERT	CA	92211	9032	33	06065	33.76854997	-116.3077307	Riverside County
218505	Fee-for-Service	1417016049	1417016049	1	1	ITAMI, ROBERT M MD	9/30/1982	2080P0205X	NA	Endocrinology	026	PHYSICIANS	41425	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
218587	Fee-for-Service	1447604525	1447604525	1	2	INFUSION EXPRESS OF CALIFORN	2/5/2024	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	IA, INC.	43360 MISSION BLVD	100	FREMONT	CA	94539	5899	01	06001	37.53249631	-121.9198141	Alameda County
218616	Fee-for-Service	1831455245	1831455245	1	1	IGI CARE INC	8/13/2012	193400000X	NA	Other	026	PHYSICIANS	120683	41	Internal Medicine	0	In state provider	None	1825 SONOMA ST	None	REDDING	CA	96001	2519	45	06089	40.5756004	-122.3928987	Shasta County
218642	Fee-for-Service	1962642579	1962642579	1	1	ISHIDA, JULIE H MD	5/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106442	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
218664	Fee-for-Service	1750506713	1750506713	1	1	INHOUS ORTHOPEDICS	7/1/2004	335E00000X	NA	Other	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	15571 BROOKHURST ST	None	WESTMINSTER	CA	92683	7554	30	06059	33.73633159	-117.9548222	Orange County
218775	Fee-for-Service	1619123379	1619123379	1	1	INDIRA VEMURI	6/11/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	80970	None	None	0	In state provider	None	15585 MONTEREY RD	A	MORGAN HILL	CA	95037	9503	43	06085	37.10874399	-121.6371955	Santa Clara County
218808	Fee-for-Service	1528152105	1528152105	1	1	INTERNAL MEDICINE ASSC	7/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3260 3RD AVE	None	SAN DIEGO	CA	92103	5697	37	06073	32.73949839	-117.1622444	San Diego County
219270	Fee-for-Service	1376206425	1376206425	1	1	INFINITE GENOMICS LLC	11/19/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	4850 NORTHSHORE LN	None	NORTH LITTLE ROCK	AR	72118	5329	00	None	34.804809	-92.3442525	Pulaski County
219468	Fee-for-Service	1578652152	1578652152	1	1	IRVINE SURGICAL MEDICAL	8/16/2005	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	GROUP CORP	15825 LAGUNA CANYON RD	STE 100	IRVINE	CA	92618	2126	30	06059	33.66406324	-117.7638431	Orange County
219473	Fee-for-Service	1629561816	1629561816	1	1	IZZO, ANNA LMFT	4/3/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	307 S. B ST.	None	SAN MATEO	CA	94401	4053	41	06081	37.56539871	-122.3222584	San Mateo County
219512	Fee-for-Service	1194935015	1194935015	1	1	INGHAM, KENDALL W	5/1/2007	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	5184 THOMASINO WAY	None	ANTELOPE	CA	95843	3830	34	06067	38.70504	-121.34259	Sacramento County
219747	Fee-for-Service	1871877837	1871877837	1	1	IMAZUMI, KEIKO	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
219928	Fee-for-Service	1639135445	1639135445	1	1	ISHAK, ANDRE M MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	81316	20	Orthopedic Surgery	0	In state provider	None	2100 SOLAR DR	STE 101	OXNARD	CA	93036	0648	56	06111	34.22156515	-119.14488	Ventura County
220105	Fee-for-Service	1265502405	1265502405	1	1	ICC CONVALESCENT CORP	6/1/2002	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	IMPERIAL CARE CENTER	11441 VENTURA BLVD	None	STUDIO CITY	CA	91604	3143	19	06037	34.13962168	-118.3801939	Los Angeles County
220483	Fee-for-Service	1619297629	1619297629	1	1	IFEACHO, TOCHUKWU V MD	4/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121692	41	Internal Medicine	0	In state provider	None	465 W PUTNAM ST	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
220500	Fee-for-Service	1295770881	1295770881	1	1	ING,MATHEW 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	1301 PUNCHBOWL STREET	None	HONOLULU	HI	96813	0000	00	None	21.30800017	-157.8550765	Honolulu County
220703	Fee-for-Service	1538235189	1538235189	1	1	ISACOFF, WILLIAM H M D INC	12/31/1991	207RH0003X	NA	Oncology	026	PHYSICIANS	24596	41	Internal Medicine	0	In state provider	None	10921 WILSHIRE BLVD	STE 505	LOS ANGELES	CA	90024	4001	19	06037	34.05857311	-118.4447628	Los Angeles County
220779	Fee-for-Service	1205268984	1205268984	1	1	ICARE PHARMACY INC	10/28/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1727 BERRYESSA RD	STE B	SAN JOSE	CA	95133	1172	43	06085	37.37462071	-121.8723473	Santa Clara County
220873	Fee-for-Service	1225504780	1225504780	1	1	IRACI, LINDSAY M NP	11/12/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
221059	Fee-for-Service	1790190825	1790190825	1	1	ISHAK, GEORGE E MD	12/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145111	41	Internal Medicine	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
221066	Fee-for-Service	1235309428	1235309428	1	1	INLAND HEALTHCARE GROUP AMC	3/9/2010	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1033 N WATERMAN AVE	SUITE E	SAN BERNARDINO	CA	92410	3808	36	06071	34.11819969	-117.2787193	San Bernardino County
221081	Fee-for-Service	1013444041	1013444041	1	1	INKELIS, SARAH M	1/31/2024	103G00000X	NA	Other	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
221249	Fee-for-Service	1952594715	1952594715	1	1	ISMAILJEE, MOHAMEDALI MD	9/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115943	None	None	0	In state provider	None	760 S WASHBURN AVE	STE 3A	CORONA	CA	92882	3303	33	06065	33.87374611	-117.567875	Riverside County
221275	Fee-for-Service	1851463483	1851463483	1	3	INDEPENDENT OPTIONS INC	2/2/1989	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	23938 PALOMINO DR	None	DIAMOND BAR	CA	91765	1719	19	06037	34.02577704	-117.8020919	Los Angeles County
221291	Fee-for-Service	1932241635	1932241635	1	1	IBEABUCHI, GEOFFREY B	4/23/2009	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	577 N. D STREET	STE 100	SAN BERNARDINO	CA	92401	1321	36	06071	34.109613	-117.291874	San Bernardino County
221498	Fee-for-Service	1487706214	1487706214	1	1	IASIS GLENWOOD REG MED	11/9/2007	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	503 MCMILLAN RD	None	WEST MONROE	LA	71291	5327	00	None	32.51343725	-92.15639623	Ouachita Parish
221525	Fee-for-Service	1659459329	1659459329	1	1	IRIZARRY, CARMEN P MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	86638	36	Psychiatry	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
221545	Fee-for-Service	1508956160	1508956160	1	1	ILYAS, MOHAMMED MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 CHILDRENS WAY	None	LITTLE ROCK	AR	72202	3500	00	None	34.742745	-92.2927905	Pulaski County
221626	Fee-for-Service	1437172210	1437172210	1	1	INNOCENZI, ROBERT A DO	12/14/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	5773	18	Ophthalmology	0	In state provider	None	12555 CENTRAL AVE	STE H	CHINO	CA	91710	3569	36	06071	34.025247	-117.6892645	San Bernardino County
221631	Fee-for-Service	1699069146	1699069146	1	1	IYENGAR, SREESH G MD	10/14/2016	207RN0300X	NA	Nephrology	026	PHYSICIANS	128686	45	Nephrology (Renal-Kidney)	0	In state provider	None	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
221784	Fee-for-Service	1487706214	1487706214	1	1	IASIS GLENWOOD REG MED	11/9/2007	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	503 MCMILLAN RD	None	WEST MONROE	LA	71291	5327	00	None	32.51343725	-92.15639623	Ouachita Parish
222009	Fee-for-Service	1942801840	1942801840	1	1	INTEGRATED HOME HEALTH CARE	12/20/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6354 1/2 VAN NUYS BLVD	SUITE 101	VAN NUYS	CA	91401	2601	19	06037	34.1858441	-118.4486607	Los Angeles County
222296	Fee-for-Service	1225336373	1225336373	1	1	IXIA HOLDINGS LLC	6/7/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	151 PIONEER LANE	None	BISHOP	CA	93514	2557	14	06027	37.36171162	-118.4073778	Inyo County
222324	Fee-for-Service	1326016536	1326016536	1	1	IVAN GUERRERO	11/22/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6817 SOUTHPOINT PKWY	STE 802	JACKSONVILLE	FL	32216	6292	00	None	30.25935517	-81.58800304	Duval County
222600	Fee-for-Service	1518007970	1518007970	2	1	IMPERIAL PARK INC	1/19/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3323 E IMPERIAL HWY	None	LYNWOOD	CA	90262	3305	19	06037	33.93072576	-118.210693	Los Angeles County
222654	Fee-for-Service	1215341482	1215341482	1	1	ITAKURA, KAORU S MD	2/20/2018	390200000X	NA	Other	026	PHYSICIANS	139082	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
222802	Fee-for-Service	1841349362	1841349362	1	1	IBARRA GONZALEZ, DELIA R LCS	4/5/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	4785 N FIRST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
222909	Fee-for-Service	1033772348	1033772348	1	1	INSIGHT CHILDREN & FAMILY TH	7/1/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ERAPY INC	16168 BEACH BLVD	SUITE 215	HUNTINGTON BEACH	CA	92647	3881	30	06059	33.728283	-117.9891305	Orange County
223001	Fee-for-Service	1003451477	1003451477	1	1	INFINITY HOSPICE AND	1/14/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	1700 IOWA AVE	STE 250	RIVERSIDE	CA	92507	2474	33	06065	33.996033	-117.3398135	Riverside County
223288	Fee-for-Service	1003451477	1003451477	1	1	INFINITY HOSPICE AND	1/14/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	1700 IOWA AVE	STE 250	RIVERSIDE	CA	92507	2474	33	06065	33.996033	-117.3398135	Riverside County
223551	Fee-for-Service	1639342058	1639342058	1	1	ISARIYAWONGSE, BRANDON K MD	10/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131363	34	Urology and Urological Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
223633	Fee-for-Service	1093115735	1093115735	1	1	IQ SURGICAL ASSOCIATES INC	10/9/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	89	Surgery-Traumatic	0	In state provider	None	202 W WILLIOW AVE	SUITE 402	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
223863	Fee-for-Service	1851587448	1851587448	1	1	IRONSTONE MEDICAL CLINIC	8/19/2008	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	4121 BROCKTON AVE	STE 104	RIVERSIDE	CA	92501	3442	33	06065	33.98089267	-117.3813658	Riverside County
223875	Fee-for-Service	1033486527	1033486527	1	1	INDULKAR, LILAVATI A MD	2/26/2018	207R00000X	NA	Other	026	PHYSICIANS	118451	41	Internal Medicine	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
223921	Fee-for-Service	1093115735	1093115735	1	1	IQ SURGICAL ASSOCIATES INC	10/9/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	202 W WILLIOW AVE	SUITE 402	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
223941	Fee-for-Service	1861853236	1861853236	1	1	IMRIE, DRU A MD	6/10/2021	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	148882	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
223943	Fee-for-Service	1922661867	1922661867	1	1	ISAAC, JOHN MD	2/18/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	181189	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
223950	Fee-for-Service	1295880656	1295880656	1	1	ISMAIL, BOBBY A PT	12/22/2017	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4318 SPYRES WAY	None	MODESTO	CA	95356	9259	50	06099	37.70194177	-120.9988293	Stanislaus County
224214	Fee-for-Service	1639558232	1639558232	1	1	INCREDIBLY INSPIRATIONAL, IN	6/24/2019	251S00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	C	2009 PALO VERDE AVE	SUITE A	LONG BEACH	CA	90815	3322	19	06037	33.792597	-118.1080155	Los Angeles County
224361	Fee-for-Service	1538178801	1538178801	1	1	IHC HEALTH SERVICES INC	11/10/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	VALLEY VIEW MEDICAL CTR	1303 N MAIN ST	None	CEDAR CITY	UT	84720	9746	00	None	37.699596	-113.0664465	Iron County
224447	Fee-for-Service	1366676199	1366676199	1	1	ISLANDS, SANDY	4/3/2020	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43585 MONTEREY AVE	SUITE 1	PALM DESERT	CA	92260	9342	33	06065	33.731946	-116.3912695	Riverside County
224503	Fee-for-Service	1639558232	1639558232	1	1	INCREDIBLY INSPIRATIONAL, IN	6/24/2019	251S00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	C	2009 PALO VERDE AVE	SUITE A	LONG BEACH	CA	90815	3322	19	06037	33.792597	-118.1080155	Los Angeles County
224651	Fee-for-Service	1538178801	1538178801	1	1	IHC HEALTH SERVICES INC	2/18/2003	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	VALLEY VIEW MEDICAL CTR	1303 N MAIN ST	None	CEDAR CITY	UT	84720	9746	00	None	37.699596	-113.0664465	Iron County
224677	Fee-for-Service	1356385231	1356385231	1	1	ISAACS, ERIC D MD	11/30/1991	207P00000X	NA	Other	026	PHYSICIANS	73156	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
224703	Fee-for-Service	1902800535	1902800535	1	1	ILLINOIS VALLEY COMMUNITY HO	2/20/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	925 WEST ST	None	PERU	IL	61354	2757	00	None	41.32915393	-89.12526253	LaSalle County
224880	Fee-for-Service	1134104672	1134104672	1	1	INGHAM REG MED CENTER	6/6/2006	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	401 W GREENLAWN AVE	None	LANSING	MI	48910	0899	00	None	42.70477827	-84.55529715	Ingham County
225124	Fee-for-Service	1417271446	1417271446	1	1	ISIGI, ROSELYN A	5/21/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4186 RIMCREST DR.	None	NORCO	CA	92860	1173	33	06065	33.94132317	-117.562202	Riverside County
225168	Fee-for-Service	1134104672	1134104672	1	1	INGHAM REG MED CENTER	6/6/2006	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	401 W GREENLAWN AVE	None	LANSING	MI	48910	0899	00	None	42.70477827	-84.55529715	Ingham County
225413	Fee-for-Service	1417271446	1417271446	1	1	ISIGI, ROSELYN A	5/21/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4186 RIMCREST DR.	None	NORCO	CA	92860	1173	33	06065	33.94132317	-117.562202	Riverside County
225460	Fee-for-Service	1740213198	1740213198	1	2	IRRADIANCE MEDICAL GROUP INC	10/14/2022	207NS0135X	NA	Dermatology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	420 E 3RD ST	STE 805	LOS ANGELES	CA	90013	1646	19	06037	34.04702011	-118.241912	Los Angeles County
225498	Fee-for-Service	1881794071	1881794071	1	1	INGMAN, KATHLEEN A PHD	7/14/2006	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
225600	Fee-for-Service	1194742106	1194742106	1	1	INCAUDO, GARY A MD	8/25/1998	207K00000X	NA	Other	026	PHYSICIANS	27753	03	Allergy	0	In state provider	None	270 COHASSET RD	STE 100	CHICO	CA	95926	2262	04	06007	39.75182825	-121.8521039	Butte County
225803	Fee-for-Service	1932393584	1932393584	1	1	IBBISON, ANDREA NP	3/11/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
225824	Fee-for-Service	1013369321	1013369321	1	1	INLAND URGENT CARE A MEDICAL	8/16/2019	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	487 MAGNOLIA AVE	SUITE 102	CORONA	CA	92879	3306	33	06065	33.85419849	-117.5625093	Riverside County
225889	Fee-for-Service	1194742106	1194742106	1	1	INCAUDO, GARY A MD	8/25/1998	207K00000X	NA	Other	026	PHYSICIANS	27753	83	Rheumatology	0	In state provider	None	270 COHASSET RD	STE 100	CHICO	CA	95926	2262	04	06007	39.75182825	-121.8521039	Butte County
226005	Fee-for-Service	1407183528	1407183528	1	1	INGENIUS 3 LLC	12/30/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	18119 PRAIRIE AVE	STE 104	TORRANCE	CA	90501	3740	19	06037	33.866343	-118.343839	Los Angeles County
226019	Fee-for-Service	1114973203	1114973203	1	1	ITZCOVICH-SCHUSTER, JOSE	3/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	41041	36	Psychiatry	0	In state provider	MD	9400 BRIGHTON WAY	STE 411	BEVERLY HILLS	CA	90210	4703	19	06037	34.07043476	-118.4011952	Los Angeles County
226293	Fee-for-Service	1316122104	1316122104	1	1	IM, SUNG H MD	2/8/2015	390200000X	NA	Other	026	PHYSICIANS	117206	05	Anesthesiology	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
226449	Fee-for-Service	1457644346	1457644346	1	1	ITO, BRANDON S MD	7/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	121975	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLAZA	STE 48-240	LOS ANGELES	CA	90024	5055	19	06037	34.06633181	-118.4451729	Los Angeles County
226466	Fee-for-Service	1376519850	1376519850	1	1	INSIGHT HEALTH CORP	12/10/2003	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	INSIGHT IMAGING LAGN HLS	24953 PASEO DE VALENCIA	STE 8C	LAGUNA HILLS	CA	92653	4337	30	06059	33.60028568	-117.7010887	Orange County
226763	Fee-for-Service	1780260380	1780260380	1	1	IZUKA, SHANNON MD	10/30/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
227038	Fee-for-Service	1336428820	1336428820	1	1	IQBAL, ASNEHA S MD	7/20/2021	2080P0207X	NA	Hematology	026	PHYSICIANS	171664	None	None	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93102	0689	42	06083	34.42887662	-119.7237878	Santa Barbara County
227089	Fee-for-Service	1285603837	1285603837	2	1	INVIEW IMAGING DIAGNOSTICS,	9/20/2021	111NR0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3450 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98818077	-121.7817767	Contra Costa County
227174	Fee-for-Service	1609498997	1609498997	1	1	ISSA, ANGELA MD	9/19/2023	207R00000X	NA	Other	026	PHYSICIANS	185000	None	None	0	In state provider	None	465 W PUTNAM AVENUE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
227206	Fee-for-Service	1346339504	1346339504	1	1	ISHIKAWA, GLENN 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	888 SOUTH KING STREET	None	HONOLULU	HI	96813	3083	00	None	21.30218603	-157.8505732	Honolulu County
227441	Fee-for-Service	1750435624	1750435624	1	1	INTERGRATIVE MEDICAL CLINIC	2/12/2018	193200000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	OF SANTA ROSA A PROF COR	175 CONCOURSE BLVD	None	SANTA ROSA	CA	95403	8217	49	06097	38.51157204	-122.7885509	Sonoma County
228086	Fee-for-Service	1891170205	1891170205	1	1	INHOUSE CARE SERVICES INC	10/5/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	126 S JACKSON ST	SUITE 302	GLENDALE	CA	91205	4921	19	06037	34.14533965	-118.2500741	Los Angeles County
228134	Fee-for-Service	1871320333	1871320333	1	1	IMAJO, KENTO PT	12/20/2024	225100000X	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
228259	Fee-for-Service	1154671980	1154671980	1	1	ILAPAKURTI, MANJUSHA MD	10/1/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	132203	-	NOT APPLICABLE	0	In state provider	None	2695 S 4TH STREET	2ND FLOOR	EL CENTRO	CA	92243	6012	13	06025	32.76973509	-115.5520629	Imperial County
228489	Fee-for-Service	1407923311	1407923311	1	1	INEL, SELIM M MD	7/15/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	52132	07	Dermatology	0	In state provider	ATTN MGA OFFICE	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
228841	Fee-for-Service	1508840448	1508840448	1	1	ISHAK, WAGUIH W MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50591	36	Psychiatry	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
229012	Fee-for-Service	1467807032	1467807032	1	1	IWATA, KATHRYN A MD	7/9/2020	207L00000X	NA	Other	026	PHYSICIANS	153425	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
229031	Fee-for-Service	1598183162	1598183162	1	1	IBERTI, COLIN T MD	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146713	41	Internal Medicine	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
229100	Fee-for-Service	1609372051	1609372051	1	1	INJEAN, PATIL	7/21/2023	207R00000X	NA	Other	026	PHYSICIANS	17749	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
229126	Fee-for-Service	1790982759	1790982759	1	1	IYER, KUMARI S MD	5/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	82074	41	Internal Medicine	0	In state provider	None	4770 W HERNDON AVE	STE 107	FRESNO	CA	93722	8401	10	06019	36.83717984	-119.8778388	Fresno County
229277	Fee-for-Service	1073240529	1073240529	1	4	INFUCARE MEDICAL GROUP OF CA	4/24/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	17332 VON KARMAN AVE	110A	IRVINE	CA	92614	6242	30	06059	33.6898038	-117.8419528	Orange County
229374	Fee-for-Service	1114399342	1114399342	1	1	IRVING, NATASHA D MD	10/5/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	155992	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
229391	Fee-for-Service	1609096395	1609096395	1	1	ISTAPHANOUS, GEORGE K MD	3/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105906	05	Anesthesiology	0	In state provider	None	4650 W SUNSET AVE	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
229423	Fee-for-Service	1972297422	1972297422	1	1	IBANEZ-FARRELL, MARITZA DOU	3/29/2024	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	36	06071	0	0	None
229494	Fee-for-Service	1245336056	1245336056	1	1	INTERIM HEALTHCARE OF	11/29/1995	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	NORTHERN CALIFORNIA INC	1647 COURT ST	None	REDDING	CA	96001	1737	45	06089	40.58145556	-122.3949686	Shasta County
229565	Fee-for-Service	1073240529	1073240529	1	4	INFUCARE MEDICAL GROUP OF CA	10/19/2023	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	17332 VON KARMAN AVE	110A	IRVINE	CA	92614	6242	30	06059	33.6898038	-117.8419528	Orange County
229598	Fee-for-Service	1851463483	1851463483	1	5	INDEPENDENT OPTIONS INC	3/11/1991	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1625 BRONZE KNOLL RD	None	DIAMOND BAR	CA	91765	2610	19	06037	33.99276486	-117.8085967	Los Angeles County
229604	Fee-for-Service	1609314905	1609314905	1	1	IBRAHIM, ADEL MD	3/26/2024	207R00000X	NA	Other	026	PHYSICIANS	169484	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
229685	Fee-for-Service	1083309033	1083309033	1	1	INLAND CARE SERVICE INC	9/13/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	4411 CHICAGO AVE	None	RIVERSIDE	CA	92507	5406	33	06065	33.96952369	-117.3485441	Riverside County
229696	Fee-for-Service	1245210228	1245210228	1	1	IDALYN CYPRUS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1520 W STATE ST	None	BOISE	ID	83702	4085	00	None	43.62316896	-116.2093186	Ada County
229744	Fee-for-Service	1699902577	1699902577	1	1	ITTY, SUJIT MD	5/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125265	18	Ophthalmology	0	In state provider	None	100 STEIN PLAZA	1-340	LOS ANGELES	CA	90095	0001	19	06037	34.06489065	-118.4443287	Los Angeles County
229929	Fee-for-Service	1437414380	1437414380	1	1	IMAM, FARAH N MD	7/24/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	132422	08	Family Practice	0	In state provider	None	16465 SIERRA LAKES PKWY	SUITE 115	FONTANA	CA	92336	1242	36	06071	34.13805177	-117.4457839	San Bernardino County
229960	Fee-for-Service	1548479397	1548479397	1	2	ION ALEXIE INC	8/3/2019	207RI0200X	NA	HIV/AIDS/Infectious Disease	022	PHYSICIANS GROUP	-	77	Infectious Disease	1	Border provider	None	2435 FIRE MESA ST	SUITE 120	LAS VEGAS	NV	89128	9009	00	None	36.20469539	-115.2575248	Clark County
230272	Fee-for-Service	1689349110	1689349110	1	1	INTERNAL LIFE HOME HEALTH,	11/30/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	7590 N GLENOAKS BLVD	STE 20	BURBANK	CA	91504	1003	19	06037	34.20858506	-118.3436243	Los Angeles County
230328	Fee-for-Service	1164523072	1164523072	1	1	INGLE, RICHARD M MD	10/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	59041	01	General Practice	0	In state provider	None	914 PINE STREET	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
230367	Fee-for-Service	1932589835	1932589835	1	1	IRVINE HEALTH CARE	4/16/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	ACUPUNCTURE INC	16444 PARAMOUNT BLVD	STE 208	PARAMOUNT	CA	90723	5454	19	06037	33.8848179	-118.1599671	Los Angeles County
230390	Fee-for-Service	1760532436	1760532436	1	1	IIDA, RICKEY OD	4/18/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
230556	Fee-for-Service	1689349110	1689349110	1	1	INTERNAL LIFE HOME HEALTH,	9/13/2024	163WH0200X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	INC	7590 N GLENOAKS BLVD	STE 20	BURBANK	CA	91504	1003	19	06037	34.20858506	-118.3436243	Los Angeles County
230748	Fee-for-Service	1306205315	1306205315	1	1	IBARRA SAUCEDO, ALEJANDRA L	1/23/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MFT	9333 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2141	19	06037	33.90413858	-118.1346616	Los Angeles County
231106	Fee-for-Service	1376916379	1376916379	1	1	IMPACT MEDICAL SERVICES LLC	4/11/2024	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1001 NW VESPER ST	None	BLUE SPRINGS	MO	64015	3667	00	None	39.02094	-94.2768945	Jackson County
231242	Fee-for-Service	1154592467	1154592467	1	1	IRA DAVID ENTERPRISES	5/1/2009	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	ADMINISTRATOR	1950 EAST 5TH STREET	None	LONG BEACH	CA	90802	2023	19	06037	33.77288461	-118.1679979	Los Angeles County
231462	Fee-for-Service	1205157955	1205157955	1	1	IKHENA-ABEL, DEBORAH E MD	11/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150458	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1263 E ARQUES AVE	None	SUNNYVALE	CA	94085	4701	43	06085	37.38060846	-121.9896672	Santa Clara County
231570	Fee-for-Service	1831583848	1831583848	1	1	IYER, ARJUN B MD	7/22/2019	207P00000X	NA	Other	026	PHYSICIANS	160392	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
231922	Fee-for-Service	1154815264	1154815264	1	2	INNOVATIVE ANESTHESIA CONSUL	6/2/2021	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	TANTS PC	6655 ALVARADO ROAD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
231923	Fee-for-Service	1649824863	1649824863	1	1	INTUITION SPEECH THERAPY, IN	7/11/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	C.	600 CENTRAL AVE	SUITE F	LAKE ELSINORE	CA	92530	6976	33	06065	33.689503	-117.340376	Riverside County
232084	Fee-for-Service	1922511807	1922511807	1	1	INCARE HOME CARE, LLC	10/24/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	17 E SIR FRANCIS DRAKE	SUITE 212	LARKSPUR	CA	94939	1727	21	06041	37.94515886	-122.5127109	Marin County
232230	Fee-for-Service	1205107851	1205107851	1	1	ICARE	3/23/2012	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	438 VINEYARD PLACE	None	PASADENA	CA	91107	2956	19	06037	34.15390554	-118.0851118	Los Angeles County
233344	Fee-for-Service	1851463483	1851463483	1	20	INDEPENDENT OPTIONS INC	9/7/1990	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HARBOR VILLAGE IV	2525 SANTA CATALINA DR	APT 108	COSTA MESA	CA	92626	6862	30	06059	33.66608015	-117.9221384	Orange County
233492	Fee-for-Service	1326340282	1326340282	1	1	INDERMOHAN S LUTHRA MD INC A	10/29/2020	174400000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PROFESSIONAL CORPORATIO	35400 BOB HOPE DR	STE 113	RANCHO MIRAGE	CA	92270	1772	33	06065	33.7914	-116.4058625	Riverside County
233721	Fee-for-Service	1821539180	1821539180	1	1	ISRAEL, JENNIFER DO	7/1/2020	390200000X	NA	Other	026	PHYSICIANS	17135	41	Internal Medicine	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
233781	Fee-for-Service	1326340282	1326340282	1	1	INDERMOHAN S LUTHRA MD INC A	9/18/2020	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PROFESSIONAL CORPORATIO	35400 BOB HOPE DR	STE 113	RANCHO MIRAGE	CA	92270	1772	33	06065	33.7914	-116.4058625	Riverside County
233948	Fee-for-Service	1003278086	1003278086	1	1	IZADI, NEEMA	6/13/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	136656	03	Allergy	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
233979	Fee-for-Service	1407322258	1407322258	1	1	IKEDA, LODIE	7/31/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	19092 CANYON TERRACE DRI	None	TRABUCO CANYON	CA	92679	1000	30	06059	33.68487021	-117.623515	Orange County
234004	Fee-for-Service	1093263345	1093263345	1	1	INSPIRING COMMUNITIES	8/22/2019	174H00000X	NA	Other	102	DIABETES PREVENTION PROGRAM SUPPLIER	-	-	NOT APPLICABLE	0	In state provider	None	3220 BLUME DR	STE 116	RICHMOND	CA	94806	1980	07	06013	37.98273485	-122.3224993	Contra Costa County
234012	Fee-for-Service	1629424577	1629424577	1	1	IZUGBOKWE, OGUGUA N MD	6/6/2020	207R00000X	NA	Other	026	PHYSICIANS	162060	41	Internal Medicine	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
234021	Fee-for-Service	1487390100	1487390100	1	1	IBARROLA, HANNAH N PT	11/11/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12761 SCHABARUM AVE	None	BALDWIN PARK	CA	91706	6807	19	06037	34.08060971	-117.9958001	Los Angeles County
234302	Fee-for-Service	1093948176	1093948176	1	1	ISFAHANI, ARASH M MD	9/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125387	18	Ophthalmology	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
234770	Fee-for-Service	1316950207	1316950207	2	1	IMPERIAL VALLEY OPTOMETR	8/10/2007	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CORP OPTOM EYES VISION C	3451 S DOGWOOD AVE	SUITE 1334	EL CENTRO	CA	92243	7906	13	06025	32.762997	-115.530678	Imperial County
234808	Fee-for-Service	1205077070	1205077070	1	1	ISLAS, YESSICA MFT	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	84282	-	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
235060	Fee-for-Service	1922485085	1922485085	1	4	INSTANT URGENT CARE	1/31/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	4400 TASSAJARA RD	C	DUBLIN	CA	94568	4604	01	06001	37.70606155	-121.8722207	Alameda County
235169	Fee-for-Service	1730128364	1730128364	1	1	IBRAHIM, RAGAA R MD	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52906	41	Internal Medicine	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
235209	Fee-for-Service	1831123884	1831123884	1	1	IMRIE STEPHEN TM	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30501	20	Orthopedic Surgery	0	In state provider	None	123 DI SALVO AVE	STE C	SAN JOSE	CA	95128	1717	43	06085	37.32628785	-121.9371289	Santa Clara County
235252	Fee-for-Service	1720215502	1720215502	1	1	IJADI-MAGHSOODI, ROYA MD	8/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115668	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8346	19	06037	34.07067	-118.4432445	Los Angeles County
235274	Fee-for-Service	1245483825	1245483825	1	3	INLAND WOMENS CARE ASSOCIAT	4/8/2021	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ES, INC.	255 TERRACINA BLVD	STE 203	REDLANDS	CA	92373	4884	36	06071	34.03788441	-117.2055761	San Bernardino County
235276	Fee-for-Service	1295171940	1295171940	1	1	IFOKWE, JOSEPH	3/22/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
235318	Fee-for-Service	1811944598	1811944598	1	1	IBRAHIM, IRENY I MD	1/1/1998	207R00000X	NA	Other	026	PHYSICIANS	64541	41	Internal Medicine	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
235334	Fee-for-Service	1316578743	1316578743	1	1	ITRANS MEDICAL TRANSPORTATIO	6/23/2020	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	N, INC	8921 DE SOTO	205	CANOGA PARK	CA	91304	1910	19	06037	34.23241304	-118.5885517	Los Angeles County
235346	Fee-for-Service	1922485085	1922485085	1	4	INSTANT URGENT CARE	1/31/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4400 TASSAJARA RD	C	DUBLIN	CA	94568	4604	01	06001	37.70606155	-121.8722207	Alameda County
235610	Fee-for-Service	1508380536	1508380536	1	2	INDEPENDENT ANESTHESIA	2/9/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
235633	Fee-for-Service	1922485085	1922485085	1	4	INSTANT URGENT CARE	1/31/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	4400 TASSAJARA RD	C	DUBLIN	CA	94568	4604	01	06001	37.70606155	-121.8722207	Alameda County
235674	Fee-for-Service	1689778128	1689778128	1	1	IRIE, KENJI MD	10/31/1980	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	30886	01	General Practice	0	In state provider	None	420 E 3RD ST	STE 903	LOS ANGELES	CA	90013	1647	19	06037	34.04702011	-118.241912	Los Angeles County
235903	Fee-for-Service	1508380536	1508380536	1	2	INDEPENDENT ANESTHESIA	10/12/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
236130	Fee-for-Service	1316924947	1316924947	1	1	IP, TZE K MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	84213	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	26732 CROWN VALLEY PKWY	STE 131	MISSION VIEJO	CA	92691	8533	30	06059	33.56347704	-117.66546	Orange County
236453	Fee-for-Service	1659722460	1659722460	1	1	IBRAHIM, ISRA MD	10/10/2023	208M00000X	NA	Other	026	PHYSICIANS	178374	None	None	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
236498	Fee-for-Service	1851463483	1851463483	1	12	INDEPENDENT OPTIONS INC	12/26/2000	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1250 ORANGE AVE	None	BEAUMONT	CA	92223	1708	33	06065	33.94190641	-116.9743893	Riverside County
236531	Fee-for-Service	1225117716	1225117716	1	1	IRWIN, SCOTT A MD	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	84936	36	Psychiatry	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
236592	Fee-for-Service	1447737432	1447737432	1	1	IMPERIAL HOME HEALTH CARE	3/24/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	229 N CENTRAL AVE	STE 500	GLENDALE	CA	91203	3507	19	06037	34.14910181	-118.2579537	Los Angeles County
236665	Fee-for-Service	1508338054	1508338054	1	2	INTEGRATIVE FOOT AND ANKLE C	1/22/2025	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	ENTER	600 NUT TREE RD	STE 110	VACAVILLE	CA	95687	4656	48	06095	38.36133624	-121.9496789	Solano County
236772	Fee-for-Service	1790839496	1790839496	1	1	IM, SAMUEL S MD	11/1/2000	207VX0201X	NA	Obstetrics & Gynecology	026	PHYSICIANS	71341	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DR S	BLDG 23	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
236876	Fee-for-Service	1437311610	1437311610	1	3	INDEPENDENCE HOME HEALTH INC	2/8/2015	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6501 FOOTHILL BLVD	SUITE 201C	TUJUNGA	CA	91042	2790	19	06037	34.24497265	-118.2734363	Los Angeles County
237156	Fee-for-Service	1285720656	1285720656	1	1	INSTITUTE OF BRAIN &	1/20/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	SPINE SURGERY MED GRP	21350 HAWTHORNE BLVD	STE 128	TORRANCE	CA	90503	5635	19	06037	33.8344453	-118.3529294	Los Angeles County
237340	Fee-for-Service	1487098117	1487098117	1	1	IBODY INC	9/6/2013	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	956 HUNTINGTON DR	None	SAN MARINO	CA	91108	1825	19	06037	34.11231693	-118.1258249	Los Angeles County
237446	Fee-for-Service	1285720656	1285720656	1	1	INSTITUTE OF BRAIN &	1/20/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	SPINE SURGERY MED GRP	21350 HAWTHORNE BLVD	STE 128	TORRANCE	CA	90503	5635	19	06037	33.8344453	-118.3529294	Los Angeles County
237493	Fee-for-Service	1881853505	1881853505	1	1	IRIBE, ELIZABETH LMFT	9/7/2018	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
237528	Fee-for-Service	1891364576	1891364576	1	1	INLAND EMPIRE MULTISPECIALTY	3/6/2023	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ICAL GROUP	6926 BROCKTON AVE	STE. 4	RIVERSIDE	CA	92506	3804	33	06065	33.947919	-117.3967225	Riverside County
237545	Fee-for-Service	1801576186	1801576186	1	1	INSIGHTS FAMILY COUNSELING S	4/1/2024	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ERVICES	720 SUNRISE AVE	200C	ROSEVILLE	CA	95661	4516	31	06061	38.735307	-121.272048	Placer County
237581	Fee-for-Service	1134182629	1134182629	1	1	IPP, ELI MD	8/31/1988	207RE0101X	NA	Endocrinology	026	PHYSICIANS	41730	None	None	0	In state provider	None	21840 NORMANDIE AVE	STE 100	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
237890	Fee-for-Service	1851463483	1851463483	1	9	INDEPENDENT OPTIONS INC	8/13/1996	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5124 VIA MINDANAO	None	OCEANSIDE	CA	92057	2618	37	06073	33.267213	-117.3056236	San Diego County
237930	Fee-for-Service	1194385781	1194385781	1	1	IBARRA, ALEJANDRO CCC-SLP	5/9/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2505 W SHAW AVE	STE. 101	FRESNO	CA	93711	3334	10	06019	36.80619423	-119.8359004	Fresno County
238272	Fee-for-Service	1700176229	1700176229	1	1	IWAKI, MICHELLE T	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122255	66	Emergency Medicine (Urgent Care)	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
238332	Fee-for-Service	1700142916	1700142916	1	1	INDARAM, MAANASA MD	7/14/2017	207W00000X	NA	Ophthalmology	026	PHYSICIANS	128261	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	ROOM 4M31	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
238411	Fee-for-Service	1073240529	1073240529	1	1	INFUCARE MEDICAL GROUP OF CA	8/3/2023	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	4240 LATHAM ST	STE A	RIVERSIDE	CA	92501	1741	33	06065	34.00198519	-117.3739252	Riverside County
238475	Fee-for-Service	1316156193	1316156193	1	1	IM, KYOUNG BIN MD	8/13/2019	2084S0012X	NA	Neurology	026	PHYSICIANS	162715	36	Psychiatry	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
238554	Fee-for-Service	1952662991	1952662991	1	1	ISHIYAMA, MARIKO DO	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12904	01	General Practice	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4404	50	06099	37.66508443	-120.9962589	Stanislaus County
238579	Fee-for-Service	1659507341	1659507341	1	1	IONESCU, ADRIAN M MD	7/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147912	05	Anesthesiology	0	In state provider	None	2185 W CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
238705	Fee-for-Service	1104495761	1104495761	1	1	IGNACIO, JENNIFER NP	11/23/2022	363LF0000X	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
238843	Fee-for-Service	1023463601	1023463601	1	1	ITO, YURI DO	11/2/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15933	41	Internal Medicine	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
239065	Fee-for-Service	1528565157	1528565157	1	1	IBRAHIM, MICHAEL M MD	2/8/2021	207R00000X	NA	Other	026	PHYSICIANS	164991	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
239117	Fee-for-Service	1649740234	1649740234	1	2	ICONSULT HEALTHCARE, INC.	4/17/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	721 N EUCLID	None	ANAHEIM	CA	92801	0000	30	06059	33.84206214	-117.9416317	Orange County
239302	Fee-for-Service	1053409714	1053409714	1	1	ING, ANDREW S MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63107	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
239362	Fee-for-Service	1497759104	1497759104	1	1	INTERNAL MEDICINE AND	12/1/1982	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	NEPHROLOGY GRP INC	3291 SKYPARK DR	None	TORRANCE	CA	90505	5004	19	06037	33.8097005	-118.3456025	Los Angeles County
239512	Fee-for-Service	1922485085	1922485085	1	1	INSTANT URGENT CARE	4/18/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3466 EL CAMINO REAL	None	SANTA CLARA	CA	95051	2809	43	06085	37.35225555	-121.9921875	Santa Clara County
239795	Fee-for-Service	1023087640	1023087640	1	1	IKUTA, PAUL T MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	42495	05	Anesthesiology	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
239802	Fee-for-Service	1922485085	1922485085	1	1	INSTANT URGENT CARE	4/18/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	3466 EL CAMINO REAL	None	SANTA CLARA	CA	95051	2809	43	06085	37.35225555	-121.9921875	Santa Clara County
239890	Fee-for-Service	1114046414	1114046414	1	1	ITO, SHIHO I MD	4/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82290	08	Family Practice	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
240063	Fee-for-Service	1881997963	1881997963	1	1	INDIAN HEALTH CENTER OF SANT	5/1/2012	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CLARA VALLEY	1642 E CAPITOL EXPY	None	SAN JOSE	CA	95121	1800	43	06085	37.3061289	-121.8119182	Santa Clara County
240090	Fee-for-Service	1922485085	1922485085	1	1	INSTANT URGENT CARE	4/18/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	3466 EL CAMINO REAL	None	SANTA CLARA	CA	95051	2809	43	06085	37.35225555	-121.9921875	Santa Clara County
240156	Fee-for-Service	1073240529	1073240529	1	6	INFUCARE MEDICAL GROUP OF CA	4/25/2024	208D00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9025 WILSHIRE BLVD	STE 205A	BEVERLY HILLS	CA	90211	1825	19	06037	34.06708809	-118.3884174	Los Angeles County
240163	Fee-for-Service	1447695325	1447695325	1	1	IYER, ADITYA K MD	9/10/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	131842	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
240248	Fee-for-Service	1851463483	1851463483	1	7	INDEPENDENT OPTIONS INC	5/15/1992	310500000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	KIOWA CREST II	1591 KIOWA CREST DR	None	DIAMOND BAR	CA	91765	3918	19	06037	33.99186751	-117.8295724	Los Angeles County
240264	Fee-for-Service	1316949506	1316949506	2	2	INSIGHT VISION CENTER	7/23/2015	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	509 SOUTH I ST	STE C	MADERA	CA	93637	4660	20	06039	36.95460782	-120.0589258	Madera County
240351	Fee-for-Service	1881997963	1881997963	1	1	INDIAN HEALTH CENTER OF SANT	12/2/2011	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CLARA VALLEY	1642 E CAPITOL EXPY	None	SAN JOSE	CA	95121	1800	43	06085	37.3061289	-121.8119182	Santa Clara County
240445	Fee-for-Service	1073240529	1073240529	1	6	INFUCARE MEDICAL GROUP OF CA	4/25/2024	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	9025 WILSHIRE BLVD	STE 205A	BEVERLY HILLS	CA	90211	1825	19	06037	34.06708809	-118.3884174	Los Angeles County
240473	Fee-for-Service	1992299838	1992299838	1	1	IMPAKT MEDICAL, LLC	1/11/2019	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	9722 FAIR OAKS BLVD	SUITE B	FAIR OAKS	CA	95628	7039	34	06067	38.639007	-121.2771105	Sacramento County
240500	Fee-for-Service	1932112455	1932112455	1	1	ISKENDERIAN, KEVORK MD	1/21/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	50646	36	Psychiatry	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
240554	Fee-for-Service	1316949506	1316949506	2	2	INSIGHT VISION CENTER	7/23/2015	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	509 SOUTH I ST	STE C	MADERA	CA	93637	4660	20	06039	36.95460782	-120.0589258	Madera County
240638	Fee-for-Service	1881997963	1881997963	1	1	INDIAN HEALTH CENTER OF SANT	12/2/2011	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CLARA VALLEY	1642 E CAPITOL EXPY	None	SAN JOSE	CA	95121	1800	43	06085	37.3061289	-121.8119182	Santa Clara County
240704	Fee-for-Service	1659536084	1659536084	1	1	INGHAM, MARTHA A PHD	2/8/2015	103TS0200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3131 CAMINO DEL RIO N	STE 237	SAN DIEGO	CA	92108	5715	37	06073	32.77548044	-117.127293	San Diego County
241003	Fee-for-Service	1598066581	1598066581	1	1	ICHIMI DOUSHIN RESOURCES INC	3/9/2012	261QP2300X	NA	Other	026	PHYSICIANS	10696	08	Family Practice	0	In state provider	None	18558 GALE AVE	STE 200	CITY OF INDUSTRY	CA	91748	1394	19	06037	33.99526938	-117.8989728	Los Angeles County
241213	Fee-for-Service	1902576846	1902576846	1	1	INLAND ARTHRITIS CENTER	12/3/2021	207RR0500X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	374 E VANDERBILT WAY	2	SAN BERNARDINO	CA	92408	3593	36	06071	34.06877142	-117.2770094	San Bernardino County
241244	Fee-for-Service	1467635094	1467635094	1	1	IMOTO, PAULA T OD	1/2/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
241361	Fee-for-Service	1124210653	1124210653	1	1	IGO, MARY K MD	3/24/2008	2084P0800X	NA	Psychiatry	026	PHYSICIANS	68164	36	Psychiatry	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
241491	Fee-for-Service	1326174061	1326174061	1	1	IBARRA, JUAN M LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	275 W MACARTHUR	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
241755	Fee-for-Service	1649530411	1649530411	1	1	IVARY, JEANNE M LMFT	5/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
241792	Fee-for-Service	1467401000	1467401000	1	1	ICM MEDICAL GROUP INC	4/29/2010	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	211 N PRAIRIE AVE	None	INGLEWOOD	CA	90301	4106	19	06037	33.965136	-118.3439955	Los Angeles County
241820	Fee-for-Service	1023207610	1023207610	1	1	INTEGRATED NURSING AND REHAB	12/21/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2225 N PERRIS BLVD	None	PERRIS	CA	92571	2580	33	06065	33.81251709	-117.2260543	Riverside County
241923	Fee-for-Service	1003380429	1003380429	1	1	IRIZARRY, ANDREW J CRNA	10/18/2022	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	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
242082	Fee-for-Service	1467401000	1467401000	1	1	ICM MEDICAL GROUP INC	4/29/2010	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	211 N PRAIRIE AVE	None	INGLEWOOD	CA	90301	4106	19	06037	33.965136	-118.3439955	Los Angeles County
242354	Fee-for-Service	1538564463	1538564463	1	3	INNOVATIVE SLEEP CENTERS, IN	6/12/2020	2084S0012X	NA	Neurology	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	C.	35 JAN COURT	STE 150	CHICO	CA	95928	4418	04	06007	39.71826923	-121.7919151	Butte County
242508	Fee-for-Service	1750514394	1750514394	1	1	INGLIS-ARKELL,CHRISTINA M MD	6/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107759	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	0648	38	06075	37.7634502	-122.4579779	San Francisco County
242985	Fee-for-Service	1659369445	1659369445	1	1	ILAS, MICHAEL J DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	6560	36	Psychiatry	0	In state provider	None	29377 RANCHO CALIFORNIA	STE 204	TEMECULA	CA	92591	5206	33	06065	33.50543172	-117.1445545	Riverside County
242987	Fee-for-Service	1851463483	1851463483	1	19	INDEPENDENT OPTIONS INC	3/18/1992	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2500 CHRISTOPHER LN	None	COSTA MESA	CA	92626	6750	30	06059	33.66466695	-117.9208249	Orange County
243271	Fee-for-Service	1659369445	1659369445	1	1	ILAS, MICHAEL J DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	6560	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	29377 RANCHO CALIFORNIA	STE 204	TEMECULA	CA	92591	5206	33	06065	33.50543172	-117.1445545	Riverside County
243317	Fee-for-Service	1053678656	1053678656	1	1	IMBERT, ELIZABETH V MD	8/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130963	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
243898	Fee-for-Service	1538254511	1538254511	1	1	IDOWU, OLUMUYIWA MD	12/7/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184126	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
243951	Fee-for-Service	1851463483	1851463483	1	27	INDEPENDENT OPTIONS INC	11/13/1986	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	DIAMOND HOUSE	512 DIAMOND RD	None	PLACENTIA	CA	92870	4801	30	06059	33.87731023	-117.8728973	Orange County
244113	Fee-for-Service	1124691365	1124691365	1	1	ICLASS TREATMENT CENTER INC.	8/6/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	390 W BLAINE ST	None	RIVERSIDE	CA	92507	4061	33	06065	33.98290776	-117.3200172	Riverside County
244545	Fee-for-Service	1871757005	1871757005	1	1	IZADI, KAMRON MD	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	102215	30	Radiology	0	In state provider	None	1695 S SAN JACINTO AVE	None	SAN JACINTO	CA	92583	5103	33	06065	33.770961	-116.954649	Riverside County
244573	Fee-for-Service	1386987493	1386987493	1	1	ISQUICK, SARAH MD	7/19/2017	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	133383	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
244653	Fee-for-Service	1598783904	1598783904	1	1	IVY CREEK OF TALLAPOOSA, LLC	3/20/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	201 MARIARDEN RD	None	DADEVILLE	AL	36853	6251	00	None	32.8199016	-85.74168323	Tallapoosa County
244749	Fee-for-Service	1922485085	1922485085	1	3	INSTANT URGENT CARE	1/31/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	3095 TELEGRAPH AVE	None	BERKELEY	CA	94705	2035	01	06001	37.85417441	-122.2599715	Alameda County
244843	Fee-for-Service	1386648061	1386648061	1	1	ICHEL, DANIEL A MD	7/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	87154	30	Radiology	0	In state provider	None	2800 L STREET	SUITE 260	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
245036	Fee-for-Service	1922485085	1922485085	1	3	INSTANT URGENT CARE	1/31/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3095 TELEGRAPH AVE	None	BERKELEY	CA	94705	2035	01	06001	37.85417441	-122.2599715	Alameda County
245039	Fee-for-Service	1396761383	1396761383	1	1	INTERNAL MEDICINE &	7/1/1994	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PULMONARY MEDICAL ASSOC	910 S SUNSET AVE	STE 2	WEST COVINA	CA	91790	3409	19	06037	34.064247	-117.9429166	Los Angeles County
245325	Fee-for-Service	1922485085	1922485085	1	3	INSTANT URGENT CARE	1/31/2023	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	3095 TELEGRAPH AVE	None	BERKELEY	CA	94705	2035	01	06001	37.85417441	-122.2599715	Alameda County
245479	Fee-for-Service	1407108160	1407108160	1	1	IRAHETA, JOSE R LMFT	6/5/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
245534	Fee-for-Service	1306421748	1306421748	1	1	INSPIRE BEHAVIORAL HEALTH	3/17/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	401 RIDGE VISTA AVE	None	SAN JOSE	CA	95127	1501	43	06085	37.37837217	-121.8351069	Santa Clara County
245569	Fee-for-Service	1851463483	1851463483	1	21	INDEPENDENT OPTIONS INC	1/19/1990	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HARBOR VILLAGE II	2532 SANTA CATALINA DR	APT 104	COSTA MESA	CA	92626	6880	30	06059	33.66640118	-117.9218102	Orange County
245646	Fee-for-Service	1164476719	1164476719	1	1	ITAMURA, JOHN M MD	12/31/1993	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	69735	20	Orthopedic Surgery	0	In state provider	None	1510 SAN PABLO ST	STE 322	LOS ANGELES	CA	90033	5305	19	06037	34.06287152	-118.2029433	Los Angeles County
245808	Fee-for-Service	1083872196	1083872196	1	1	IKEDA, MARC D MD	8/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105562	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
246344	Fee-for-Service	1932562527	1932562527	1	1	ILIEV, ILIA	9/10/2024	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
246499	Fee-for-Service	1831685577	1831685577	1	1	ILICETO, ALESSANDRO	6/26/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	175049	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
246903	Fee-for-Service	1134235971	1134235971	2	1	I. PAUL HEILVEIL PH.D., A PS	9/6/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ENTER	410 ARDEN AVE	STE 201	GLENDALE	CA	91203	4006	19	06037	34.15842441	-118.2618749	Los Angeles County
246905	Fee-for-Service	1497551626	1497551626	1	1	INNERLIGHT PSYCHOTHERAPY INC	3/3/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	77 ASPEN WAY	103	WATSONVILLE	CA	95076	6040	44	06087	36.93112743	-121.7802608	Santa Cruz County
246985	Fee-for-Service	1922485085	1922485085	1	2	INSTANT URGENT CARE	7/14/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	2435 SAN RAMON VALLEY BL	SUTE 1A	SAN RAMON	CA	94583	1663	07	06013	37.77514445	-121.9774599	Contra Costa County
247005	Fee-for-Service	1073240529	1073240529	1	3	INFUCARE MEDICAL GROUP OF CA	10/11/2023	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	4065 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2556	19	06037	34.02396048	-118.18395	Los Angeles County
247013	Fee-for-Service	1851463483	1851463483	1	23	INDEPENDENT OPTIONS INC	10/26/2004	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HARBOR VILLAGE V	2541 SANTA CATALINA DR	STE 108	COSTA MESA	CA	92626	6890	30	06059	33.66738367	-117.9216713	Orange County
247144	Fee-for-Service	1972909596	1972909596	1	1	IVY HOSPICE CARE INC	7/29/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	545 N MOUNTAIN AVENUE	STE 101	UPLAND	CA	91786	5054	36	06071	34.100631	-117.6702865	San Bernardino County
247261	Fee-for-Service	1962677013	1962677013	1	1	INLAND EYE SPECIALISTS	6/3/2011	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	521 E ELDER ST	STE 102	FALLBROOK	CA	92028	3082	37	06073	33.38015149	-117.246267	San Diego County
247273	Fee-for-Service	1922485085	1922485085	1	2	INSTANT URGENT CARE	7/14/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2435 SAN RAMON VALLEY BL	SUTE 1A	SAN RAMON	CA	94583	1663	07	06013	37.77514445	-121.9774599	Contra Costa County
247292	Fee-for-Service	1073240529	1073240529	1	3	INFUCARE MEDICAL GROUP OF CA	4/24/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4065 WHITTIER BLVD	None	LOS ANGELES	CA	90023	2556	19	06037	34.02396048	-118.18395	Los Angeles County
247310	Fee-for-Service	1538496195	1538496195	1	1	IYER, SONALI L MD	1/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	103293	41	Internal Medicine	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
247341	Fee-for-Service	1669413449	1669413449	1	1	ITAKURA, HARUKA MD	6/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77384	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
247393	Fee-for-Service	1902822745	1902822745	1	1	IKUTA, PAMELA K DO	4/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7643	None	None	0	In state provider	None	914 PINE ST	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
247431	Fee-for-Service	1972909596	1972909596	1	1	IVY 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	545 N MOUNTAIN AVENUE	STE 101	UPLAND	CA	91786	5054	36	06071	34.100631	-117.6702865	San Bernardino County
247522	Fee-for-Service	1225686769	1225686769	1	1	IAQUINTO, ELIZABETH LMFT	9/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6276 N 1ST ST	103	FRESNO	CA	93710	5400	10	06019	36.82794977	-119.7721574	Fresno County
247630	Fee-for-Service	1669413449	1669413449	1	1	ITAKURA, HARUKA MD	6/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77384	68	Hematology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
247758	Fee-for-Service	1568498145	1568498145	1	1	IONESCU, LUDMILLA N MD	12/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130451	01	General Practice	0	In state provider	None	15611 POMERADO RD	SUITE 400	POWAY	CA	92064	2437	37	06073	32.99706	-117.05544	San Diego County
247855	Fee-for-Service	1003964057	1003964057	1	1	IMPERIAL, DINO A DO	12/1/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	6714	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
247871	Fee-for-Service	1841235645	1841235645	1	1	ISHO, MATHEW MD	8/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93470	None	None	0	In state provider	None	550 WASHINGTON ST	STE 821	SAN DIEGO	CA	92103	2232	37	06073	32.75003652	-117.1603431	San Diego County
247917	Fee-for-Service	1669413449	1669413449	1	1	ITAKURA, HARUKA MD	6/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77384	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
248188	Fee-for-Service	1104570282	1104570282	1	1	INLAND EMPIRE BEHAVIORAL GRO	11/22/2023	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	UP NURSING CORPORATION	11801 PIERCE ST	STE 200 OFFICE 253	RIVERSIDE	CA	92505	5191	33	06065	33.90100297	-117.49363	Riverside County
248277	Fee-for-Service	1851931364	1851931364	1	1	INFINITY MEDICAL CARE, INC.	9/2/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1820 FULLERTON AVE	STE 260	CORONA	CA	92881	3160	33	06065	33.858756	-117.5503465	Riverside County
248375	Fee-for-Service	1154673713	1154673713	1	1	IBRAHIM, WALEED MD	7/26/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	182614	None	None	0	In state provider	None	19111 TOWN CENTER DR	None	APPLE VALLEY	CA	92308	8989	36	06071	34.46573149	-117.2467156	San Bernardino County
248441	Fee-for-Service	1700871233	1700871233	1	1	INTRA CARE HOME HEALTH	11/11/2008	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PROVIDERS INC	4929 WILSHIRE BLVD	STE 210	LOS ANGELES	CA	90010	3817	19	06037	34.0621435	-118.3380975	Los Angeles County
248478	Fee-for-Service	1104570282	1104570282	1	1	INLAND EMPIRE BEHAVIORAL GRO	11/22/2023	261QM1300X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	UP NURSING CORPORATION	11801 PIERCE ST	STE 200 OFFICE 253	RIVERSIDE	CA	92505	5191	33	06065	33.90100297	-117.49363	Riverside County
248569	Fee-for-Service	1073240529	1073240529	1	2	INFUCARE MEDICAL GROUP OF CA	4/24/2024	261QI0500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7625 MESA COLLEGE DR	250A	SAN DIEGO	CA	92111	5343	37	06073	32.80089797	-117.1572727	San Diego County
248599	Fee-for-Service	1417448168	1417448168	1	1	INLAND VALLEY TRAUMA AND	12/26/2018	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	ACUTE CARE SURGERY APC	36320 INLAND VALLEY DR	STE 101	WILDOMAR	CA	92595	7512	33	06065	33.592158	-117.2367705	Riverside County
248765	Fee-for-Service	1104570282	1104570282	1	1	INLAND EMPIRE BEHAVIORAL GRO	11/22/2023	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	UP NURSING CORPORATION	11801 PIERCE ST	STE 200 OFFICE 253	RIVERSIDE	CA	92505	5191	33	06065	33.90100297	-117.49363	Riverside County
248797	Fee-for-Service	1972106144	1972106144	1	2	IZRA TRANSPORT INC	10/27/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	9747 BUSINESSPARK AVE	239	SAN DIEGO	CA	92131	1661	37	06073	32.90044976	-117.1120762	San Diego County
248857	Fee-for-Service	1073240529	1073240529	1	2	INFUCARE MEDICAL GROUP OF CA	10/11/2023	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	7625 MESA COLLEGE DR	250A	SAN DIEGO	CA	92111	5343	37	06073	32.80089797	-117.1572727	San Diego County
248941	Fee-for-Service	1740906890	1740906890	2	1	IMPERIALAGENCY	11/1/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	901 W CIVIC CENTER DR	2ND FL, OFFICE NUMBER 4	SANTA ANA	CA	92703	2352	30	06059	33.75155572	-117.8778014	Orange County
249020	Fee-for-Service	1306506126	1306506126	1	1	INOKHODOV, ALEKSEY NP	2/7/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11103 VENICE BLVD	None	LOS ANGELES	CA	90034	6914	19	06037	34.01379685	-118.4159354	Los Angeles County
249055	Fee-for-Service	1104570282	1104570282	1	1	INLAND EMPIRE BEHAVIORAL GRO	11/22/2023	261QM1300X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	UP NURSING CORPORATION	11801 PIERCE ST	STE 200 OFFICE 253	RIVERSIDE	CA	92505	5191	33	06065	33.90100297	-117.49363	Riverside County
249723	Fee-for-Service	1023618824	1023618824	1	1	INGRAM'S PHARMACY, LLC	11/30/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1115 UNION AVE	UNIT # 147-1C	BAKERSFIELD	CA	93307	1050	15	06029	35.366859	-119.0030565	Kern County
249764	Fee-for-Service	1710326749	1710326749	1	1	ILAGAN, MARK K DO	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14538	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
249917	Fee-for-Service	1861843898	1861843898	1	1	INOZEMTSEV, KONSTANTIN MD	4/6/2022	208VP0000X	NA	Other	026	PHYSICIANS	174221	None	None	0	In state provider	None	3434 VILLA LANE	STE 150	NAPA	CA	94558	6405	28	06055	38.32515937	-122.2938358	Napa County
250113	Fee-for-Service	1952131856	1952131856	1	1	IBLOOM THERAPY INC.,	9/19/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3699 BARNARD DR	521	OCEANSIDE	CA	92056	4003	37	06073	33.18638668	-117.2968828	San Diego County
250228	Fee-for-Service	1093063703	1093063703	1	1	ISRAELYAN, LINA LMFT	2/10/2023	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
250300	Fee-for-Service	1982670402	1982670402	1	1	IP, MICHAEL S MD	5/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141494	18	Ophthalmology	0	In state provider	None	100 STEIN PLAZA	RM 1340	LOS ANGELES	CA	90095	7065	19	06037	34.06489065	-118.4443287	Los Angeles County
250332	Fee-for-Service	1871600114	1871600114	1	1	ING, JEFFREY MD	4/27/2006	207W00000X	NA	Ophthalmology	026	PHYSICIANS	78322	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	1617 SAINT MARKS PLZ	STE D	STOCKTON	CA	95207	6423	39	06077	37.98864819	-121.3268062	San Joaquin County
250623	Fee-for-Service	1831258730	1831258730	1	1	IMPERIAL AMBULANCE INC	1/1/1979	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	22 N COTTAGE ST	None	PORTERVILLE	CA	93257	3220	54	06107	36.06652599	-119.0329264	Tulare County
251348	Fee-for-Service	1427073865	1427073865	1	2	INOUYE, PAUL T MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142073	89	Surgery-Traumatic	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
251364	Fee-for-Service	1073240529	1073240529	1	7	INFUCARE MEDICAL GROUP OF CA	5/20/2024	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	39755 MURRIETA HOT SPRIN	SUITE F110A	MURRIETA	CA	92563	9151	33	06065	33.55575954	-117.1627899	Riverside County
251514	Fee-for-Service	1881899805	1881899805	1	1	INTEMANN, PETER M MD	12/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117173	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
251618	Fee-for-Service	1346685781	1346685781	1	1	IMAM, IMAM M MD	3/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2400 S AVE	STE A	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
251650	Fee-for-Service	1073240529	1073240529	1	7	INFUCARE MEDICAL GROUP OF CA	5/20/2024	208D00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	39755 MURRIETA HOT SPRIN	SUITE F110A	MURRIETA	CA	92563	9151	33	06065	33.55575954	-117.1627899	Riverside County
251676	Fee-for-Service	1225154792	1225154792	1	1	IMPERIAL CO OFFICE OF ED	4/8/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DEPT OF SPECIAL SVS	1398 SPERBER RD	BLDG D, SUITE 101	EL CENTRO	CA	92243	9621	13	06025	32.75037551	-115.5646125	Imperial County
251789	Fee-for-Service	1215521844	1215521844	1	1	INPATHY BEHAVIORAL HEALTHCAR	3/2/2021	101YP2500X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	E GROUP PC	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
251805	Fee-for-Service	1336205442	1336205442	1	1	ILUORE, AUGUSTINE E MD	6/30/1998	207R00000X	NA	Other	026	PHYSICIANS	53317	01	General Practice	0	In state provider	None	11633 HAWTHORNE BLVD	STE 201	HAWTHORNE	CA	90250	2322	19	06037	33.928488	-118.3527475	Los Angeles County
251951	Fee-for-Service	1972748424	1972748424	1	1	INFORM DIAGNOSTICS INC	10/11/2018	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	4207 E COTTON CENTER BLV	BUILDING 10	PHOENIX	AZ	85040	8893	00	None	33.401583	-111.9899115	Maricopa County
252036	Fee-for-Service	1003984543	1003984543	1	1	IYER, GAYATHRIS S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	HENRY FORD HEALTH SYSTEM	2799 W GRAND BLVD	None	DETROIT	MI	48202	2608	00	None	42.36645079	-83.08385497	Wayne County
252076	Fee-for-Service	1215521844	1215521844	1	1	INPATHY BEHAVIORAL HEALTHCAR	8/27/2021	101YP2500X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	E GROUP PC	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
252206	Fee-for-Service	1902313919	1902313919	1	1	INTEGRATED CRITICAL CARE AND	2/28/2018	207RC0200X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PULMONARY SPECIALISTS I	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
252365	Fee-for-Service	1215521844	1215521844	1	1	INPATHY BEHAVIORAL HEALTHCAR	3/2/2021	101YP2500X	NA	Other	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	E GROUP PC	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
252394	Fee-for-Service	1639199060	1639199060	1	1	INLAND CARDIOTHORACIC	9/30/1990	174400000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	SURGICAL ASSOCIATES	4500 BROCKTON AVE	STE 203	RIVERSIDE	CA	92501	4027	33	06065	33.97785263	-117.3836152	Riverside County
252653	Fee-for-Service	1215521844	1215521844	1	1	INPATHY BEHAVIORAL HEALTHCAR	9/10/2021	101YP2500X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	E GROUP PC	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
252763	Fee-for-Service	1346781606	1346781606	1	1	IHN, HANSEL MD	8/15/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	157997	20	Orthopedic Surgery	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
252900	Fee-for-Service	1356976757	1356976757	1	1	INTREPID	4/25/2021	207T00000X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	701 E 28TH ST,	STE 117	LONG BEACH	CA	90806	2700	19	06037	33.80803441	-118.1847137	Los Angeles County
252942	Fee-for-Service	1215521844	1215521844	1	1	INPATHY BEHAVIORAL HEALTHCAR	3/2/2021	101YP2500X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	E GROUP PC	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
252958	Fee-for-Service	1851463483	1851463483	1	10	INDEPENDENT OPTIONS INC	9/4/1996	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MARBLEHEAD HOUSE	4728 MARBLEHEAD BAY DR	None	OCEANSIDE	CA	92057	3407	37	06073	33.25330321	-117.3080357	San Diego County
253327	Fee-for-Service	1447366711	1447366711	1	1	INGRAM, JOHN E MD	2/1/1984	208800000X	NA	Other	026	PHYSICIANS	24803	34	Urology and Urological Surgery	0	In state provider	None	2888 LONG BEACH BLVD	STE 340	LONG BEACH	CA	90806	1552	19	06037	33.809706	-118.189343	Los Angeles County
253744	Fee-for-Service	1508907874	1508907874	1	1	INDUS HEALTHCARE, INC	2/2/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2740 N GAREY AVE	STE 100	POMONA	CA	91767	1800	19	06037	34.095168	-117.748473	Los Angeles County
253913	Fee-for-Service	1629784152	1629784152	1	1	INSAT TELEMED CORPORATION A	2/16/2024	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	800 E. WASHINGTON BLVD	None	CRESECENT CITY	CA	95531	8359	08	06015	41.77272521	-124.1940494	Del Norte County
254017	Fee-for-Service	1124193297	1124193297	1	1	INLAND ARTIFICIAL LIMB &	7/27/2007	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	BRACE INC	5365 WALNUT AVE	#K	CHINO	CA	91710	2622	36	06071	34.02626051	-117.6883155	San Bernardino County
254074	Fee-for-Service	1750780516	1750780516	1	1	ISLAM, JULIE R MD	9/3/2019	207RE0101X	NA	Endocrinology	026	PHYSICIANS	149552	67	Endocrinology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3220	33	06065	33.763572	-116.4056895	Riverside County
254400	Fee-for-Service	1336726637	1336726637	1	1	IBARRA, KAREN P MD	4/15/2025	2084N0400X	NA	Neurology	026	PHYSICIANS	None	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
254450	Fee-for-Service	1942773296	1942773296	1	1	IMBORDINO, KATHRYN CRNA	4/7/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
254523	Fee-for-Service	1528070364	1528070364	1	1	ITO, KERRY A DC	7/1/1998	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1746 GRAND CANAL BLVD	STE 8	STOCKTON	CA	95207	8111	39	06077	37.98654767	-121.327303	San Joaquin County
254967	Fee-for-Service	1760019947	1760019947	1	1	ISMAIL, MOHAMED R MD	12/11/2023	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
255026	Fee-for-Service	1083015200	1083015200	1	1	IN GOOD HANDS HOSPICE INC	2/22/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12158 HAMLIN STREET	SUITE 3	NORTH HOLLYWOOD	CA	91606	1433	19	06037	34.18845983	-118.3984616	Los Angeles County
255312	Fee-for-Service	1083015200	1083015200	1	1	IN GOOD HANDS HOSPICE INC	2/22/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12158 HAMLIN STREET	SUITE 3	NORTH HOLLYWOOD	CA	91606	1433	19	06037	34.18845983	-118.3984616	Los Angeles County
255348	Fee-for-Service	1417251349	1417251349	1	1	IRINGAN, JOSELITO R B LPT	7/17/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
255426	Fee-for-Service	1578218335	1578218335	1	1	INTEGRITYMD INC	3/24/2023	261QP2300X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	1001 NUT TREE RD	110	VACAVILLE	CA	95687	4166	48	06095	38.3564252	-121.9532031	Solano County
255450	Fee-for-Service	1134403314	1134403314	1	1	ILYITSKY, ELIZABETH LCSW	1/16/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17777 VENTURA BLVD	STE 105	ENCINO	CA	91316	3738	19	06037	34.16286556	-118.5200521	Los Angeles County
255457	Fee-for-Service	1255489118	1255489118	1	1	IMLEY, TRACY M MD	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80439	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
255498	Fee-for-Service	1760416770	1760416770	1	1	IMANDOUST, MOHAMMAD MD	2/1/2003	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	50910	40	Pediatrics	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
255579	Fee-for-Service	1316009103	1316009103	1	1	IRVINE, JOHN A MD	10/31/1986	207W00000X	NA	Ophthalmology	026	PHYSICIANS	59884	18	Ophthalmology	0	In state provider	None	1355 SAN PABLO ST	None	LOS ANGELES	CA	90033	1035	19	06037	34.06080447	-118.203734	Los Angeles County
255797	Fee-for-Service	1639500606	1639500606	2	1	ISHOLA, OLANREWAJU T MD	5/3/2023	207R00000X	NA	Other	026	PHYSICIANS	168856	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
255976	Fee-for-Service	1922139120	1922139120	1	1	INOVA HEALTHCARE SERVICES	11/12/2019	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2501 PARKERS LN	None	ALEXANDRIA	VA	22306	3209	00	None	38.739861	-77.076279	City of Fairfax
255993	Fee-for-Service	1134631666	1134631666	1	1	INTERVENTIONAL	12/15/2017	2085N0700X	NA	MRI Provider	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	NEURORADIOLOGY INC	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
256002	Fee-for-Service	1215096169	1215096169	1	1	INPATIENT SPECIALISTS	4/24/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL GRP, INC	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
256041	Fee-for-Service	1912074824	1912074824	1	1	ICHIUJI, MARY M MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	42204	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
256055	Fee-for-Service	1891773123	1891773123	1	1	ISACOFF, WILLIAM H MD	9/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	24596	41	Internal Medicine	0	In state provider	None	100 UCLA MEDICAL PLZ	STE 345	LOS ANGELES	CA	90024	6999	19	06037	34.06544724	-118.4459249	Los Angeles County
256128	Fee-for-Service	1447604525	1447604525	1	1	INFUSION EXPRESS OF CALIFORN	9/11/2017	261QI0500X	NA	Other	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	IA INC	43360 MISSION BLVD	SUITE 100	FREMONT	CA	94539	5829	01	06001	37.53249631	-121.9198141	Alameda County
256137	Fee-for-Service	1669592473	1669592473	1	1	IQBAL, ATIF MD	9/11/2018	208600000X	NA	General Surgery	026	PHYSICIANS	101690	None	None	0	In state provider	None	18225 BROOKHURST STREET	SUITE 5	FOUNTAIN VALLEY	CA	92708	6719	30	06059	33.69890502	-117.9544165	Orange County
256167	Fee-for-Service	1124691365	1124691365	1	2	ICLASS TREATMENT CENTER INC.	11/16/2022	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1850 NORTH RIVERSIDE AVE	STE 180	RIVERSIDE	CA	92376	8071	33	06065	34.132905	-117.3704675	San Bernardino County
256262	Fee-for-Service	1922139120	1922139120	1	1	INOVA HEALTHCARE SERVICES	11/12/2019	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2501 PARKERS LN	None	ALEXANDRIA	VA	22306	3209	00	None	38.739861	-77.076279	City of Fairfax
256282	Fee-for-Service	1134631666	1134631666	1	1	INTERVENTIONAL	12/15/2017	2085N0700X	NA	MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	NEURORADIOLOGY INC	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
256328	Fee-for-Service	1912074824	1912074824	1	1	ICHIUJI, MARY M MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	42204	78	Neoplastic Diseases/Oncology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
256377	Fee-for-Service	1114025491	1114025491	1	1	IHC HEALTH SERVICES, INC	9/1/1999	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	UTAH VALLEY REG MED CTR	1034 N 500 W	None	PROVO	UT	84604	3380	00	None	40.248072	-111.6673905	Utah County
256453	Fee-for-Service	1124691365	1124691365	1	2	ICLASS TREATMENT CENTER INC.	11/16/2022	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1850 NORTH RIVERSIDE AVE	STE 180	RIVERSIDE	CA	92376	8071	33	06065	34.132905	-117.3704675	San Bernardino County
256615	Fee-for-Service	1912074824	1912074824	1	1	ICHIUJI, MARY M MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	42204	68	Hematology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
256661	Fee-for-Service	1922160829	1922160829	1	1	INNOVATIVE SENIOR	3/18/2011	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	REHABILTATION	6725 INGLEWOOD AVE	None	STOCKTON	CA	95207	3865	39	06077	38.01268496	-121.3174803	San Joaquin County
256666	Fee-for-Service	1114025491	1114025491	1	1	IHC HEALTH SERVICES, INC	9/1/1999	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	UTAH VALLEY REG MED CTR	1034 N 500 W	None	PROVO	UT	84604	3380	00	None	40.248072	-111.6673905	Utah County
256688	Fee-for-Service	1508380536	1508380536	1	1	INDEPENDENT ANESTHESIA CONSU	10/12/2017	367500000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	LTANTS OF RIVERSIDE A ME	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
256788	Fee-for-Service	1376061572	1376061572	1	1	INLAND EMPIRE NEPHROLOGY, IN	1/24/2018	246ZN0300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
256973	Fee-for-Service	1508380536	1508380536	1	1	INDEPENDENT ANESTHESIA CONSU	2/9/2018	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	LTANTS OF RIVERSIDE A ME	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
257013	Fee-for-Service	1528298064	1528298064	2	1	IM PHARMACY INC	5/2/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10970 SHERMAN WAY	STE 110	BURBANK	CA	91505	1003	19	06037	34.20116247	-118.369557	Los Angeles County
257151	Fee-for-Service	1013952621	1013952621	1	1	INA M VANHEST MD	10/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	347 N KUAKINI ST	None	HONOLULU	HI	96817	2336	00	None	21.32247447	-157.8564644	Honolulu County
257223	Fee-for-Service	1821021221	1821021221	1	2	ISERI, ALLEN L M D	7/2/2012	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	802 MAGNOLIA AVE	#205	CORONA	CA	92879	3104	33	06065	33.8596449	-117.5529774	Riverside County
257294	Fee-for-Service	1972233393	1972233393	1	1	IKEDA, JESSICA CNP	10/19/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	14330 CULVER DR	None	IRVINE	CA	92604	0303	30	06059	33.70654758	-117.7857461	Orange County
257330	Fee-for-Service	1407104136	1407104136	1	1	IGLESIAS, MARCO LMFT	11/13/2024	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
257408	Fee-for-Service	1952332603	1952332603	1	1	INLAND PEDIATRICS INC	6/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	64482	None	None	0	In state provider	INLAND PEDIATRICS	3838 SHERMAN DR	STE 7	RIVERSIDE	CA	92503	4001	33	06065	33.92678822	-117.4368632	Riverside County
257476	Fee-for-Service	1629088059	1629088059	1	1	INGERSOLL, HENRY G MD	7/15/1977	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	27265	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
257804	Fee-for-Service	1144290727	1144290727	1	1	IQBAL,MUHAMMED MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2001 LAUREL AVE	STE 603	KNOXVILLE	TN	37916	1827	00	None	35.95732787	-83.93843936	Knox County
257958	Fee-for-Service	1396824199	1396824199	1	1	IRELAND, JULIA H DO	4/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	7644	01	General Practice	0	In state provider	None	2250 HAYES ST	SUITE 302	SAN FRANCISCO	CA	94117	1078	38	06075	37.77302042	-122.45342	San Francisco County
258112	Fee-for-Service	1083264519	1083264519	1	1	ICAZBALCETA-SOTO, VANESSA L	4/18/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	PCC	4849 RONSON CT	SUITE 207	SAN DIEGO	CA	92111	1805	37	06073	32.83028739	-117.1459009	San Diego County
258232	Fee-for-Service	1730459249	1730459249	1	1	IN HOME CARE GROUP, LLC	7/30/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6830 VIA DEL ORO	SUITE 106A	SAN JOSE	CA	95119	1353	43	06085	37.2319347	-121.7780661	Santa Clara County
258373	Fee-for-Service	1609809631	1609809631	1	1	INLAND UROLOGY MED GRP I	1/1/1979	208800000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	210 W BONITA AVE	STE 100	POMONA	CA	91767	1865	19	06037	34.09639602	-117.750267	Los Angeles County
258448	Fee-for-Service	1609856939	1609856939	1	1	ISHIHARA, TERRY T MD	1/26/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	87861	None	None	0	In state provider	None	621 S BUTTE STREET	None	SAN PEDRO	CA	90732	3510	19	06037	33.73839738	-118.3065444	Los Angeles County
258582	Fee-for-Service	1487820536	1487820536	1	1	IMAM, IMRAN MD	6/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94765	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
259074	Fee-for-Service	1306365366	1306365366	1	1	INES, NICOLE P NP	9/17/2021	363LP0200X	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
259094	Fee-for-Service	1821679143	1821679143	1	1	ICHIUJI, BRYNNE MD	2/20/2025	208600000X	NA	General Surgery	026	PHYSICIANS	None	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
259130	Fee-for-Service	1437298288	1437298288	1	1	IKEDA, DEBRA M MD	3/31/1991	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	59883	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
259137	Fee-for-Service	1568245447	1568245447	1	1	IVY RIDGE CARE INC	9/25/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2030 23RD ST	None	SACRAMENTO	CA	95818	1718	34	06067	38.56392	-121.481352	Sacramento County
259499	Fee-for-Service	1932287794	1932287794	1	1	IVEY, LOUIS ALBERT MD FACS	7/31/1992	208600000X	NA	General Surgery	026	PHYSICIANS	76248	02	General Surgery	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
259523	Fee-for-Service	1508338054	1508338054	1	1	INTEGRATIVE FOOT AND ANKLE C	10/29/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	ENTER	600 NUT TREE RD	STE 110	VACAVILLE	CA	95687	4656	48	06095	38.36133624	-121.9496789	Solano County
259758	Fee-for-Service	1366483109	1366483109	1	1	IRVINE, DAVID N MD	10/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	43675	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 RIVER DR	None	FORT BRAGG	CA	95437	5403	23	06045	39.43163763	-123.8007631	Mendocino County
259834	Fee-for-Service	1154498160	1154498160	1	1	INOCENTES, ALAN R MD	12/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75004	25	Physical Medicine and Rehabilitation	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
259858	Fee-for-Service	1093097735	1093097735	1	1	IWAY, EDSEL N MD	9/22/2014	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
260332	Fee-for-Service	1538564463	1538564463	1	2	INNOVATIVE SLEEP CENTERS, IN	1/11/2020	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	C.	1558 POOLE BLVD	STE B	YUBA CITY	CA	95993	2667	51	06101	39.14469453	-121.642578	Sutter County
260391	Fee-for-Service	1033856398	1033856398	1	1	IMPRESSIVE CARE INC	11/29/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	13302 ARMINTA STREET	None	NORTH HOLLYWOOD	CA	91605	1729	19	06037	34.2133617	-118.4228344	Los Angeles County
260585	Fee-for-Service	1548354038	1548354038	1	1	INDIO SURGERY CENTER INC	8/28/2006	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	46900 MONROE ST	STE B201	INDIO	CA	92201	4827	33	06065	33.707718	-116.233843	Riverside County
260897	Fee-for-Service	1154551919	1154551919	1	1	IHC HEALTH SERVICES, INC	11/20/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3741 WEST 12600 SOUTH	None	RIVERTON	UT	84065	7215	00	None	40.520232	-111.980151	Salt Lake County
260982	Fee-for-Service	1871885970	1871885970	2	1	IN THE ARMS OF GRACE HOSPICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	3111 LOS FELIZ BLVD	SUITE 107	LOS ANGELES	CA	90039	1599	19	06037	34.12432566	-118.2669792	Los Angeles County
261070	Fee-for-Service	1669477782	1669477782	1	1	ISRAEL, JENNIFER J MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69046	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1245 WILSHIRE BLVD	STE 801	LOS ANGELES	CA	90017	4808	19	06037	34.05362775	-118.2661889	Los Angeles County
261186	Fee-for-Service	1154551919	1154551919	1	1	IHC HEALTH SERVICES, INC	11/20/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3741 WEST 12600 SOUTH	None	RIVERTON	UT	84065	7215	00	None	40.520232	-111.980151	Salt Lake County
261270	Fee-for-Service	1871885970	1871885970	2	1	IN THE ARMS OF GRACE HOSPICE	10/11/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	3111 LOS FELIZ BLVD	SUITE 107	LOS ANGELES	CA	90039	1599	19	06037	34.12432566	-118.2669792	Los Angeles County
261447	Fee-for-Service	1235182114	1235182114	1	1	IEZZA, GIOIA MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	66738	None	None	0	In state provider	None	1001 POTRERO AVE	RM 5H	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
261480	Fee-for-Service	1114481447	1114481447	1	1	IDAHO FALLS COMMUNITY HOSPIT	9/1/2021	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	AL	2327 CORONADO ST	None	IDAHO FALLS	ID	83404	7407	00	None	43.4725863	-111.987632	Bonneville County
261510	Fee-for-Service	1699897579	1699897579	1	1	IBRAHIM, SHERIF I MD	3/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102341	41	Internal Medicine	0	In state provider	None	1180 EAST SHAW	STE 101	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
261716	Fee-for-Service	1265692172	1265692172	1	1	INYANGETOR, DAVID MD	8/28/2020	207R00000X	NA	Other	026	PHYSICIANS	160627	41	Internal Medicine	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
261733	Fee-for-Service	1114564374	1114564374	1	1	IGNASH, ELIZABETH A LMFT	1/23/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2035 E BALL RD	STE 100A, 100P	ANAHEIM	CA	92806	5158	30	06059	33.81812448	-117.8880075	Orange County
261771	Fee-for-Service	1114481447	1114481447	1	1	IDAHO FALLS COMMUNITY HOSPIT	9/1/2021	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	AL	2327 CORONADO ST	None	IDAHO FALLS	ID	83404	7407	00	None	43.4725863	-111.987632	Bonneville County
261789	Fee-for-Service	1992327977	1992327977	1	1	IBRAHIM, YAZEED DO	7/21/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	20185	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
261880	Fee-for-Service	1235431172	1235431172	1	1	INSCRIPTIONS CHILDRENS	4/9/2014	261Q00000X	NA	Other	026	PHYSICIANS	9032	40	Pediatrics	0	In state provider	CLINIC INC	36243 INLAND VALLEY DR	STE 80	WILDOMAR	CA	92595	9547	33	06065	33.591528	-117.2393325	Riverside County
262034	Fee-for-Service	1386602993	1386602993	1	1	INDA, SVEN E MD	6/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
262098	Fee-for-Service	1750575692	1750575692	1	1	INGRAM, DREW C MD	6/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101346	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
262465	Fee-for-Service	1962146787	1962146787	1	1	ISRAELYAN, ARMAN DO	10/20/2024	207P00000X	NA	Other	026	PHYSICIANS	22480	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
262477	Fee-for-Service	1972680809	1972680809	1	1	IVATURI, RADHA D MD	7/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88866	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
262531	Fee-for-Service	1518129543	1518129543	1	1	IYER, GAYATRI C MD	10/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115610	08	Family Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
262804	Fee-for-Service	1932213709	1932213709	1	1	ILBEIGI, MOSTAFA S MD	6/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	64208	05	Anesthesiology	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
262886	Fee-for-Service	1659476984	1659476984	1	1	IMPERIAL, MARIA E MD	10/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50939	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
262924	Fee-for-Service	1750333977	1750333977	1	1	IN HOME HEALTH LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3700 OLD REDWOOD	SUITE 103	SANTA ROSA	CA	95404	5740	49	06097	38.47904986	-122.7325094	Sonoma County
263026	Fee-for-Service	1740398023	1740398023	1	1	ITAGAKI, BRIAN H MD	7/13/2010	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	37936	20	Orthopedic Surgery	0	In state provider	None	420 E 3RD ST	STE 704	LOS ANGELES	CA	90013	1646	19	06037	34.04702011	-118.241912	Los Angeles County
263174	Fee-for-Service	1659476984	1659476984	1	1	IMPERIAL, MARIA E MD	10/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50939	40	Pediatrics	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
263186	Fee-for-Service	1083656664	1083656664	1	2	IMMACULATE HEART OF MARY	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14329 WOODRUFF AVE	SUITE A	BELLFLOWER	CA	90706	2562	19	06037	33.90123788	-118.1167412	Los Angeles County
263211	Fee-for-Service	1750333977	1750333977	1	1	IN HOME HEALTH LLC	7/19/1996	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3700 OLD REDWOOD	SUITE 103	SANTA ROSA	CA	95404	5740	49	06097	38.47904986	-122.7325094	Sonoma County
263269	Fee-for-Service	1386064137	1386064137	1	1	IACOB, ALEXANDRA MD	6/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139198	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3899	36	06071	34.04824949	-117.2401425	San Bernardino County
263480	Fee-for-Service	1811524853	1811524853	1	1	IREIFEJ, BRANDEN	7/9/2024	207R00000X	NA	Other	026	PHYSICIANS	185206	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
263585	Fee-for-Service	1760513980	1760513980	1	1	INOVA HEALTHCARE SERVICES	11/12/2019	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3600 JOSEPH SIEWICK DR	None	FAIRFAX	VA	22033	1709	00	None	38.884806	-77.379912	City of Fairfax
263871	Fee-for-Service	1760513980	1760513980	1	1	INOVA HEALTHCARE SERVICES	11/12/2019	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3600 JOSEPH SIEWICK DR	None	FAIRFAX	VA	22033	1709	00	None	38.884806	-77.379912	City of Fairfax
264549	Fee-for-Service	1326425208	1326425208	1	1	IV, JOHNY MD	6/25/2019	207L00000X	NA	Other	026	PHYSICIANS	158595	05	Anesthesiology	0	In state provider	None	2601 E CHAPMAN AVENUE	None	ORANGE	CA	92869	3206	30	06059	33.78785251	-117.826365	Orange County
264567	Fee-for-Service	1437668720	1437668720	1	1	IMPERIAL MANOR SKILLED	3/2/2018	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	NURSING INC	100 E 2ND ST	None	IMPERIAL	CA	92251	1813	13	06025	32.84124806	-115.5696736	Imperial County
264588	Fee-for-Service	1841900016	1841900016	1	1	INNERLIGHT THERAPY	3/12/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	206 SACRAMENTO ST	204	NEVADA CITY	CA	95959	2633	29	06057	39.26103141	-121.0166729	Nevada County
264719	Fee-for-Service	1801817739	1801817739	1	1	IMPACT REHABILITATION	8/1/2002	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	CENTER	245 N TUSTIN ST	None	ORANGE	CA	92867	7718	30	06059	33.790581	-117.835691	Orange County
264730	Fee-for-Service	1801536503	1801536503	1	1	INSPIRATIONS HOME CARE IV	6/3/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LLC	1117 CARTER LANE	None	CORONA	CA	92881	8673	33	06065	33.84291796	-117.5504215	Riverside County
264934	Fee-for-Service	1295852796	1295852796	1	1	INTERFAITH COMMUNITY SERVICE	3/26/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	550 WEST WASHINGTON AVE	None	ESCONDIDO	CA	92025	1643	37	06073	33.12462731	-117.0914704	San Diego County
265154	Fee-for-Service	1124078480	1124078480	1	1	INOUYE, STEVEN TADASHI	9/30/2003	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	433 9TH ST	None	CRESCENT CITY	CA	95531	3431	08	06015	41.75436666	-124.2050778	Del Norte County
265219	Fee-for-Service	1073772844	1073772844	1	1	INGWERSON, JULIE L MD	9/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	110646	None	None	0	In state provider	None	10305 PROMENADE PKWY	None	ELK GROVE	CA	95757	9400	34	06067	38.384523	-121.371318	Sacramento County
265440	Fee-for-Service	1922341890	1922341890	1	1	ILYAS, OMER MD	2/3/2020	207R00000X	NA	Other	026	PHYSICIANS	166249	41	Internal Medicine	0	In state provider	None	785 N MEDICAL CTR DR W	STE 203	CLOVIS	CA	93611	0000	10	06019	36.84377271	-119.6609536	Fresno County
265727	Fee-for-Service	1922341890	1922341890	1	1	ILYAS, OMER MD	2/3/2020	207R00000X	NA	Other	026	PHYSICIANS	166249	68	Hematology	0	In state provider	None	785 N MEDICAL CTR DR W	STE 203	CLOVIS	CA	93611	0000	10	06019	36.84377271	-119.6609536	Fresno County
265734	Fee-for-Service	1871670851	1871670851	1	1	IYER, RAJIV C MD	9/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109238	24	Plastic Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
266019	Fee-for-Service	1871670851	1871670851	1	1	IYER, RAJIV C MD	9/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109238	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
266072	Fee-for-Service	1811919244	1811919244	1	1	INGULLI, ELIZABETH G MD	4/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87981	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
266287	Fee-for-Service	1215463799	1215463799	1	1	IMMUNO-ONCOLOGY CLINIC INC.	1/16/2018	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2040 E MARIPOSA AVE	None	EL SEGUNDO	CA	90245	5027	19	06037	33.92356852	-118.389987	Los Angeles County
266458	Fee-for-Service	1700948510	1700948510	1	1	IXCARAGUA, ISOLINA LMFT	7/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5005 LAMART DR	100B3	RIVERSIDE	CA	92507	8902	33	06065	33.959493	-117.3322255	Riverside County
266474	Fee-for-Service	1982782777	1982782777	1	1	ILFELD, JEFFREY S MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60689	41	Internal Medicine	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
266868	Fee-for-Service	1518593953	1518593953	1	1	ICARE MEDICAL GROUP	6/29/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	500 N GARFIELD AVE	201	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
266977	Fee-for-Service	1548790520	1548790520	1	1	INGOLIA, GREGORY M MD	12/15/2020	208M00000X	NA	Other	026	PHYSICIANS	170645	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
267123	Fee-for-Service	1750404752	1750404752	1	1	IAGARU, ANDREI H MD	4/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92375	42	Nuclear Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
267148	Fee-for-Service	1902871684	1902871684	1	1	IMPERATO, THOMAS J MD	12/1/1987	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	24544	41	Internal Medicine	0	In state provider	None	7600 HOSPITAL DR	None	SACRAMENTO	CA	95823	5406	34	06067	38.463876	-121.414698	Sacramento County
267295	Fee-for-Service	1538172747	1538172747	1	1	ISLAM, ASHEQUL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	759 CHESTNUT ST	None	SPRINGFIELD	MA	01199	0000	00	None	42.122601	-72.602856	Hampden County
267431	Fee-for-Service	1902871684	1902871684	1	1	IMPERATO, THOMAS J MD	12/1/1987	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	24544	10	Gastroenterology (M.D. only)	0	In state provider	None	7600 HOSPITAL DR	None	SACRAMENTO	CA	95823	5406	34	06067	38.463876	-121.414698	Sacramento County
267714	Fee-for-Service	1992131395	1992131395	1	1	INNOVATIVE DIALYSIS CENTERS	7/23/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	OF LA JOLLA LLC	2084 OTAY LAKES RD	SUITE 101	CHULA VISTA	CA	91913	1368	37	06073	32.642991	-116.97264	San Diego County
267716	Fee-for-Service	1902871684	1902871684	1	1	IMPERATO, THOMAS J MD	12/1/1987	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	24544	01	General Practice	0	In state provider	None	7600 HOSPITAL DR	None	SACRAMENTO	CA	95823	5406	34	06067	38.463876	-121.414698	Sacramento County
267840	Fee-for-Service	1770904302	1770904302	1	1	INTEGRAL PSYCHOLOGICAL CONSU	6/13/2014	251S00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CONSULTING SERVICES PC	5251 OFFICE PARK DR	201 A&B	BAKERSFIELD	CA	93309	0404	15	06029	35.36594362	-119.0610068	Kern County
267843	Fee-for-Service	1497140354	1497140354	1	1	IRVING, LE TREICE K MD	9/10/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	169639	13	Neurology (M.D. only)	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
267875	Fee-for-Service	1740339837	1740339837	1	1	IBITZ, LINDA M LMFT	9/11/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1821 FOURTH ST	None	SANTA ROSA	CA	95404	3202	49	06097	38.450619	-122.69781	Sonoma County
267989	Fee-for-Service	1467604017	1467604017	1	1	IROEZI, NGOZI D MD	5/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112724	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
268079	Fee-for-Service	1720017536	1720017536	1	1	IX, JOACHIM H MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77110	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
268254	Fee-for-Service	1073240529	1073240529	1	5	INFUCARE MEDICAL GROUP OF CA	4/25/2024	208D00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	558 SAINT CHARLES DR	121	THOUSAND OAKS	CA	91360	3903	56	06111	34.18553108	-118.8779244	Ventura County
268357	Fee-for-Service	1780730689	1780730689	1	1	INTERIM PSYCHIATRIC CARE, ME	1/22/2024	106H00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	None	None	0	In state provider	DICAL CORPORATION	9327 FAIRWAY VIEW PL	STE 110	RANCHO CUCAMONGA	CA	91730	0968	36	06071	34.084008	-117.5600535	San Bernardino County
268553	Fee-for-Service	1073240529	1073240529	1	5	INFUCARE MEDICAL GROUP OF CA	4/25/2024	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	558 SAINT CHARLES DR	121	THOUSAND OAKS	CA	91360	3903	56	06111	34.18553108	-118.8779244	Ventura County
268631	Fee-for-Service	1659681112	1659681112	1	1	INDEPENDENT LIVING CENTE	12/15/2010	251B00000X	NA	Other	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	14407 GILMORE STREET	#101	VAN NUYS	CA	91401	1400	19	06037	34.18767148	-118.4468805	Los Angeles County
268641	Fee-for-Service	1780730689	1780730689	1	1	INTERIM PSYCHIATRIC CARE, ME	1/22/2024	106H00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	DICAL CORPORATION	9327 FAIRWAY VIEW PL	STE 110	RANCHO CUCAMONGA	CA	91730	0968	36	06071	34.084008	-117.5600535	San Bernardino County
268752	Fee-for-Service	1629393293	1629393293	1	1	IGBINOSA, NGOZI O MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120339	None	None	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
269218	Fee-for-Service	1225000433	1225000433	1	1	INSIGHT HEALTH CORP	4/16/2004	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	INSIGHT IMAGING THSD OAK	375 ROLLING OAKS DR	STE 150	THOUSAND OAKS	CA	91361	1026	56	06111	34.17433197	-118.8706258	Ventura County
269251	Fee-for-Service	1194097741	1194097741	1	1	INTEGRITY CARE OF THE WEST	2/10/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	15130 VENTURA BLVD	SUITE 304	SHERMAN OAKS	CA	91403	3378	19	06037	34.15320952	-118.4627115	Los Angeles County
269530	Fee-for-Service	1194097741	1194097741	1	1	INTEGRITY CARE OF THE WEST	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	15130 VENTURA BLVD	SUITE 304	SHERMAN OAKS	CA	91403	3378	19	06037	34.15320952	-118.4627115	Los Angeles County
269759	Fee-for-Service	1699278648	1699278648	1	1	IN RHYTHM NON EMERGENCY MEDI	1/10/2020	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	CAL TRANSPORTATION, INC.	2117 D STREET	None	BAKERSFIELD	CA	93301	3727	15	06029	35.378748	-119.0258355	Kern County
269812	Fee-for-Service	1073619904	1073619904	1	1	INLAND MEDICAL	5/1/1988	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	ENTERPRISES	3551 W OLYMPIC BLVD	None	LOS ANGELES	CA	90019	3504	19	06037	34.05258703	-118.3169935	Los Angeles County
269938	Fee-for-Service	1801819347	1801819347	1	1	INIGUEZ, MARIA G MD	12/11/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	68428	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
270120	Fee-for-Service	1497210033	1497210033	1	1	INSIGHT COUNSELING OF LA	10/1/2021	106H00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	130 N BRAND BLVD	202	GLENDALE	CA	91203	2644	19	06037	34.147521	-118.2549325	Los Angeles County
270396	Fee-for-Service	1497210033	1497210033	1	1	INSIGHT COUNSELING OF LA	6/24/2021	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	130 N BRAND BLVD	202	GLENDALE	CA	91203	2644	19	06037	34.147521	-118.2549325	Los Angeles County
270431	Fee-for-Service	1467094995	1467094995	2	1	IPBS INC	8/18/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9917 TOPANGA CANYON	None	CHATSWORTH	CA	91311	3602	19	06037	34.250535	-118.6060655	Los Angeles County
270432	Fee-for-Service	1023452703	1023452703	1	1	ISAAC, SHANI K MD	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	131894	-	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
270578	Fee-for-Service	1194143677	1194143677	1	1	IWATA, AYAKA MD	10/20/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	168503	84	Surgery-Head and Neck	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
270674	Fee-for-Service	1497210033	1497210033	1	1	INSIGHT COUNSELING OF LA	11/6/2020	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	130 N BRAND BLVD	202	GLENDALE	CA	91203	2644	19	06037	34.147521	-118.2549325	Los Angeles County
270825	Fee-for-Service	1730105784	1730105784	1	1	ISMAIL, MOHAMMAD MD	4/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	45544	45	Nephrology (Renal-Kidney)	0	In state provider	None	16415 COLORADO AVE	STE 207	PARAMOUNT	CA	90723	5054	19	06037	33.8853075	-118.1614695	Los Angeles County
270860	Fee-for-Service	1659759926	1659759926	1	1	ISAAC, LINDA PHD	3/26/2018	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
270893	Fee-for-Service	1902904196	1902904196	1	1	IZSAK, BENJAMIN MD INC	8/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	37115	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	81715 DR CARREON BLVD	STE A1	INDIO	CA	92201	5564	33	06065	33.7073825	-116.2385415	Riverside County
271031	Fee-for-Service	1861858904	1861858904	1	1	IMPACT CARE ACCESS NETWORK I	5/24/2017	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	NC	9390 HESPERIA RD	SUITE # 7	HESPERIA	CA	92345	3602	36	06071	34.4212584	-117.3021441	San Bernardino County
271056	Fee-for-Service	1659019750	1659019750	1	1	IN AND OUT MEDICAL TRANSPORT	11/11/2022	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ATION	15035 VENTURA BLVD	C	SHERMAN OAKS	CA	91403	2316	19	06037	34.15295101	-118.4609266	Los Angeles County
271191	Fee-for-Service	1134231129	1134231129	1	1	IONE PHARMACY	7/27/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	307 PRESTON AVE	None	IONE	CA	95640	9158	03	06005	38.35311206	-120.9350008	Amador County
271294	Fee-for-Service	1710413703	1710413703	2	1	ILLUMINATE HEALTH INC.	8/26/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3948 N PECK RD	A9	EL MONTE	CA	91732	2255	19	06037	34.07745077	-118.0210415	Los Angeles County
271312	Fee-for-Service	1861858904	1861858904	1	1	IMPACT CARE ACCESS NETWORK I	9/14/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	NC	9390 HESPERIA RD	SUITE # 7	HESPERIA	CA	92345	3602	36	06071	34.4212584	-117.3021441	San Bernardino County
271520	Fee-for-Service	1366452880	1366452880	1	1	IHC HEALTH SERVICES INC	11/8/2001	273R00000X	NA	Other	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	DIXIE REGIONAL MED CTR	544 S 400 E	None	SAINT GEORGE	UT	84770	3705	00	None	37.09902122	-113.5748483	Washington County
271619	Fee-for-Service	1740394386	1740394386	1	1	IBANEZ, BERENICE PHD	7/15/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
271633	Fee-for-Service	1821036252	1821036252	1	1	ING, DARCY S PHD	12/5/2005	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
271797	Fee-for-Service	1366452880	1366452880	1	1	IHC HEALTH SERVICES INC	11/8/2001	273R00000X	NA	Other	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	DIXIE REGIONAL MED CTR	544 S 400 E	None	SAINT GEORGE	UT	84770	3705	00	None	37.09902122	-113.5748483	Washington County
271997	Fee-for-Service	1528078581	1528078581	1	1	IHC HEALTH SERVICES INC	10/29/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COTTONWOOD HOSP MED CTR	324 8TH AVE	None	SALT LAKE CITY	UT	84143	1002	00	None	40.7784387	-111.8789303	Salt Lake County
272148	Fee-for-Service	1922486406	1922486406	1	1	INFUSION AND CLINICAL SERVIC	12/19/2023	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	23 MICHELTORENA ST	None	SANTA BARBARA	CA	93101	2509	42	06083	34.42547083	-119.7090455	Santa Barbara County
272267	Fee-for-Service	1295270254	1295270254	1	1	INLAND EMPIRE WOMAN'S CENTER	9/20/2018	174400000X	NA	Other	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	, MEDICAL ASSOCIATES	1800 N. WESTERN AVE	SUITE 204	SAN BERNARDINO	CA	92411	1353	36	06071	34.1315778	-117.3182453	San Bernardino County
272277	Fee-for-Service	1528078581	1528078581	1	1	IHC HEALTH SERVICES INC	3/29/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COTTONWOOD HOSP MED CTR	324 8TH AVE	None	SALT LAKE CITY	UT	84143	1002	00	None	40.7784387	-111.8789303	Salt Lake County
272332	Fee-for-Service	1497863773	1497863773	1	1	IHNKEN, KAI A MD	8/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66563	33	Thoracic Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
272498	Fee-for-Service	1538564463	1538564463	1	1	INNOVATIVE SLEEP CENTERS, IN	1/3/2020	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	C.	1505 VICTOR AVE	None	REDDING	CA	96003	4031	45	06089	40.58541565	-122.3388174	Shasta County
272538	Fee-for-Service	1295270254	1295270254	1	1	INLAND EMPIRE WOMAN'S CENTER	9/20/2018	174400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	, MEDICAL ASSOCIATES	1800 N. WESTERN AVE	SUITE 204	SAN BERNARDINO	CA	92411	1353	36	06071	34.1315778	-117.3182453	San Bernardino County
272627	Fee-for-Service	1326553868	1326553868	1	1	INTULIFE	9/24/2024	No Taxonomy Provided	Both NEMT & NMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	7920 MIRAMAR RD	121	SAN DIEGO	CA	92126	4248	37	06073	32.88637891	-117.1487079	San Diego County
272757	Fee-for-Service	1013110733	1013110733	1	1	IRFAN I WADIWALA 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	425 HOLDERRIETH BLVD	STE 207	TOMBALL	TX	77375	4552	00	None	30.08975789	-95.62390872	Harris County
272768	Fee-for-Service	1538564463	1538564463	1	1	INNOVATIVE SLEEP CENTERS, IN	1/3/2020	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	C.	1505 VICTOR AVE	None	REDDING	CA	96003	4031	45	06089	40.58541565	-122.3388174	Shasta County
272805	Fee-for-Service	1134122435	1134122435	2	1	ISRAEL, ALAN T OD	1/23/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	E	755 PEACH AVE	E-5	CLOVIS	CA	93611	7247	10	06019	36.843633	-119.7201405	Fresno County
272807	Fee-for-Service	1295270254	1295270254	1	1	INLAND EMPIRE WOMAN'S CENTER	9/20/2018	174400000X	NA	Other	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	, MEDICAL ASSOCIATES	1800 N. WESTERN AVE	SUITE 204	SAN BERNARDINO	CA	92411	1353	36	06071	34.1315778	-117.3182453	San Bernardino County
273314	Fee-for-Service	1942733811	1942733811	1	1	IAFE, NICHOLAS A MD	3/23/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	157197	None	None	0	In state provider	None	100 STEIN PLZ	None	LOS ANGELES	CA	90095	7065	19	06037	34.06489065	-118.4443287	Los Angeles County
273538	Fee-for-Service	1619340098	1619340098	1	1	INNOVATIVE SPEECH & LANGUAGE	5/23/2016	193200000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	PATHOLOGY INC	8665 WILSHIRE BLVD	STE 412	BEVERLY HILLS	CA	90211	2975	19	06037	34.06625528	-118.380319	Los Angeles County
273795	Fee-for-Service	1811557366	1811557366	1	2	I4H PHARMACY LLC	3/31/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11705 SLATE AVE	STE 100	RIVERSIDE	CA	92505	5198	33	06065	33.9027276	-117.4928061	Riverside County
273803	Fee-for-Service	1053756346	1053756346	1	1	IUTZI, CASSIE J MD	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133772	41	Internal Medicine	0	In state provider	None	1179 N MCDOWELL BLVD	None	PETALUMA	CA	94954	6559	49	06097	38.26876442	-122.6598332	Sonoma County
273805	Fee-for-Service	1619340098	1619340098	1	1	INNOVATIVE SPEECH & LANGUAGE	5/23/2016	193200000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	PATHOLOGY INC	8665 WILSHIRE BLVD	STE 412	BEVERLY HILLS	CA	90211	2975	19	06037	34.06625528	-118.380319	Los Angeles County
273825	Fee-for-Service	1063671618	1063671618	1	1	ISKANDER, JESSICA B MD	11/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121693	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
273977	Fee-for-Service	1679122519	1679122519	1	1	ISRAEL, OLIVIA OD	9/10/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
274095	Fee-for-Service	1578533675	1578533675	1	1	IQBAL, COREY W MD	7/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121959	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
274292	Fee-for-Service	1982959425	1982959425	1	1	IYENGAR, RAVI MD	1/25/2023	207RE0101X	NA	Endocrinology	026	PHYSICIANS	183607	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
274884	Fee-for-Service	1366454639	1366454639	1	1	IMPERIAL FAMILY MED GRP	3/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	APC	12651 LAKEWOOD BLVD	None	DOWNEY	CA	90242	4563	19	06037	33.91612375	-118.1389293	Los Angeles County
275756	Fee-for-Service	1982803573	1982803573	1	1	INNES, ANH L	11/28/2007	207RP1001X	NA	Pulmonology	026	PHYSICIANS	79839	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	0648	38	06075	37.76332993	-122.4582988	San Francisco County
275783	Fee-for-Service	1972129948	1972129948	1	1	INNOVATE BEHAVIORAL HEALTH M	8/25/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	None	None	0	In state provider	EDICAL GROUP INC	732 N MOUNTAIN AVE	SUITE A	UPLAND	CA	91786	4372	36	06071	34.102485	-117.6701635	San Bernardino County
275828	Fee-for-Service	1659638666	1659638666	1	1	IVY, AUTUMN S MD	8/10/2017	2084N0400X	NA	Neurology	026	PHYSICIANS	126865	79	Neurology-Child	0	In state provider	None	101 THE CITY DR S	BLDG 29	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
275964	Fee-for-Service	1730269622	1730269622	1	2	IMPERIAL VALLEY MEDICAL	12/6/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CLINIC INC	535 W CESAR CHAVEZ BLVD	None	CALEXICO	CA	92231	2103	13	06025	32.67021337	-115.5022183	Imperial County
276002	Fee-for-Service	1811178395	1811178395	1	1	INGMAN, STEPHEN J OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	S R VENTURES INC	11879 KEMPER RD	STE 6	AUBURN	CA	95603	9021	31	06061	38.93136899	-121.0916266	Placer County
276141	Fee-for-Service	1083952857	1083952857	1	4	INFUSION AND CLINICAL SERVIC	2/14/2022	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	4043 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	0000	15	06029	35.35411151	-119.0532915	Kern County
276219	Fee-for-Service	1730269622	1730269622	1	2	IMPERIAL VALLEY MEDICAL	1/9/2017	No Taxonomy Provided	NA	None	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	CLINIC INC	535 W CESAR CHAVEZ BLVD	None	CALEXICO	CA	92231	2103	13	06025	32.67021337	-115.5022183	Imperial County
276394	Fee-for-Service	1083952857	1083952857	1	4	INFUSION AND CLINICAL SERVIC	1/24/2023	2084P0800X	NA	Psychiatry	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	4043 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	0000	15	06029	35.35411151	-119.0532915	Kern County
276486	Fee-for-Service	1124566328	1124566328	1	1	INGRUM, ELIJAH PT	9/5/2024	225100000X	NA	Physical Therapist	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
276643	Fee-for-Service	1083952857	1083952857	1	4	INFUSION AND CLINICAL SERVIC	2/14/2022	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	4043 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	0000	15	06029	35.35411151	-119.0532915	Kern County
276740	Fee-for-Service	1053719385	1053719385	1	1	IBARRA, CRISTINA M NP	5/2/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE 2050	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
276886	Fee-for-Service	1083952857	1083952857	1	4	INFUSION AND CLINICAL SERVIC	2/14/2022	2084P0800X	NA	Psychiatry	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4043 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	0000	15	06029	35.35411151	-119.0532915	Kern County
276917	Fee-for-Service	1467957167	1467957167	1	1	ING, DAVID	10/22/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17780	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
276996	Fee-for-Service	1477054567	1477054567	1	1	INNOVA RX INC.	12/12/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8737 BEVERLY BLVD	102	WEST HOLLYWOOD	CA	90048	1835	19	06037	34.07687959	-118.381876	Los Angeles County
277132	Fee-for-Service	1083952857	1083952857	1	4	INFUSION AND CLINICAL SERVIC	11/16/2022	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4043 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	0000	15	06029	35.35411151	-119.0532915	Kern County
277263	Fee-for-Service	1932105277	1932105277	1	1	INOSHITA, ARTHUR M.	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	33622	41	Internal Medicine	0	In state provider	None	3003 LOMA VISTA RD	STE E	VENTURA	CA	93003	2942	56	06111	34.27572109	-119.255478	Ventura County
277293	Fee-for-Service	1477631109	1477631109	1	1	ISLAM, PARVEZ S MD	1/28/2008	207R00000X	NA	Other	026	PHYSICIANS	51863	41	Internal Medicine	0	In state provider	None	588 N SUNRISE AVE	STE 120	ROSEVILLE	CA	95661	2843	31	06061	38.7585915	-121.2527015	Placer County
277462	Fee-for-Service	1972962819	1972962819	1	1	IWUCHUKWU, JOY N CNP	11/4/2020	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1800 WESTWIND DR	STE 301	BAKERSFIELD	CA	93301	3055	15	06029	35.37531587	-119.0424856	Kern County
277489	Fee-for-Service	1730251356	1730251356	2	1	IDRISS, SOHA D MD	3/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	52614	None	None	0	In state provider	None	1720 CESAR E CHAVEZ AVE	None	LOS ANGELES	CA	90033	2414	19	06037	34.04925	-118.2177405	Los Angeles County
277655	Fee-for-Service	1154359156	1154359156	1	1	IULIANO, EDWARD M DO	3/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	13267	30	Radiology	0	In state provider	None	4000 EMPIRE DR	STE 100	BAKERSFIELD	CA	93309	0401	15	06029	35.37480064	-119.0459033	Kern County
277852	Fee-for-Service	1437100153	1437100153	1	1	IZADPANAH, ARASH MD	5/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84579	07	Dermatology	0	In state provider	None	3811 VALLEY CENTRE DR	None	SAN DIEGO	CA	92130	3318	37	06073	32.93760492	-117.2320932	San Diego County
277956	Fee-for-Service	1154864379	1154864379	1	1	INGLE, RICHARD MD INC	1/11/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	59041	01	General Practice	0	In state provider	None	914 PINE STREET	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
277993	Fee-for-Service	1073632261	1073632261	1	1	INLAND PULMONARY	5/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9655 MONTE VISTA AVE	STE 402	MONTCLAIR	CA	91763	2238	36	06071	34.07991502	-117.6982245	San Bernardino County
278001	Fee-for-Service	1619270378	1619270378	1	1	IDROGO, ANTHONY J LCSW	9/17/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	498 MAIN STREET	None	TULELAKE	CA	96134	0725	47	06093	41.95501066	-121.4767132	Siskiyou County
278129	Fee-for-Service	1588638399	1588638399	1	1	IPE, JOSEPH MD	8/3/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72752	None	None	0	In state provider	None	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
278150	Fee-for-Service	1396824439	1396824439	1	1	ISHIHARA, STANFORD MD	1/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33128	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
278199	Fee-for-Service	1154864379	1154864379	1	1	INGLE, RICHARD MD INC	1/11/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	59041	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	914 PINE STREET	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
278380	Fee-for-Service	1821125543	1821125543	1	1	ISTERABADI, LARISSA B MD	11/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	84267	40	Pediatrics	0	In state provider	None	4900 PROSPECT AVE	None	YORBA LINDA	CA	92886	2128	30	06059	33.88961003	-117.8379389	Orange County
278530	Fee-for-Service	1972385078	1972385078	1	1	INDEPENDENT MEDICAL SPECIALI	12/28/2024	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	STS INC	451 E ALMOND AVE	SUITE 103	MADERA	CA	93637	5562	20	06039	36.94554615	-120.0523936	Madera County
278637	Fee-for-Service	1326212358	1326212358	1	1	IBRAHIM, SAMUEL A A MD	5/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120880	02	General Surgery	0	In state provider	None	79180 CORPORATE CENTER D	SUITE 101	LA QUINTA	CA	92253	7235	33	06065	33.71043152	-116.2831995	Riverside County
278785	Fee-for-Service	1295266815	1295266815	1	1	IP, COLIN S MD	3/7/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	175936	None	None	0	In state provider	None	835 THIRD AVE	SUITE A	CHULA VISTA	CA	91911	1352	37	06073	32.62293517	-117.0726661	San Diego County
279025	Fee-for-Service	1265550743	1265550743	1	1	IEZZA, ALEXANDER P MD	3/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92670	20	Orthopedic Surgery	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
279034	Fee-for-Service	1285299016	1285299016	1	1	IQBAL, HAMZA MD	9/20/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
279114	Fee-for-Service	1053549543	1053549543	1	1	ISAIAS, REGINA L LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2601 E MAIN ST	None	VENTURA	CA	93003	2801	56	06111	34.27443821	-119.2609368	Ventura County
279272	Fee-for-Service	1902452683	1902452683	1	1	IRIKURA, ALICIA M PT	6/15/2020	225100000X	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
279369	Fee-for-Service	1912133166	1912133166	1	1	IYENGAR, SRIDHARA K S MD INC	12/29/2014	208G00000X	NA	General Surgery	026	PHYSICIANS	42391	33	Thoracic Surgery	0	In state provider	None	11100 WARNER AVE	STE 320	FOUNTAN VALLEY	CA	92708	7511	30	06059	33.716291	-117.9355051	Orange County
279602	Fee-for-Service	1912133166	1912133166	1	1	IYENGAR, SRIDHARA K S MD INC	12/29/2014	208G00000X	NA	General Surgery	026	PHYSICIANS	42391	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11100 WARNER AVE	STE 320	FOUNTAN VALLEY	CA	92708	7511	30	06059	33.716291	-117.9355051	Orange County
279835	Fee-for-Service	1346526845	1346526845	1	1	INFUSION CONNECTION PHARMACY	8/21/2017	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	INC	3216 SANTA MONICA BLVD	STE A	SANTA MONICA	CA	90404	2606	19	06037	34.03820065	-118.4681391	Los Angeles County
280097	Fee-for-Service	1407882608	1407882608	1	1	INLAND URGENT CARE A MEDICAL	12/19/2013	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	36320 INLAND VALLEY DR	SUITE 307	WILDOMAR	CA	92595	7512	33	06065	33.592158	-117.2367705	Riverside County
280116	Fee-for-Service	1891898714	1891898714	1	1	ILGEN, MARGARETHA E LMFT	1/17/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	906 G ST	None	SACRAMENTO	CA	95814	1800	34	06067	38.583468	-121.49289	Sacramento County
280240	Fee-for-Service	1801841663	1801841663	1	2	IGNARSKI, TODD E MD	3/15/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	145040	None	None	0	In state provider	None	15248 ELEVENTH ST	None	VICTORVILLE	CA	92395	3704	36	06071	34.52825401	-117.2925587	San Bernardino County
280738	Fee-for-Service	1295141950	1295141950	1	1	INLAND EMPIRE IMAGING	6/5/2015	293D00000X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	260 E ONTARIO AVENUE	SUITE 101A	CORONA	CA	92879	3508	33	06065	33.8560157	-117.5678999	Riverside County
280758	Fee-for-Service	1194933416	1194933416	1	1	IBRAHIM, ERINY A	6/13/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4201 W CHAPMAN AVE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
280773	Fee-for-Service	1154700540	1154700540	1	1	ITALIYA, DISHABEN V MD	4/28/2022	207R00000X	NA	Other	026	PHYSICIANS	172773	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
280943	Fee-for-Service	1245420199	1245420199	1	1	ISKANDER MEDICAL GROUP, INC.	5/9/2018	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	4477 W 118TH ST	SUITE 301	HAWTHORNE	CA	90250	2258	19	06037	33.92734752	-118.354221	Los Angeles County
281110	Fee-for-Service	1275616138	1275616138	1	1	INNA SHKOLNIK	9/17/2002	172A00000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	SHKOLNIK, INNA	105 SAGAMORE ST.	None	SAN FRANCISCO	CA	94112	2945	38	06075	37.71139054	-122.456322	San Francisco County
281162	Fee-for-Service	1578121133	1578121133	1	1	IREIFEJ, JUSTIN A MD	6/1/2022	208M00000X	NA	Other	026	PHYSICIANS	178702	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
281797	Fee-for-Service	1225617889	1225617889	1	1	INVICTA HOSPICE INC	11/16/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	225 E BROADWAY	STE 102C	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
282006	Fee-for-Service	1225617889	1225617889	1	1	INVICTA HOSPICE INC	11/16/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	225 E BROADWAY	STE 102C	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
282013	Fee-for-Service	1962693598	1962693598	1	1	IREIFEJ, YOUSEF W MD	10/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100115	08	Family Practice	0	In state provider	None	7955 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4001	30	06059	33.75932839	-117.9902744	Orange County
282206	Fee-for-Service	1891352803	1891352803	1	1	INAM-UL-HAQ, AHMED MD	8/26/2022	207R00000X	NA	Other	026	PHYSICIANS	177014	None	None	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
282350	Fee-for-Service	1598286544	1598286544	1	1	IMAM, ZAID MD	9/12/2023	207R00000X	NA	Other	026	PHYSICIANS	178270	None	None	0	In state provider	None	2557 MOWRY AVE	STE 12	FREMONT	CA	94538	1614	01	06001	37.55561575	-121.9826617	Alameda County
282396	Fee-for-Service	1134620651	1134620651	1	1	INNOVATIVE DEVELOPMENT AND	8/10/2018	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LIVING SOLUTIONS OF CA	32 W SIERRA AVE	None	CLOVIS	CA	93612	0525	10	06019	36.83024394	-119.7110301	Fresno County
282588	Fee-for-Service	1437157732	1437157732	1	1	INLAND VALLEY CONSULTANT INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3770 MYERS STREET	None	RIVERSIDE	CA	92503	4279	33	06065	33.91784703	-117.4498636	Riverside County
282823	Fee-for-Service	1083952857	1083952857	1	3	INFUSION AND CLINICAL SERVIC	12/30/2022	2084P0800X	NA	Psychiatry	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	611 AIRPORT DR	None	BAKERSFIELD	CA	93308	4127	15	06029	35.41154006	-119.0391293	Kern County
282835	Fee-for-Service	1790023745	1790023745	1	1	ISAAC NATHAN DAUM NP	1/13/2014	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	7106	00	None	39.742164	-104.8350375	Adams County
282869	Fee-for-Service	1326249210	1326249210	1	1	IKEMOTO, KIM I OD	9/15/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3900 E PACIFIC COAST HWY	None	LONG BEACH	CA	90804	2013	19	06037	33.78982251	-118.1462265	Los Angeles County
283022	Fee-for-Service	1083952857	1083952857	1	3	INFUSION AND CLINICAL SERVIC	11/16/2022	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	611 AIRPORT DR	None	BAKERSFIELD	CA	93308	4127	15	06029	35.41154006	-119.0391293	Kern County
283066	Fee-for-Service	1083952857	1083952857	1	5	INFUSION AND CLINICAL SERVIC	12/19/2023	1041C0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	AL CALIFORNIA	901 OLIVE DR	None	BAKERSFIELD	CA	93308	4137	15	06029	35.41225153	-119.0396655	Kern County
283212	Fee-for-Service	1083952857	1083952857	1	3	INFUSION AND CLINICAL SERVIC	2/16/2022	2084P0800X	NA	Psychiatry	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	611 AIRPORT DR	None	BAKERSFIELD	CA	93308	4127	15	06029	35.41154006	-119.0391293	Kern County
283218	Fee-for-Service	1558101022	1558101022	1	1	INNOVATIVE WOUND CARE INC	1/10/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	5150 N 6TH ST	STE 104	FRESNO	CA	93710	7505	10	06019	36.81127498	-119.7632093	Fresno County
283258	Fee-for-Service	1083952857	1083952857	1	5	INFUSION AND CLINICAL SERVIC	12/19/2023	1041C0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AL CALIFORNIA	901 OLIVE DR	None	BAKERSFIELD	CA	93308	4137	15	06029	35.41225153	-119.0396655	Kern County
283402	Fee-for-Service	1083952857	1083952857	1	3	INFUSION AND CLINICAL SERVIC	12/8/2021	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	611 AIRPORT DR	None	BAKERSFIELD	CA	93308	4127	15	06029	35.41154006	-119.0391293	Kern County
283447	Fee-for-Service	1083952857	1083952857	1	5	INFUSION AND CLINICAL SERVIC	12/19/2023	1041C0700X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	AL CALIFORNIA	901 OLIVE DR	None	BAKERSFIELD	CA	93308	4137	15	06029	35.41225153	-119.0396655	Kern County
283536	Fee-for-Service	1588735534	1588735534	1	1	IDEA, RAUL JAY S MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	50633	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
283587	Fee-for-Service	1083952857	1083952857	1	3	INFUSION AND CLINICAL SERVIC	12/8/2021	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	611 AIRPORT DR	None	BAKERSFIELD	CA	93308	4127	15	06029	35.41154006	-119.0391293	Kern County
283597	Fee-for-Service	1750926374	1750926374	2	1	INTEGRATED PSYCHOLOGICAL ASS	12/2/2021	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ESSMENT SERVICES, INC	8355 CHURCH ST	None	GILROY	CA	95020	4406	43	06085	37.01873743	-121.5768381	Santa Clara County
283742	Fee-for-Service	1770100323	1770100323	1	1	INTEGRA HOME HEALTH INC	12/15/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	13257 SATICOY ST	STE A	NORTH HOLLYWOOD	CA	91605	3401	19	06037	34.20811942	-118.4218375	Los Angeles County
283780	Fee-for-Service	1750926374	1750926374	2	1	INTEGRATED PSYCHOLOGICAL ASS	12/2/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ESSMENT SERVICES, INC	8355 CHURCH ST	None	GILROY	CA	95020	4406	43	06085	37.01873743	-121.5768381	Santa Clara County
283965	Fee-for-Service	1750926374	1750926374	2	1	INTEGRATED PSYCHOLOGICAL ASS	2/24/2022	103TC0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ESSMENT SERVICES, INC	8355 CHURCH ST	None	GILROY	CA	95020	4406	43	06085	37.01873743	-121.5768381	Santa Clara County
284082	Fee-for-Service	1811350457	1811350457	1	1	INTUITIVE ACUPUNCTURE, INC	9/12/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1025 PACIFIC ST	None	SAN LUIS OBISPO	CA	93401	5056	40	06079	35.27997695	-120.6588498	San Luis Obispo County
284142	Fee-for-Service	1750926374	1750926374	2	1	INTEGRATED PSYCHOLOGICAL ASS	1/12/2023	103TC0700X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ESSMENT SERVICES, INC	8355 CHURCH ST	None	GILROY	CA	95020	4406	43	06085	37.01873743	-121.5768381	Santa Clara County
284360	Fee-for-Service	1629251772	1629251772	1	1	INSTITUTE ON AGING	1/8/2009	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	INSTITUTE ON AGING	3575 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3212	38	06075	37.78122373	-122.4579478	San Francisco County
284418	Fee-for-Service	1669426250	1669426250	1	1	INLAND EYE INSTITUTE	9/8/1987	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	MEDICAL GROUP	1900 E WASHINGTON ST	None	COLTON	CA	92324	4614	36	06071	34.04839685	-117.2950602	San Bernardino County
284680	Fee-for-Service	1437557881	1437557881	1	1	INSTANT CARE HOSPICE, INC	7/10/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6850 SEPULVEDA BLVD	STE 215	VAN NUYS	CA	91405	4450	19	06037	34.1955	-118.4661705	Los Angeles County
284687	Fee-for-Service	1588043814	1588043814	1	1	INBAR, TAMI MD	7/31/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	147246	40	Pediatrics	0	In state provider	None	1401 AVOCADO AVE	709	NEWPORT BEACH	CA	92660	8714	30	06059	33.61235015	-117.8704573	Orange County
284693	Fee-for-Service	1538427000	1538427000	1	1	ILADA, ARMI B MD	9/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115669	40	Pediatrics	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
284725	Fee-for-Service	1316445414	1316445414	1	1	INSTITUTE ON AGING	1/26/2022	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	473 E CARNEGIE DRIVE	SUITE 200	SAN BERNARDINO	CA	94407	2407	36	06071	34.0683677	-117.2746246	San Bernardino County
284760	Fee-for-Service	1235886037	1235886037	1	1	IBRAHIM, FAWZY DPM	10/24/2024	213EP1101X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3424 1ST AVE	None	SAN DIEGO	CA	92103	4802	37	06073	32.74125896	-117.1640165	San Diego County
284850	Fee-for-Service	1437557881	1437557881	1	1	INSTANT 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	6850 SEPULVEDA BLVD	STE 215	VAN NUYS	CA	91405	4450	19	06037	34.1955	-118.4661705	Los Angeles County
285292	Fee-for-Service	1447327325	1447327325	1	1	IRIARTE GUIOMAR C MD	1/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	46328	84	Surgery-Head and Neck	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
285373	Fee-for-Service	1184280497	1184280497	1	1	ILUSTRISIMO, THOMAS L DO	6/11/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
285491	Fee-for-Service	1528153756	1528153756	1	1	ING, FRANK F MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84720	40	Pediatrics	0	In state provider	None	3030 CHILDRENS WAY	STE 201	SAN DIEGO	CA	92123	4227	37	06073	32.798889	-117.150826	San Diego County
285649	Fee-for-Service	1528153756	1528153756	1	1	ING, FRANK F MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84720	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3030 CHILDRENS WAY	STE 201	SAN DIEGO	CA	92123	4227	37	06073	32.798889	-117.150826	San Diego County
285727	Fee-for-Service	1518918358	1518918358	1	1	IRWIN, MELANIE MD	4/1/2008	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
285878	Fee-for-Service	1518918358	1518918358	1	1	IRWIN, MELANIE MD	7/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99872	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
286231	Fee-for-Service	1467725283	1467725283	1	1	INDEPENDENT PHYSICAL THERAPY	9/6/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	15477 VENTURA BLVD	SUITE 200	SHERMAN OAKS	CA	91403	3013	19	06037	34.15468022	-118.4712272	Los Angeles County
286291	Fee-for-Service	1568922466	1568922466	1	1	INNEH, OYENMWEN J	12/17/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	191697	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
286305	Fee-for-Service	1821372202	1821372202	1	1	INLAND WELLNESS HEALTH CARE	9/3/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	869 E FOOTHILL BLVD	SUITE IB	UPLAND	CA	91786	4063	36	06071	34.10724031	-117.6393375	San Bernardino County
286478	Fee-for-Service	1871100289	1871100289	1	1	INSPIRED HOSPICE CARE INC	7/8/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12015 MORA DRIVE	UNIT 3	SANTA FE SPRINGS	CA	90670	7323	19	06037	33.9408585	-118.0779133	Los Angeles County
286481	Fee-for-Service	1083952857	1083952857	1	2	INFUSION AND CLINICAL SERVIC	3/2/2021	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	TRAL CALIFORNIA	5400 ALDRIN CT	None	BAKERSFIELD	CA	93313	2103	15	06029	35.31652652	-119.062791	Kern County
286567	Fee-for-Service	1346502507	1346502507	1	1	ISANI, MUBINA A MD	11/17/2024	2086S0120X	NA	General Surgery	026	PHYSICIANS	137737	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
286569	Fee-for-Service	1235139437	1235139437	1	1	IZADI, MEHDI DO	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	5509	01	General Practice	0	In state provider	None	3737 E CENTURY	None	LYNWOOD	CA	90262	0000	19	06037	33.9208801	-118.1881395	Los Angeles County
286624	Fee-for-Service	1871100289	1871100289	1	1	INSPIRED HOSPICE CARE INC	7/8/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12015 MORA DRIVE	UNIT 3	SANTA FE SPRINGS	CA	90670	7323	19	06037	33.9408585	-118.0779133	Los Angeles County
286625	Fee-for-Service	1083952857	1083952857	1	2	INFUSION AND CLINICAL SERVIC	11/16/2022	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	TRAL CALIFORNIA	5400 ALDRIN CT	None	BAKERSFIELD	CA	93313	2103	15	06029	35.31652652	-119.062791	Kern County
286767	Fee-for-Service	1083952857	1083952857	1	2	INFUSION AND CLINICAL SERVIC	12/30/2022	2084P0800X	NA	Psychiatry	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	TRAL CALIFORNIA	5400 ALDRIN CT	None	BAKERSFIELD	CA	93313	2103	15	06029	35.31652652	-119.062791	Kern County
286787	Fee-for-Service	1821655671	1821655671	1	1	INNES, BRENDAN MD	9/1/2023	207P00000X	NA	Other	026	PHYSICIANS	185092	None	None	0	In state provider	None	751 BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
286862	Fee-for-Service	1033313838	1033313838	1	1	INTERNIST'S MEDICAL GRP	1/28/1987	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2930 MCCLURE ST	None	OAKLAND	CA	94609	3505	01	06001	37.81864787	-122.2662557	Alameda County
286908	Fee-for-Service	1083952857	1083952857	1	2	INFUSION AND CLINICAL SERVIC	3/2/2021	2084P0800X	NA	Psychiatry	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	TRAL CALIFORNIA	5400 ALDRIN CT	None	BAKERSFIELD	CA	93313	2103	15	06029	35.31652652	-119.062791	Kern County
286997	Fee-for-Service	1427767169	1427767169	1	1	IRVINE EYE CENTER INCORPORAT	6/20/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	18 ENDEAVOR	104	IRVINE	CA	92618	3164	30	06059	33.6675519	-117.7622659	Orange County
287047	Fee-for-Service	1083952857	1083952857	1	2	INFUSION AND CLINICAL SERVIC	3/2/2021	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	TRAL CALIFORNIA	5400 ALDRIN CT	None	BAKERSFIELD	CA	93313	2103	15	06029	35.31652652	-119.062791	Kern County
287184	Fee-for-Service	1083952857	1083952857	1	2	INFUSION AND CLINICAL SERVIC	9/28/2021	2084P0800X	NA	Psychiatry	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	TRAL CALIFORNIA	5400 ALDRIN CT	None	BAKERSFIELD	CA	93313	2103	15	06029	35.31652652	-119.062791	Kern County
287616	Fee-for-Service	1083039432	1083039432	1	1	IRVING, TIMOTHY F LCSW	10/23/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27349 JEFFERSON AVE	SUITE 111	TEMECULA	CA	92590	5634	33	06065	33.51993406	-117.1641955	Riverside County
287743	Fee-for-Service	1861502841	1861502841	1	1	INLAND EMPIRE ANESTHESIA	7/1/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	MEDICAL GROUP INC	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
287765	Fee-for-Service	1962518407	1962518407	2	1	INFINITY MEDICAL GROUP INC	6/2/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	19333 BEAR VALLEY RD	STE 201	APPLE VALLEY	CA	92308	5150	36	06071	34.47104148	-117.2413863	San Bernardino County
287770	Fee-for-Service	1740393743	1740393743	1	1	INRIG, JULA L K MD	10/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132959	45	Nephrology (Renal-Kidney)	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
287868	Fee-for-Service	1861502841	1861502841	1	1	INLAND EMPIRE ANESTHESIA	11/15/2022	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
287870	Fee-for-Service	1124103726	1124103726	1	1	IN FOCUS OPTOMETRY, INC	5/1/1999	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	42 S 1ST ST	None	SAN JOSE	CA	95113	2409	43	06085	37.33534508	-121.889988	Santa Clara County
287897	Fee-for-Service	1740393743	1740393743	1	1	INRIG, JULA L K MD	10/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132959	41	Internal Medicine	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
287995	Fee-for-Service	1861502841	1861502841	1	1	INLAND EMPIRE ANESTHESIA	1/24/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	MEDICAL GROUP INC	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
288035	Fee-for-Service	1578542767	1578542767	1	1	IVANOVIC, VLADIMIR MD	8/5/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	137658	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
288069	Fee-for-Service	1043448061	1043448061	1	1	IRONS, JORY W LMFT	12/17/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3065 FREEPORT BLVD	#2	SACRAMENTO	CA	95818	4347	34	06067	38.548557	-121.4892315	Sacramento County
288574	Fee-for-Service	1003861139	1003861139	1	1	INAMDAR, SHASHITA R MD	6/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102089	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
288734	Fee-for-Service	1295021855	1295021855	1	1	IRANI, ROXANNA A MD	7/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155578	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
288796	Fee-for-Service	1437654381	1437654381	1	1	IRGENS-MOLLER, NICOLE MD	4/4/2024	207P00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
289293	Fee-for-Service	1508046004	1508046004	1	1	IRIAFEN, HARRISON M	4/5/2007	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	GOOD SHEPARD MED SUPPLY	14640 VICTORY BLVD	STE 205	VAN NUYS	CA	91411	1623	19	06037	34.18663255	-118.452402	Los Angeles County
289344	Fee-for-Service	1750885166	1750885166	1	1	ILINSKY, DANIEL MD	6/22/2023	208800000X	NA	Other	026	PHYSICIANS	185405	None	None	0	In state provider	None	1127 WILSHIRE BLVD	805	LOS ANGELES	CA	90017	3909	19	06037	34.05270508	-118.2641005	Los Angeles County
289393	Fee-for-Service	1437848496	1437848496	1	1	IGBINIGIE, FUNMILAYO	12/17/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
289410	Fee-for-Service	1639185242	1639185242	1	1	INDULAL K RUGHANI, 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	3355 RIVERBEND DR	STE 240	SPRINGFIELD	OR	97477	8800	00	None	44.08239413	-123.0281717	Lane County
289450	Fee-for-Service	1013516624	1013516624	1	1	IMPERIAL COUNTY PHYSICIANS M	2/13/2024	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	EDICAL GROUP CLINIC	1503 N IMPERIAL AVE	STE 105	EL CENTRO	CA	92243	6302	13	06025	32.806881	-115.5697535	Imperial County
289466	Fee-for-Service	1174214092	1174214092	1	1	IHS PHARMACY LLC	3/24/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7227 VAN NUYS BLVD	UNIT B	VAN NUYS	CA	91405	2256	19	06037	34.202268	-118.4487785	Los Angeles County
289531	Fee-for-Service	1639373731	1639373731	1	1	IBAZEBO, EHIREME A MD	8/31/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	156633	36	Psychiatry	0	In state provider	None	1707 EYE ST	100	BAKERSFIELD	CA	93301	5208	15	06029	35.37461686	-119.020062	Kern County
289534	Fee-for-Service	1013516624	1013516624	1	1	IMPERIAL COUNTY PHYSICIANS M	2/13/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	EDICAL GROUP CLINIC	1503 N IMPERIAL AVE	STE 105	EL CENTRO	CA	92243	6302	13	06025	32.806881	-115.5697535	Imperial County
289704	Fee-for-Service	1235585639	1235585639	1	1	IRWIN-SINGH, CRYSTAL L DO	8/1/2019	207P00000X	NA	Other	026	PHYSICIANS	15353	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1303 EAST HERNDON AVENUE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
289778	Fee-for-Service	1750333977	1750333977	1	3	IN HOME HEALTH LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1050 NORTHGATE DR	SUITE 400	SAN RAFAEL	CA	94903	2566	21	06041	38.00839453	-122.5435599	Marin County
289852	Fee-for-Service	1750333977	1750333977	1	3	IN HOME HEALTH LLC	10/31/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1050 NORTHGATE DR	SUITE 400	SAN RAFAEL	CA	94903	2566	21	06041	38.00839453	-122.5435599	Marin County
290343	Fee-for-Service	1083952857	1083952857	1	1	INFUSION AND CLINICAL SERVIC	3/12/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	5401 WHITE LANE	None	BAKERSFIELD	CA	93309	6279	15	06029	35.31803715	-119.0627831	Kern County
290394	Fee-for-Service	1083952857	1083952857	1	1	INFUSION AND CLINICAL SERVIC	1/24/2023	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	5401 WHITE LANE	None	BAKERSFIELD	CA	93309	6279	15	06029	35.31803715	-119.0627831	Kern County
290436	Fee-for-Service	1083952857	1083952857	1	1	INFUSION AND CLINICAL SERVIC	8/21/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	SERVICES INC	5401 WHITE LANE	None	BAKERSFIELD	CA	93309	6279	15	06029	35.31803715	-119.0627831	Kern County
290437	Fee-for-Service	1306883392	1306883392	1	1	INLAND PHARMACY INC	5/30/1979	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1001 E LATHAM AVE	SUITE P	HEMET	CA	92543	4435	33	06065	33.74937254	-116.961804	Riverside County
290480	Fee-for-Service	1083952857	1083952857	1	1	INFUSION AND CLINICAL SERVIC	6/16/2021	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	5401 WHITE LANE	None	BAKERSFIELD	CA	93309	6279	15	06029	35.31803715	-119.0627831	Kern County
290521	Fee-for-Service	1083952857	1083952857	1	1	INFUSION AND CLINICAL SERVIC	11/16/2022	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	SERVICES INC	5401 WHITE LANE	None	BAKERSFIELD	CA	93309	6279	15	06029	35.31803715	-119.0627831	Kern County
291104	Fee-for-Service	1750786026	1750786026	1	1	INTEGRATIVE PSYCHOLOGY INC	5/12/2016	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	260 S LOS ROBLES AVE	STE 311	PASADENA	CA	91101	2824	19	06037	34.141437	-118.1413435	Los Angeles County
291197	Fee-for-Service	1457457608	1457457608	1	1	INTERNAL MEDICINE ASSOC	8/15/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	OF BERKELEY	2500 MILVIA ST	STE 214	BERKELEY	CA	94704	2636	01	06001	37.86338897	-122.2698455	Alameda County
291468	Fee-for-Service	1932251089	1932251089	2	1	ILLINGWORTH, MICHAEL L	12/18/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	68327	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1945 N FINE AVE	SUITE 100	FRESNO	CA	93727	1528	10	06019	36.76832721	-119.7290143	Fresno County
291510	Non-Physician Medical Practitioner	None	1154080869	0	0	ISAAC, JULIE M	2/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5821 JAMESON CT	None	CARMICHAEL	CA	95608	0820	00	06000	38.651409	-121.3290945	Sacramento County
291542	Non-Physician Medical Practitioner	None	1659067452	0	0	IRACHETA, DANIEL PA-C	3/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	00	06000	33.9760587	-117.3800672	Riverside County
291679	Non-Physician Medical Practitioner	None	1164862850	0	0	ILEJAY, MARIBEL D R NP	9/19/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9426 OAKLEY WAY	None	ELK GROVE	CA	95624	6024	00	06000	38.413251	-121.3474365	Sacramento County
291900	Non-Physician Medical Practitioner	None	1730337528	0	0	IVANS, ERICA LEE	1/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	160 CAPP ST	None	SAN FRANCISCO	CA	94110	1210	00	06000	37.76405528	-122.4186219	San Francisco County
292029	Non-Physician Medical Practitioner	None	1609153436	0	0	INTERGRATED COMMUNITY HEALTHCARE SOLUTIONS (ICHS)	4/10/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8332 COMMONWEALTH AVE	None	BUENA PARK	CA	90621	2526	00	06000	33.86991554	-117.9878805	Orange County
292284	Non-Physician Medical Practitioner	None	1417262908	0	0	IZZARELLI, JENNIFER V	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	111 NORTH SEPULVEDA BOUL	SUITE 210	MANHATTAN BEACH	CA	90266	0000	00	06000	33.87976731	-118.3960924	Los Angeles County
292292	Non-Physician Medical Practitioner	None	1275269060	0	0	IMPERIAL, ANTHONY PA-C	7/16/2024	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
292301	Non-Physician Medical Practitioner	None	1114957289	0	0	IBARRA, MARTHA A NP	2/20/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4190 ARIZONA ST	None	SAN DIEGO	CA	92104	1760	00	06000	32.75378925	-117.1376168	San Diego County
292347	Non-Physician Medical Practitioner	None	1215246079	0	0	IMBERT, JACQUELINE 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	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	00	06000	33.9760587	-117.3800672	Riverside County
292480	Non-Physician Medical Practitioner	None	1811410145	0	0	ISARRARAS, LOURDES CRUZ G NP	12/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4500 TRUXEL ROAD	APT 3437	SACRAMENTO	CA	95834	3728	00	06000	38.653578	-121.5095265	Sacramento County
292538	Non-Physician Medical Practitioner	None	1629765581	0	0	INGLE, ANGELA B NP	10/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	807 ILLINOIS AVENUE	None	LOS BANOS	CA	93635	3512	00	06000	37.064394	-120.857788	Merced County
292669	Non-Physician Medical Practitioner	None	1144743857	0	0	ISRAEL, ANGEL GABRIEL NP	2/11/2021	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
292781	Non-Physician Medical Practitioner	None	1780946608	0	0	IDOWU, QUEEN A 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	2960 CAMINO DIABLO	105	WALNUT CREEK	CA	94597	3988	00	06000	37.89859467	-122.0843018	Contra Costa County
292806	Non-Physician Medical Practitioner	None	1093412470	0	0	INGLIS, AUDREY PA	6/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
292916	Non-Physician Medical Practitioner	None	1629462312	0	0	INDIAN HEALTH CENTER OF SANTA CLARA VALLEY	7/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2039 FOREST AVE STE 105	None	SAN JOSE	CA	95128	4815	00	06000	37.32712088	-121.934375	Santa Clara County
293100	Non-Physician Medical Practitioner	None	1568877041	0	0	IWAN, HANNAH J NP	4/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	370 DISTEL CIRCLE	None	LOS ALTOS	CA	94022	1404	00	06000	37.39572142	-122.1051204	Santa Clara County
293318	Non-Physician Medical Practitioner	None	1225209836	0	0	ILOUNO, BENEDICTA N NP	7/6/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1009 FERNREST DR	None	HARBOR CITY	CA	90710	1517	00	06000	33.80540211	-118.2938532	Los Angeles County
293512	Non-Physician Medical Practitioner	None	1427207398	0	0	IAMICELI, LISA	11/14/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
293597	Non-Physician Medical Practitioner	None	1639154537	0	0	IDERA, MICHELE	6/6/2023	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
293763	Non-Physician Medical Practitioner	None	1730436353	0	0	IA, SIEM	8/27/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 UCLA MEDICAL PLZ	STE 265	LOS ANGELES	CA	90095	0000	00	06000	34.065126	-118.446237	Los Angeles County
293774	Non-Physician Medical Practitioner	None	1508460833	0	0	IAZICHYAN, DIANA I 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	7204 FOOTHILL BLVD	None	TUJUNGA	CA	91042	2719	00	06000	34.24862229	-118.2886742	Los Angeles County
293963	Non-Physician Medical Practitioner	None	1205987286	0	0	IGNATCZYK, LINDSAY N	3/1/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23816 MOBILE STREET	None	WEST HILLS	CA	91307	3137	00	06000	34.18817995	-118.6457106	Los Angeles County
293998	Non-Physician Medical Practitioner	None	1588735849	0	0	IBRAHIMI, ISAAC A	11/1/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19850 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	4002	00	06000	37.69966123	-122.0876469	Alameda County
294004	Non-Physician Medical Practitioner	None	1033896451	0	0	IRUNGU, DISMUS W NP	7/31/2023	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
294039	Non-Physician Medical Practitioner	None	1922416023	0	0	IDRO, ZEKHARIAH I PA	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	82013 DR CARREON BLVD	SUITE 4G	INDIO	CA	99201	9203	00	06000	33.70738152	-116.233002	Riverside County
294166	Non-Physician Medical Practitioner	None	1043828916	0	0	IQBAL, BUSHRA NP	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	3755 BEACON AVE	None	FREMONT	CA	94538	1411	00	06000	37.54813209	-121.9825183	Alameda County
295025	Non-Physician Medical Practitioner	None	1164459491	0	0	ISENMAN, KRISTINE K	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	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	00	06000	35.393499	-119.008257	Kern County
295114	Non-Physician Medical Practitioner	None	1326502162	0	0	IELATI, PAIGE C PA	6/26/2019	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
295388	Non-Physician Medical Practitioner	None	1659020675	0	0	IRONS, MATTHEW PA-C	4/27/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	152 PIONEER LANE	A-H	BISHOP	CA	93514	2563	00	06000	37.36269	-118.407312	Inyo County
296033	Non-Physician Medical Practitioner	None	1265942858	0	0	IQBAL, NAJAM P NP	4/1/2018	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
296057	Non-Physician Medical Practitioner	None	1265716302	0	0	ILORETA, ALLEN Y	3/19/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	403 N KENWOOD	UNIT C	ORANGE	CA	92869	7576	00	06000	33.79338099	-117.8194812	Orange County
296214	Non-Physician Medical Practitioner	None	1871270793	0	0	INGWERSON, ANABEL PA-C	10/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2490 HOSPITAL DRIVE	SUITE 111	MOUNTAIN VIEW	CA	94040	4124	00	06000	37.369827	-122.0818185	Santa Clara County
296365	Non-Physician Medical Practitioner	None	1134522394	0	0	IVESON, BRADEN PA-C	3/4/2024	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
296466	Non-Physician Medical Practitioner	None	1851512560	0	0	INGRAM, JESSE JR	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	1033 LA MARILLO CIR	None	CORONA	CA	92879	8234	00	06000	33.90001752	-117.5332461	Riverside County
296533	Non-Physician Medical Practitioner	None	1811005333	0	0	INGRAM, CAROLYNE M NP	3/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	999 S FAIRMONT AVE	STE 230	LODI	CA	95240	5142	00	06000	38.1206163	-121.2858323	San Joaquin County
296863	Non-Physician Medical Practitioner	None	1427558949	0	0	IGBINOSUN, FOLLEY F NP	11/3/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1207 E FLORIDA AVE	None	HEMET	CA	92543	4513	00	06000	33.74753552	-116.9593245	Riverside County
296880	Non-Physician Medical Practitioner	None	1144677600	0	0	IRANI, NILOFAR	3/8/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10855 CHURCH STREET	UNIT 1604	RANCHO CUCAMONGA	CA	91730	8585	00	06000	34.11104225	-117.5693492	San Bernardino County
296898	Non-Physician Medical Practitioner	None	1356018568	0	0	INIGUEZ GARCIA, YAMILETTE NP	8/1/2022	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
296914	Non-Physician Medical Practitioner	None	1710520671	0	0	IZADYAR, DIBA PA	5/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 SAN BERNARDINO RD	1100	UPLAND	CA	91786	4923	00	06000	34.10129201	-117.636283	San Bernardino County
297023	Non-Physician Medical Practitioner	None	1912038878	0	0	INGRAM, LEWIS E	9/6/2007	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	SUITE 3016	SACRAMENTO	CA	95817	2229	00	06000	38.553822	-121.452822	Sacramento County
297213	Non-Physician Medical Practitioner	None	1295144632	0	0	IZAGUIRRE, YLIANA PA-C	11/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	06000	29.70724683	-95.4026169	Harris County
297507	Non-Physician Medical Practitioner	None	1295310704	0	0	IGNACIO, LESTER NP	2/21/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	600 COFFEE RD	None	MODESTO	CA	95355	4201	00	06000	37.653219	-120.975542	Stanislaus County
298094	Non-Physician Medical Practitioner	None	1831627090	0	0	ISAACSON, CHRISTOPHER S NP	10/25/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7771 TULEAR STREET	None	RENO	NV	89506	5932	00	06000	39.63716024	-119.8520976	Washoe County
298219	Non-Physician Medical Practitioner	None	1699378174	0	0	ILUORE, PATRICIA NP	1/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5525 ETIWANDA AVE	STE 320	TARZANA	CA	91356	3647	00	06000	34.17046451	-118.5308463	Los Angeles County
298283	Non-Physician Medical Practitioner	None	1366555799	0	0	IKE, CHARLES	7/28/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	815 DR MARTIN LUTHER KIN	None	BAKERSFIELD	CA	93307	1365	00	06000	35.3655	-118.985202	Kern County
298360	Non-Physician Medical Practitioner	None	1609429539	0	0	ICASAS, JOSHUA JAMES A PA-C	12/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24331 EL TORO ROAD	SUITE 200	LAGUNA WOODS	CA	92637	3116	00	06000	33.60928782	-117.7295058	Orange County
298773	Non-Physician Medical Practitioner	None	1952650228	0	0	INTEGRATED COMMUNITY HEALTHCARE SOLUTIONS	11/6/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8332 COMMONWEALTH AVE #	None	BUENA PARK	CA	90621	2526	00	06000	33.86991554	-117.9878805	Orange County
298865	Non-Physician Medical Practitioner	None	1336617174	0	0	INZUNZA, DIEGO V PA-C	7/17/2020	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
298938	Non-Physician Medical Practitioner	None	1750014189	0	0	ISHAK, MARY M PA-C	8/16/2023	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	STE 1300	LOS ANGELES	CA	90033	5312	00	06000	34.06269295	-118.2030006	Los Angeles County
299023	Non-Physician Medical Practitioner	None	1942418884	0	0	INSTITUTE ON AGING	3/31/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3575B GEARY BLVD	None	SAN FRANCISCO	CA	94118	3212	00	06000	37.78121015	-122.4576229	San Francisco County
299354	Non-Physician Medical Practitioner	None	1326320771	0	0	ISORENA, JENNIFER PANUELOS	11/14/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 MEDICAL PLZ	SUITE 214	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
299760	Non-Physician Medical Practitioner	None	1639602766	0	0	INDRIES, TABITHA J NP	2/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25671 PADUA DR	None	LAGUNA HILLS	CA	92653	5119	00	06000	33.59774685	-117.6822255	Orange County
299764	Non-Physician Medical Practitioner	None	1982184669	0	0	ISRAEL, MAXIMILLIAN PA	12/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10880 WILSHIRE BLVD	1101	LOS ANGELES	CA	90024	4112	00	06000	34.05897499	-118.4431123	Los Angeles County
299792	Non-Physician Medical Practitioner	None	1205301405	0	0	IKPATT, EFE J NP	7/11/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	00	06000	37.55769729	-121.9808861	Alameda County
299914	Non-Physician Medical Practitioner	None	1215476643	0	0	IGO, JONATHAN P NP	8/26/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25405 HANCOCK AVE	STE 217	MURRIETA	CA	92562	5978	00	06000	33.5580833	-117.1850127	Riverside County
299984	Non-Physician Medical Practitioner	None	1427222967	0	0	ISEN, JULIA	4/28/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	645 NORTHERN AVE	None	MILL VALLEY	CA	94941	3935	00	06000	37.87967714	-122.5458332	Marin County
300031	Non-Physician Medical Practitioner	None	1972962819	0	0	IWUCHUKWU, JOY N NP	6/8/2019	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
300280	Non-Physician Medical Practitioner	None	1326112103	0	0	ISAACS, DAWN LOUISE	5/3/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
300331	Non-Physician Medical Practitioner	None	1518136191	0	0	INSOGNA, MARTA PA-C	7/12/2021	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
300594	Non-Physician Medical Practitioner	None	1548564040	0	0	INGKOM, MELISSA K NP	7/28/2024	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	None	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
300824	Non-Physician Medical Practitioner	None	1881997963	0	0	INDIAN HEALTH CENTER OF SANTA CLARA VALLEY	12/2/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1642 E CAPITOL EXPY	None	SAN JOSE	CA	95121	1800	00	06000	37.3061289	-121.8119182	Santa Clara County
300917	Non-Physician Medical Practitioner	None	1871104067	0	0	IKEDA, SATOSHI PA-C	12/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	555 EAST HARDY STREET	None	INGLEWOOD	CA	90301	4011	00	06000	33.94909549	-118.3481595	Los Angeles County
300957	Non-Physician Medical Practitioner	None	1740726850	0	0	IBARRA, ELIZABETH NP	2/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6440 PLATT AVE	None	WEST HILLS	CA	91307	3216	00	06000	34.18784988	-118.6427021	Los Angeles County
300979	Non-Physician Medical Practitioner	None	1609314020	0	0	IMRU, RUTH NP	10/20/2017	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
301156	Non-Physician Medical Practitioner	None	1104495761	0	0	IGNACIO, JENNIFER D NP	10/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
301188	Non-Physician Medical Practitioner	None	1700186491	0	0	IM, BRIAN J	6/9/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17811 CECELIA PLACE	None	CERRITOS	CA	90703	8712	00	06000	33.86914602	-118.0494965	Los Angeles County
301197	Non-Physician Medical Practitioner	None	1598783086	0	0	IRELAND, JILL M	9/3/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	44215 15TH ST WEST	STE 315	LANCASTER	CA	93534	5505	00	06000	34.68666415	-118.1568572	Los Angeles County
301608	Non-Physician Medical Practitioner	None	1518122472	0	0	IKHARO-OKHOMINA, AFISHETU NP	6/3/2021	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
301663	Non-Physician Medical Practitioner	None	1699440958	0	0	IPSEN, CORY C PA-C	10/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	782 MEDICAL CENTER DR E	STE 311	CLOVIS	CA	93611	6892	00	06000	36.84379626	-119.6609117	Fresno County
301708	Non-Physician Medical Practitioner	None	1043854151	0	0	INFANTE, ROXANA PA	6/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	00	06000	37.89281357	-122.0598728	Contra Costa County
302103	Non-Physician Medical Practitioner	None	1427240167	0	0	IBARRA, ANA ESMERALDA	1/18/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	201 S ALVARADO ST	SUITE 110	LOS ANGELES	CA	90057	2320	00	06000	34.06417777	-118.2719543	Los Angeles County
302270	Non-Physician Medical Practitioner	None	1053866244	0	0	IGNACIO, DOMINADOR C NP	6/21/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2215 TRUXTUN AVENUE	None	BAKERSFIELD	CA	93301	3602	00	06000	35.37327448	-119.0278665	Kern County
302362	Non-Physician Medical Practitioner	None	1073645263	0	0	IMBUS, ANDREW H	12/15/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	645 CHAPARRAL CT	None	ALTADENA	CA	91001	3858	00	06000	34.20660041	-118.1564659	Los Angeles County
302446	Non-Physician Medical Practitioner	None	1053566752	0	0	IRWIN, BRIAN PA	8/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	00	06000	39.506454	-121.5412785	Butte County
302480	Non-Physician Medical Practitioner	None	1316984362	0	0	IRWIN, COLLEEN	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	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
302518	Non-Physician Medical Practitioner	None	1457750234	0	0	INGERICK, SAMANTHA B NP	8/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	537 LYTTON AVE	None	PALO ALTO	CA	94301	1543	00	06000	37.44961879	-122.1599792	Santa Clara County
302588	Non-Physician Medical Practitioner	None	1508281791	0	0	INABA, RIE	4/7/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10270 E TARON DR	APT 220	ELK GROVE	CA	95757	8242	00	06000	38.401893	-121.4652285	Sacramento County
303382	Non-Physician Medical Practitioner	None	1093781288	0	0	IWANYCZKO, AARON	1/11/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2031 ANDERSON RD	STE A	DAVIS	CA	95616	0672	00	06000	38.56133924	-121.7586174	Yolo County
303496	Non-Physician Medical Practitioner	None	1912639881	0	0	IGWE, AMARACHI 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	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	00	06000	33.67831005	-117.852138	Orange County
303613	Non-Physician Medical Practitioner	None	1932439767	0	0	ITO, TERRANCE	2/21/2012	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	DEPT OF EMERGENCY MEDICI	LOS ANGELES	CA	90033	1029	00	06000	34.05855992	-118.209755	Los Angeles County
303647	Non-Physician Medical Practitioner	None	1629650783	0	0	IRVING, SIDNEY E NP	5/14/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7600 OLD DOMINION CT	None	APTOS	CA	95003	3821	00	06000	36.97913818	-121.9099818	Santa Cruz County
303962	Non-Physician Medical Practitioner	None	1619149929	0	0	IWASAKI, GORDON 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	3434 VILLA LANE	STE 150	NAPA	CA	94558	6405	00	06000	38.32515937	-122.2938358	Napa County
304367	Non-Physician Medical Practitioner	None	1962949826	0	0	INGEMANSSON, CASSANDRA R NP	2/26/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	308 KATARINA LN	None	FOLSOM	CA	95630	7197	00	06000	38.698749	-121.189059	Sacramento County
304432	Non-Physician Medical Practitioner	None	1508377953	0	0	IRVING, AKVILE PA-C	12/1/2022	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
304566	Non-Physician Medical Practitioner	None	1538213277	0	0	ILYAS, SADAF	6/24/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	230 PROSPECT PL STE 340B	None	CORONADO	CA	92118	1991	00	06000	32.69468235	-117.1677128	San Diego County
304575	Non-Physician Medical Practitioner	None	1780327791	0	0	ISKANDARYAN, ROMINA NP	8/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14411 HAMLIN ST	None	VAN NUYS	CA	91401	1467	00	06000	34.18869553	-118.447074	Los Angeles County
304713	Non-Physician Medical Practitioner	None	1417259268	0	0	ILIA, ELDA	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	2072 CAPE COD CT	None	CLAREMONT	CA	91711	2844	00	06000	34.12114435	-117.7106282	Los Angeles County
304816	Non-Physician Medical Practitioner	None	1497950208	0	0	INOCELDA, ANDREW G	3/30/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2576 WELLSPRING ST	None	CARLSBAD	CA	92010	5604	00	06000	33.15624602	-117.3031887	San Diego County
304979	Non-Physician Medical Practitioner	None	1275066029	0	0	IKE, IJEOMA NP	4/30/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2220 W MANCHESTER BLVD	None	INGLEWOOD	CA	90305	2514	00	06000	33.9598587	-118.318258	Los Angeles County
305015	Non-Physician Medical Practitioner	None	1316272461	0	0	IMHOFF, BARBARA A	8/26/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	750 TIE GULCH RD	None	SANTA CRUZ	CA	95066	9641	00	06000	37.05701628	-121.9877104	Santa Cruz County
305034	Non-Physician Medical Practitioner	None	1639568363	0	0	IMOTO, LISA C NP	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	77 N ALMANDEN AVE	None	SAN JOSE	CA	95110	2792	00	06000	37.33606064	-121.8949984	Santa Clara County
305256	Non-Physician Medical Practitioner	None	1366641425	0	0	IBARRA, MAXIMO	5/4/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	2347	00	06000	33.94435533	-117.9931159	Los Angeles County
305400	Non-Physician Medical Practitioner	None	1063662278	0	0	ITAMI, ROBERTA	12/5/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	00	06000	34.27623479	-119.2520218	Ventura County
305745	Non-Physician Medical Practitioner	None	1437297645	0	0	IRWIN, LARRY J	1/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1680 ASHCROFT DR	None	FAIRVIEW	TX	75069	1919	00	06000	33.12925397	-96.58507825	Collin County
306495	Non-Physician Medical Practitioner	None	1184058737	0	0	IVIE, JANICE C NP	4/30/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	102 FAIRVIEW DRIVE	None	VACAVILLE	CA	95687	6400	00	06000	38.33697995	-121.9528091	Solano County
306526	Non-Physician Medical Practitioner	None	1356726533	0	0	IMADA, ROBERT M NP	3/25/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	00	06000	37.37715796	-122.0651926	Santa Clara County
306614	Non-Physician Medical Practitioner	None	1013792670	0	0	ITOH, AYANO NP	1/29/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1225 NORTH H STREET	None	LOMPOC	CA	93436	3301	00	06000	34.65803329	-120.4576446	Santa Barbara County
306947	Non-Physician Medical Practitioner	None	1558052159	0	0	IFEMAZI, EMMANUEL	10/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	536 CAMINO MERCADO	STE.306	ARROYO GRANDE	CA	93420	1418	00	06000	35.12986992	-120.6006027	San Luis Obispo County
307068	Non-Physician Medical Practitioner	None	1770109548	0	0	ISAAK TSEGAI, SEMHAR NP	3/22/2023	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
307427	Non-Physician Medical Practitioner	None	1164940433	0	0	IN, SOPHEAR NP	8/17/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2437 S ARGYLE AVE	None	FRESNO	CA	93727	8813	00	06000	36.713367	-119.6928135	Fresno County
307486	Non-Physician Medical Practitioner	None	1427803444	0	0	INZUNZA, MIRIAM NP	2/14/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5101 FLORENCE AVE	STE 4	BELL	CA	90201	3801	00	06000	33.96904913	-118.1757922	Los Angeles County
307745	Non-Physician Medical Practitioner	None	1962456475	0	0	ISHAK, JEANINE A	3/26/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3901 LAS POSAS RD.	SUITE 17	CAMARILLO	CA	93010	0000	00	06000	34.2415821	-119.0183756	Ventura County
307845	Non-Physician Medical Practitioner	None	1366626376	0	0	INTON, ZOSIMA B NP	10/27/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	00	06000	38.00771973	-122.1331484	Contra Costa County
307972	Non-Physician Medical Practitioner	None	1386107688	0	0	ILLUSTRISIMO, WILLA E CNP	3/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6540 STOCKTON BLVD	STE 3A	SACRAMENTO	CA	95823	1635	00	06000	38.507094	-121.434858	Sacramento County
308346	Non-Physician Medical Practitioner	None	1598420572	0	0	IBRAHIM, ALIM A PA-C	6/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 E ROMIE LN	None	SALINAS	CA	93901	4017	00	06000	36.66043696	-121.6483124	Monterey County
308528	Non-Physician Medical Practitioner	None	1548972441	0	0	IBARRA, IGNACIO NP	8/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1845 CHICAGO AVE	B	RIVERSIDE	CA	92507	2366	00	06000	33.994269	-117.3485375	Riverside County
308575	Non-Physician Medical Practitioner	None	1104929165	0	0	INIGO, MARICAR	9/27/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	243 GEORGIA STREET	STE B	VALLEJO	CA	94590	0000	00	06000	38.10111026	-122.2588175	Solano County
308948	Non-Physician Medical Practitioner	None	1992309561	0	0	IHEMEDU, AMARACHI C NP	11/8/2022	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
309122	Non-Physician Medical Practitioner	None	1134322159	0	0	INLAND COUNTIES REGIONAL CENTER	12/1/1990	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	674 E BRIER DR	None	SAN BERNARDINO	CA	92408	2800	00	06000	34.07132448	-117.270567	San Bernardino County
309128	Non-Physician Medical Practitioner	None	1871738864	0	0	IYER, VICTORIA G NP	9/16/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	00	06000	32.72663119	-117.1611714	San Diego County
309164	Non-Physician Medical Practitioner	None	1366569246	0	0	ICHIRIU, WANDA G	8/17/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 S GRAND AVE STE 800	None	LOS ANGELES	CA	90015	3048	00	06000	34.03692236	-118.2655238	Los Angeles County
309351	Non-Physician Medical Practitioner	None	1881700276	0	0	ITCHON, ANTONITA B	11/4/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	431 EL CAMINO REAL	APT 2404	SANTA CLARA	CA	95050	7409	00	06000	37.34777276	-121.9324238	Santa Clara County
309415	Non-Physician Medical Practitioner	None	1932170578	0	0	ITH, CHAD VIRIYA	3/5/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	710 LAWRENCE EXPRESSWAY	DEPT 148	SANTA CLARA	CA	95051	0000	00	06000	37.33636857	-121.9958111	Santa Clara County
309496	Non-Physician Medical Practitioner	None	1215124953	0	0	IOCCO, JANET L	2/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2491 SAN FERNANDO CT	None	CLAREMONT	CA	91711	1649	00	06000	34.1280852	-117.7241464	Los Angeles County
309576	Non-Physician Medical Practitioner	None	1063076735	0	0	INDUCTIVO, CARMINA D NP	3/10/2021	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	None	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
310010	Non-Physician Medical Practitioner	None	1952037731	0	0	INGRAM, CORRETHA	11/6/2023	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
310552	Non-Physician Medical Practitioner	None	1548395056	0	0	IMPASTATO, LAUREL WOOD	2/8/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	00	06000	34.049547	-117.264078	San Bernardino County
310647	Non-Physician Medical Practitioner	None	1891384053	0	0	IGWE, CHIMEZIE L	6/3/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8710 MONROE CT	SUITE 150	RANCHO CUCAMONGA	CA	91730	4883	00	06000	34.09544496	-117.5747968	San Bernardino County
310700	Non-Physician Medical Practitioner	None	1871503342	0	0	IDAHOSA-ERESE, FESTUS PA	1/2/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15791 BEAR VALLEY RD	None	HESPERIA	CA	92345	1740	00	06000	34.47063553	-117.3190095	San Bernardino County
310710	Non-Physician Medical Practitioner	None	1649628322	0	0	IHEMEDU, MAGNUS C NP	9/8/2022	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
310840	Non-Physician Medical Practitioner	None	1225750367	0	0	INGA, ARACELLY M	2/3/2023	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
310889	Non-Physician Medical Practitioner	None	1386838407	0	0	INGERSOLL, OTIS PERRY MAX	5/15/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2850 TELEGRAPH AVE	#130	BERKELEY	CA	94705	1192	00	06000	37.85808554	-122.2594469	Alameda County
310938	Non-Physician Medical Practitioner	None	1215117643	0	0	IRWIN, STARK J	1/16/2008	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, 4TH FLOOR	CALIFORNIA PACIFIC MEDIC	SAN FRANCISCO	CA	94115	0000	00	06000	37.79101969	-122.43208	San Francisco County
311291	Non-Physician Medical Practitioner	None	1225369333	0	0	IGLESIAS, ALICIA	6/10/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9939 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	00	06000	33.91571158	-117.4549231	Riverside County
311584	Non-Physician Medical Practitioner	None	1487348876	0	0	IRANI, SHAHRZAD 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	1317 OAKDALE ROAD	STE. 800	MODESTO	CA	95355	3361	00	06000	37.662489	-120.957588	Stanislaus County
311619	Non-Physician Medical Practitioner	None	1528356441	0	0	INZUNZA, HUMBERTO ROBERT	12/19/2011	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 LN	SUITE 301	FRESNO	CA	93701	2230	00	06000	36.74333844	-119.7831874	Fresno County
311718	Non-Physician Medical Practitioner	None	1770896961	0	0	IBARRA, ANGELICA	9/15/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10316 WOODLEY AVE	None	GRANADA HILLS	CA	91344	6916	00	06000	34.258077	-118.484801	Los Angeles County
311733	Non-Physician Medical Practitioner	None	1942726252	0	0	IMPERATO, TOD B	9/28/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	310 CLARA AVE	None	UKIAH	CA	95482	4531	00	06000	39.15543998	-123.2033008	Mendocino County
311747	Non-Physician Medical Practitioner	None	1457431371	0	0	IBARRA, LORRAINE	1/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7780 SVL BX	None	VICTORVILLE	CA	92395	5117	00	06000	0	0	None
311773	Non-Physician Medical Practitioner	None	1629797139	0	0	IRVIN, MATTHEW E PA-C	11/16/2023	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
311925	Non-Physician Medical Practitioner	None	1225567431	0	0	INGRAM, RORY B NP	6/30/2024	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
312098	Non-Physician Medical Practitioner	None	1629463088	0	0	IGLESIAS, BIANCA	6/18/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	801 EAST CHAPEL STREET	SUITE 2	SANTA MARIA	CA	93454	4607	00	06000	34.9542915	-120.424455	Santa Barbara County
312355	Non-Physician Medical Practitioner	None	1215246996	0	0	IMPERIAL BEACH COMMUNITY CLINIC	1/27/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1016 OUTER RD	None	SAN DIEGO	CA	92154	1351	00	06000	32.57795659	-117.0825179	San Diego County
312379	Non-Physician Medical Practitioner	None	1639583545	0	0	IIJIMA, LISA K NP	10/17/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4742 SEVEN HILLS ROAD	None	CASTRO VALLEY	CA	94546	2431	00	06000	37.70879835	-122.0673449	Alameda County
312574	Non-Physician Medical Practitioner	None	1235666041	0	0	IGWE, CHINWENDU L NP	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	36320 INLAND VALLEY DR	STE 308	WILDOMAR	CA	92595	7512	00	06000	33.592158	-117.2367705	Riverside County
312609	Non-Physician Medical Practitioner	None	1316450828	0	0	IBE, ALYSON A	5/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	919 S WESTERN AVE	UNIT 13	ANAHEIM	CA	92804	3758	00	06000	33.81841844	-118.0021123	Orange County
312680	Non-Physician Medical Practitioner	None	1760813380	0	0	IKEJIOFOR, NKECHI NP	5/18/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13012 WOODRUFF AVE	None	DOWNEY	CA	90242	5039	00	06000	33.91293265	-118.1164665	Los Angeles County
312924	Non-Physician Medical Practitioner	None	1922523034	0	0	IPPOLITO, LISA M NP	9/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4380 FERRIERA RANCH DR	None	TURLOCK	CA	95382	7278	00	06000	37.53364307	-120.8506305	Stanislaus County
313005	Non-Physician Medical Practitioner	None	1295556256	0	0	IORIO, ALANNA NP	11/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	838 NORDAHL RD	STE 300	SAN MARCOS	CA	92069	3599	00	06000	33.13569751	-117.1191477	San Diego County
313071	Non-Physician Medical Practitioner	None	1417176322	0	0	IZVERNARI, MARTHA KIM	9/5/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1695 S. SAN JACINTO AVE	SUITE L	SAN JACINTO	CA	92583	5103	00	06000	33.770961	-116.954649	Riverside County
313101	Non-Physician Medical Practitioner	None	1730303637	0	0	ITAGAKI, CECILE H NP	12/12/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2128 MENDOCINO ST	None	FULLERTON	CA	92831	1200	00	06000	33.89143175	-117.892342	Orange County
313850	Non-Physician Medical Practitioner	None	1376944587	0	0	IROZ, SUSAN R NP	11/24/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	6241 GRAND TETON DRIVE	None	LAS VEGAS	NV	89131	1901	00	06000	36.30495471	-115.2294004	Clark County
313998	Non-Physician Medical Practitioner	None	1134563695	0	0	IGNACIO, CARMELA VILLARIN	6/3/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24853 ALESSANDRO BLVD	#4	MORENO VALLEY	CA	92553	6102	00	06000	33.91718453	-117.228627	Riverside County
314125	Non-Physician Medical Practitioner	None	1922397876	0	0	IWUAJOKU, JOSEPH PA	8/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2403 ATLANTIC AVE	None	LONG BEACH	CA	90806	3221	00	06000	33.800967	-118.1850555	Los Angeles County
314212	Non-Physician Medical Practitioner	None	1154406999	0	0	ING, MICHELLE L	12/10/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1837 DUNLAP PL	None	WOODLAND	CA	95776	5454	00	06000	38.64974978	-121.735114	Yolo County
314399	Non-Physician Medical Practitioner	None	1194374942	0	0	ISAACKS, MATTHEW R NP	4/22/2020	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
314488	Non-Physician Medical Practitioner	None	1407050289	0	0	INCISO, WILLIAM C	1/13/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10132 CALIFORNIA AVE	None	SOUTH GATE	CA	90280	6008	00	06000	33.94212073	-118.2077802	Los Angeles County
314553	Non-Physician Medical Practitioner	None	1407576093	0	0	ILUMIN, TRISHA MAE G PA	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	1508 ALHAMBRA BLVD	200	SACRAMENTO	CA	95816	6510	00	06000	38.567007	-121.468068	Sacramento County
314611	Non-Physician Medical Practitioner	None	1568647543	0	0	IZMAYLOVA, OLGA	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	4150 CLEMENT ST	None	SAN FRANCISCO	CA	94121	1545	00	06000	37.78109398	-122.5051321	San Francisco County
314644	Non-Physician Medical Practitioner	None	1114290780	0	0	INDIAN HEALTH CENTER OF SANTA CLARA VALLEY	5/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	455 OCONNOR DR STE 200	None	SAN JOSE	CA	95128	1632	00	06000	37.326654	-121.939897	Santa Clara County
314719	Non-Physician Medical Practitioner	None	1023179447	0	0	IGNATOVA, ANNA	5/2/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4131 GEARY BLVD	4TH FLOOR	SAN FRANCISCO	CA	94118	3101	00	06000	37.78096053	-122.4637512	San Francisco County
314776	Non-Physician Medical Practitioner	None	1295263648	0	0	IMSEIS, REBECCA M	1/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15310 BITNEY SPRINGS RD	None	NEVADA CITY	CA	95959	9020	00	06000	39.25468905	-121.1741444	Nevada County
315027	Non-Physician Medical Practitioner	None	1689632671	0	0	IRELAND, JOSHUA E	9/8/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28431 SILVERKING TRAIL	None	SANTA CLARITA	CA	91390	5246	00	06000	34.46127478	-118.5110311	Los Angeles County
315036	Non-Physician Medical Practitioner	None	1699151043	0	0	ITO, CHIHARU NP	10/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
315184	Non-Physician Medical Practitioner	None	1700428711	0	0	IBRAHIM, ISLAM G PA	7/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	00	06000	33.9040752	-118.1328995	Los Angeles County
315400	Non-Physician Medical Practitioner	None	1720449358	0	0	ILLESCAS, CINDY B NP	4/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2133 YUCATECA STREET	None	PERRIS	CA	92570	2594	00	06000	33.767172	-117.238154	Riverside County
315497	Non-Physician Medical Practitioner	None	1730334152	0	0	IBE, CLETUS N PA	5/9/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	00	06000	37.7634502	-122.4579779	San Francisco County
315647	Non-Physician Medical Practitioner	None	1932941556	0	0	IMPAGLIAZZO, ELISABETTA NP	7/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 E 28TH ST	419	LONG BEACH	CA	90806	2775	00	06000	33.80803441	-118.1847137	Los Angeles County
315698	Non-Physician Medical Practitioner	None	1144794108	0	0	ISEYEMI, OLUWATOYIN NP	8/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	00	06000	38.570976	-121.416651	Sacramento County
315755	Non-Physician Medical Practitioner	None	1508095654	0	0	ISAAK, SANDRA J NP	8/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2960 16TH AVENUE	None	KINGSBURG	CA	93631	3105	00	06000	36.53537973	-119.5497504	Fresno County
315867	Non-Physician Medical Practitioner	None	1952534422	0	0	IYER, GAUTHAM S	1/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1 HOSPITAL DR	SUITE MA 438,	COLUMBIA	MO	65212	0001	00	06000	38.938725	-92.327679	Boone County
315918	Non-Physician Medical Practitioner	None	1225408768	0	0	IBANEZ, PAMELA	12/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	430 9TH AVENUE	APT 5	SAN FRANCISCO	CA	94118	2940	00	06000	37.78016951	-122.4674207	San Francisco County
316049	Non-Physician Medical Practitioner	None	1841296936	0	0	IDONI, JOSEPH I PA	8/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	622 ACADEMY AVE	None	SANGER	CA	93657	2423	00	06000	36.70716792	-119.5560631	Fresno County
316116	Ordering, Referring, Prescribing	N/A	1003140336	0	0	IACOVIELLO, CECILIA L CNP	10/11/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	18942	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
316450	Ordering, Referring, Prescribing	N/A	1003941774	0	0	IBARRA, ARIANA A LCSW	6/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	68692	N/A	N/A	N/A	N/A	N/A	101 WIKIUP DRIVE	None	SANTA ROSA	CA	95403	1375	00	06000	38.50788547	-122.7587646	Sonoma County
316598	Ordering, Referring, Prescribing	N/A	1013213842	0	0	IMMITT, JESSICA C LCSW	5/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75900	N/A	N/A	N/A	N/A	N/A	808 E ST	None	EUREKA	CA	95501	1940	00	06000	40.79921446	-124.1665245	Humboldt County
316802	Ordering, Referring, Prescribing	N/A	1013547090	0	0	IRVIN, ERIN E NP	12/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013571	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
317878	Ordering, Referring, Prescribing	N/A	1043672488	0	0	ISOM, PATRICIA LCSW	6/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW95129	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
317948	Ordering, Referring, Prescribing	N/A	1043767353	0	0	IBARRA, GENESIS LCSW	6/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	89977	N/A	N/A	N/A	N/A	N/A	8711 MACARTHUR BLVD	None	OAKLAND	CA	94605	4031	00	06000	37.75770582	-122.1622017	Alameda County
318055	Ordering, Referring, Prescribing	N/A	1053046862	0	0	IRGENS, MEGAN PHD	7/11/2024	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	35162	N/A	N/A	N/A	N/A	N/A	3095 RICHMOND PKWY	210	SAN PABLO	CA	94806	5773	00	06000	37.99005821	-122.3290377	Contra Costa County
318200	Ordering, Referring, Prescribing	N/A	1053560581	0	0	IWANIER, JUDY B LCSW	4/24/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW18299	N/A	N/A	N/A	N/A	N/A	5 KELLER STREET	#2	PETALUMA	CA	94952	2349	00	06000	38.23242894	-122.6415421	Sonoma County
318345	Ordering, Referring, Prescribing	N/A	1053773754	0	0	IRIARTE, TESSINY N NP	7/27/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	765851	N/A	N/A	N/A	N/A	N/A	45104 10TH ST W	None	LANCASTER	CA	92534	2310	00	06000	34.702929	-118.1480935	Los Angeles County
318390	Ordering, Referring, Prescribing	N/A	1053839076	0	0	ISLAS, ROXANA	10/30/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW105104	N/A	N/A	N/A	N/A	N/A	2629 CLARENDON AVE	None	HUNTINGTON PARK	CA	90255	4119	00	06000	33.98356476	-118.2241387	Los Angeles County
318711	Ordering, Referring, Prescribing	N/A	1063773141	0	0	IRAM, FAIZA MD	9/14/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C168755	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
318776	Ordering, Referring, Prescribing	N/A	1063841526	0	0	IRONS, ANDRIE V LMFT	10/25/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT97787	N/A	N/A	N/A	N/A	N/A	480 TESCONI CIR	None	SANTA ROSA	CA	95401	4691	00	06000	38.449557	-122.7357315	Sonoma County
318878	Ordering, Referring, Prescribing	N/A	1063999340	0	0	IQBAL, MOHAMMED F MD	6/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165662	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
318949	Ordering, Referring, Prescribing	N/A	1073109054	0	0	ISAAC-SMITH, SHAWNEE LCSW	6/24/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW97267	N/A	N/A	N/A	N/A	N/A	715 COURTLAND STREET	None	VENICE	CA	90291	2870	00	06000	34.0037409	-118.4615374	Los Angeles County
319012	Ordering, Referring, Prescribing	N/A	1073369559	0	0	ISRAIL, MARTENA NP	5/1/2024	Taxonomy not applicable	NA	n/a	000	Unknown	95029975	N/A	N/A	N/A	N/A	N/A	1303 W 6TH ST	102	CORONA	CA	92882	3196	00	06000	33.87785815	-117.5891694	Riverside County
319100	Ordering, Referring, Prescribing	N/A	1073763629	0	0	ISAAC, CHRISTOPHER LMFT	7/14/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	88764	N/A	N/A	N/A	N/A	N/A	409 CAMINO DEL RIO S	201	SAN DIEGO	CA	92108	3504	00	06000	32.76105674	-117.1609032	San Diego County
319189	Ordering, Referring, Prescribing	N/A	1073947966	0	0	IGLESIAS, CONNIE G	4/7/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100981	N/A	N/A	N/A	N/A	N/A	3303 N BROADWAY	4TH FLOOR	LOS ANGELES	CA	90031	2803	00	06000	34.07380397	-118.20586	Los Angeles County
319355	Ordering, Referring, Prescribing	N/A	1083178263	0	0	ISHMAIL, DALTON PA	1/11/2023	Taxonomy not applicable	NA	n/a	000	Unknown	57389	N/A	N/A	N/A	N/A	N/A	265 POSADA LN	STE B	TEMPLETON	CA	93465	0001	00	06000	35.55354235	-120.7214149	San Luis Obispo County
319470	Ordering, Referring, Prescribing	N/A	1083638100	0	0	ILANO, MARIA D MD	3/22/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A47981	N/A	N/A	N/A	N/A	N/A	2751 NAPA VALLEY CORPORA	None	NAPA	CA	94558	6216	00	06000	38.24829023	-122.2745626	Napa County
319577	Ordering, Referring, Prescribing	N/A	1083921357	0	0	IM, MARYLUNE LMFT	2/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112415	N/A	N/A	N/A	N/A	N/A	2323A E PALMDALE BLVD	None	PALMDALE	CA	93550	4957	00	06000	34.58021347	-118.0857516	Los Angeles County
319578	Ordering, Referring, Prescribing	N/A	1083927784	0	0	INIGUEZ, VANESSA LCSW	11/16/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	79709	N/A	N/A	N/A	N/A	N/A	9101 WHITTIER BLVD.	None	PICO RIVERA	CA	90660	2405	00	06000	34.00074139	-118.0822944	Los Angeles County
319597	Ordering, Referring, Prescribing	N/A	1083961643	0	0	IBRAHIMI-MEALIFF, ANAISSA M LMFT	12/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT88198	N/A	N/A	N/A	N/A	N/A	1950 MARKET STREET	None	RIVERSIDE	CA	92501	1720	00	06000	34.00316496	-117.3767967	Riverside County
319620	Ordering, Referring, Prescribing	N/A	1083996748	0	0	IOFFE, VIKTORIYA PHARMD	11/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH60377	N/A	N/A	N/A	N/A	N/A	2177 SUNSET BLVD	None	ROCKLIN	CA	95765	4743	00	06000	38.80527905	-121.2731306	Placer County
320548	Ordering, Referring, Prescribing	N/A	1114310810	0	0	IRVIN, NOELIA E LMFT	3/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT115491	N/A	N/A	N/A	N/A	N/A	2621 OSWELL ST	None	BAKERSFIELD	CA	93306	3172	00	06000	35.393283	-118.9496505	Kern County
320563	Ordering, Referring, Prescribing	N/A	1114327871	0	0	IGONIA-MOCK, MARIA CHRISTINA	1/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH70626	N/A	N/A	N/A	N/A	N/A	100 CALISTOGA RD	None	SANTA ROSA	CA	95409	3702	00	06000	38.465622	-122.6517525	Sonoma County
320604	Ordering, Referring, Prescribing	N/A	1114392669	0	0	ISMAIL, HABIBA N	5/12/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D63162	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
320624	Ordering, Referring, Prescribing	N/A	1114421948	0	0	IMPERIALE, PAMELA MD	3/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165906	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95801	2201	00	06000	38.555181	-121.4566785	Sacramento County
320861	Ordering, Referring, Prescribing	N/A	1124219068	0	0	IDLE, SANDY A LCSW	7/5/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW83891	N/A	N/A	N/A	N/A	N/A	308 E SAN JACINTO AVE	None	PERRIS	CA	92570	2878	00	06000	33.78658073	-117.2226438	Riverside County
320894	Ordering, Referring, Prescribing	N/A	1124292412	0	0	IN, MI GA LCSW	12/15/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24286	N/A	N/A	N/A	N/A	N/A	529 MAPLE AVE	None	LOS ANGELES	CA	90013	1511	00	06000	34.04465262	-118.2472846	Los Angeles County
320986	Ordering, Referring, Prescribing	N/A	1124436431	0	0	IGNACIO, KIMBERLY A LCSW	2/14/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	113686	N/A	N/A	N/A	N/A	N/A	1940 E DEERE AVE	SUITE 100	SANTA ANA	CA	92705	5718	00	06000	33.70430421	-117.8482556	Orange County
321254	Ordering, Referring, Prescribing	N/A	1134329725	0	0	IKHIMIUKOR, EUGENE MD	1/11/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A98779	N/A	N/A	N/A	N/A	N/A	6235 RIVER CREST DRIVE	N	RIVERSIDE	CA	92507	0788	00	06000	33.93833587	-117.2922207	Riverside County
321349	Ordering, Referring, Prescribing	N/A	1134517667	0	0	IGNACIO, JOY	8/22/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	654375	N/A	N/A	N/A	N/A	N/A	5524 ASSEMBLY COURT	None	SACRAMENTO	CA	95823	2625	00	06000	38.493306	-121.4392995	Sacramento County
321422	Ordering, Referring, Prescribing	N/A	1134633068	0	0	INGRAM, KESHIA R LMFT	7/22/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	127097	N/A	N/A	N/A	N/A	N/A	1340 ARNOLD DR	100	MARTINEZ	CA	94553	4189	00	06000	37.99250264	-122.0983907	Contra Costa County
321489	Ordering, Referring, Prescribing	N/A	1134750656	0	0	ISLER, AMY RN	2/24/2019	Taxonomy not applicable	NA	n/a	000	Unknown	RN95029182	N/A	N/A	N/A	N/A	N/A	111 S. DE ANZA BLVD	None	MOUNTAIN HOUSE	CA	95391	9539	00	06000	37.77769878	-121.5347197	San Joaquin County
321496	Ordering, Referring, Prescribing	N/A	1134767544	0	0	IADISERNIA, DEBORAH LMFT	11/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114491	N/A	N/A	N/A	N/A	N/A	460 N MAGNOLIA AVE	STE 110	EL CAJON	CA	92020	3610	00	06000	32.800266	-116.962389	San Diego County
321685	Ordering, Referring, Prescribing	N/A	1144571456	0	0	IWAY, LINDA V PHARMD	3/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67660	N/A	N/A	N/A	N/A	N/A	2550 BELL RD	None	AUBURN	CA	95603	2502	00	06000	38.94246051	-121.09284	Placer County
321929	Ordering, Referring, Prescribing	N/A	1144957556	0	0	IMRAN, ANUM PHARMD	4/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86015	N/A	N/A	N/A	N/A	N/A	30251 MURRIETA RD	None	MENIFEE	CA	92584	8385	00	06000	33.684399	-117.2060495	Riverside County
321972	Ordering, Referring, Prescribing	N/A	1154109619	0	0	IN, TRISHA	9/6/2023	Taxonomy not applicable	NA	n/a	000	Unknown	DDS109265	N/A	N/A	N/A	N/A	N/A	1080 N. WESTERN AVE.	None	LOS ANGELES	CA	90029	2310	00	06000	34.090281	-118.3091425	Los Angeles County
321975	Ordering, Referring, Prescribing	N/A	1154162261	0	0	ISFAHANI, AZIN T	6/12/2023	Taxonomy not applicable	NA	n/a	000	Unknown	86088	N/A	N/A	N/A	N/A	N/A	26024 ACERO	110	MISSION VIEJO	CA	92691	2768	00	06000	33.61784172	-117.6769661	Orange County
321976	Ordering, Referring, Prescribing	N/A	1154186658	0	0	INIGUEZ, EVELYN PHARMD	2/14/2023	Taxonomy not applicable	NA	n/a	000	Unknown	77523	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
322073	Ordering, Referring, Prescribing	N/A	1154541019	0	0	IRENE, SUNDAY O MD	2/9/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A98496	N/A	N/A	N/A	N/A	N/A	815 DR. MARTIN LUTHER KI	None	BAKERSFIELD	CA	93307	1365	00	06000	35.3655	-118.985202	Kern County
322219	Ordering, Referring, Prescribing	N/A	1154796191	0	0	IRVING NOBLE, MADELINE LPCC	3/5/2024	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC6236	N/A	N/A	N/A	N/A	N/A	1520 EUREKA RD	SUITE 102	ROSEVILLE	CA	95661	2849	00	06000	38.74944235	-121.2487091	Placer County
322253	Ordering, Referring, Prescribing	N/A	1154852002	0	0	ISHINO, ALLYSE S MD	11/1/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159266	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FLOOR SUITE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
322715	Ordering, Referring, Prescribing	N/A	1164990834	0	0	ISAAC, MINA	12/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78537	N/A	N/A	N/A	N/A	N/A	330 E LAMBERT RD	125	BREA	CA	92821	4100	00	06000	33.92494139	-117.8918336	Orange County
322997	Ordering, Referring, Prescribing	N/A	1174823033	0	0	INATOMI, CAROL N PHARMD	3/31/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH 48116	N/A	N/A	N/A	N/A	N/A	11030 W. JEFFERSON BLVD.	None	CULVER CITY	CA	90230	5520	00	06000	33.9966	-118.395332	Los Angeles County
323001	Ordering, Referring, Prescribing	N/A	1174834790	0	0	IWAOKA-SCOTT, ALLISON MD	4/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A115124	N/A	N/A	N/A	N/A	N/A	100 BLANKEN AVENUE	None	SAN FRANCISCO	CA	94134	2407	00	06000	37.7119479	-122.4006456	San Francisco County
323175	Ordering, Referring, Prescribing	N/A	1184058737	0	0	IVIE, JANICE C NP	3/31/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001148	N/A	N/A	N/A	N/A	N/A	941 MERCHANT STREET	SUITE A	VACAVILLE	CA	95688	5315	00	06000	38.34814705	-121.9968806	Solano County
323561	Ordering, Referring, Prescribing	N/A	1194023994	0	0	IZADI, AFSHEEN LMFT	9/25/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	134295	N/A	N/A	N/A	N/A	N/A	9517 REA AVE	None	CALIFORNIA CITY	CA	93505	4831	00	06000	35.13946652	-117.959445	Kern County
323775	Ordering, Referring, Prescribing	N/A	1194455741	0	0	IZEKOR, ABIOLA O CNP	12/20/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023778	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
324191	Ordering, Referring, Prescribing	N/A	1205556743	0	0	ISRAEL, KIMBERLY S LCSW	6/18/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW21662	N/A	N/A	N/A	N/A	N/A	2310 ALDERGROVE AVE,	None	ESCONDIDO	CA	92029	1935	00	06000	33.11810947	-117.1147557	San Diego County
324316	Ordering, Referring, Prescribing	N/A	1215068150	0	0	ISKANDAR, MONA F	6/26/2001	Taxonomy not applicable	NA	n/a	099	DENTIST	D39282	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
324349	Ordering, Referring, Prescribing	N/A	1215124953	0	0	IOCCO, JANET L	5/25/2017	Taxonomy not applicable	NA	n/a	000	Unknown	19375	N/A	N/A	N/A	N/A	N/A	5870 ARLINGTON AVE	None	RIVERSIDE	CA	92504	2037	00	06000	33.94592702	-117.4313099	Riverside County
324393	Ordering, Referring, Prescribing	N/A	1215219498	0	0	IBARRA, SANDRA LCSW	12/18/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW79710	N/A	N/A	N/A	N/A	N/A	530 W BADILLO ST	None	COVINA	CA	91722	3787	00	06000	34.08625283	-117.8999625	Los Angeles County
324709	Ordering, Referring, Prescribing	N/A	1225154081	0	0	ISHIDA, YO LCSW	10/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29526	N/A	N/A	N/A	N/A	N/A	3845 SPRING DR	None	SPRING VALLEY	CA	91977	1030	00	06000	32.74889129	-117.0031816	San Diego County
324727	Ordering, Referring, Prescribing	N/A	1225169220	0	0	INGLIZIAN, PAUL R LCSW	8/17/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW11608	N/A	N/A	N/A	N/A	N/A	3580 WILSHIRE BLVD	800	LOS ANGELES	CA	90010	2501	00	06000	34.06170677	-118.302787	Los Angeles County
325025	Ordering, Referring, Prescribing	N/A	1225701188	0	0	IP, KA YAN LCSW	8/21/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	109138	N/A	N/A	N/A	N/A	N/A	6221 GEARY BLVD	2ND FLOOR	SAN FRANCISCO	CA	94121	1887	00	06000	37.77994312	-122.4862014	San Francisco County
325207	Ordering, Referring, Prescribing	N/A	1235470063	0	0	IDROGO, RUDY R LMFT	2/21/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT106588	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
325611	Ordering, Referring, Prescribing	N/A	1245584929	0	0	ISMAIL, DUNIA PHARMD	3/15/2018	Taxonomy not applicable	NA	n/a	000	Unknown	48502	N/A	N/A	N/A	N/A	N/A	155 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3005	00	06000	34.13579917	-118.1534676	Los Angeles County
325790	Ordering, Referring, Prescribing	N/A	1245847862	0	0	IBARRA, MIGUEL CSW	12/16/2024	Taxonomy not applicable	NA	n/a	000	Unknown	127759	N/A	N/A	N/A	N/A	N/A	726 POLK ST	4TH FL	SAN FRANCISCO	CA	94109	7813	00	06000	37.78379532	-122.4192766	San Francisco County
325812	Ordering, Referring, Prescribing	N/A	1245891480	0	0	IGBO, CHINENYE MD	2/12/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A177006	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
325831	Ordering, Referring, Prescribing	N/A	1245956366	0	0	ISOM, AKIA M LMFT	12/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	143367	N/A	N/A	N/A	N/A	N/A	928 BROADWAY	None	SAN DIEGO	CA	92101	5514	00	06000	32.71575045	-117.1560915	San Diego County
325916	Ordering, Referring, Prescribing	N/A	1255424404	0	0	IBRAHIM, FAHMY MD	11/14/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A89455	N/A	N/A	N/A	N/A	N/A	2571 A NAPA VALLEY CORPO	A	NAPA	CA	94558	2045	00	06000	38.25467924	-122.2747386	Napa County
326064	Ordering, Referring, Prescribing	N/A	1255715678	0	0	IMMEL, GRACE R PA-C	8/16/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61518	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
326148	Ordering, Referring, Prescribing	N/A	1255851895	0	0	IRVIN, ANNA SOPHIA DO	1/21/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16710	N/A	N/A	N/A	N/A	N/A	1201 ALHAMBRA BLVD	STE 330	SACRAMENTO	CA	95816	5238	00	06000	38.570076	-121.4657145	Sacramento County
326194	Ordering, Referring, Prescribing	N/A	1255913372	0	0	INCERTI, NANCY	6/22/2020	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	6389	N/A	N/A	N/A	N/A	N/A	50 BRANSCOMB ROAD	None	LAYTONVILLE	CA	95454	0841	00	06000	39.68781544	-123.4842982	Mendocino County
326330	Ordering, Referring, Prescribing	N/A	1265448112	0	0	IYENGAR, RADHA MD	2/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A49273	N/A	N/A	N/A	N/A	N/A	1295 CARLSBAD VILLAGE DR	SUITE 100	CARLSBAD	CA	92008	1950	00	06000	33.16543047	-117.3387964	San Diego County
326424	Ordering, Referring, Prescribing	N/A	1265692800	0	0	ISHIBASHI, NAOMI DDS	10/2/2023	Taxonomy not applicable	NA	n/a	000	Unknown	DDS57159	N/A	N/A	N/A	N/A	N/A	1 HOPE DR	None	TUSTIN	CA	92782	0000	00	06000	33.71470753	-117.8323965	Orange County
326429	Ordering, Referring, Prescribing	N/A	1265698369	0	0	IVEY, GRACE LCSW	9/17/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74067	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
326530	Ordering, Referring, Prescribing	N/A	1265847289	0	0	ISAKSON, NICOLE	4/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	83867	N/A	N/A	N/A	N/A	N/A	1055 W HENDERSON AVE	2	PORTERVILLE	CA	93257	1490	00	06000	36.08036906	-119.0410926	Tulare County
326826	Ordering, Referring, Prescribing	N/A	1275677585	0	0	ISHITANI, ESTHER R MD	1/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A74330	N/A	N/A	N/A	N/A	N/A	6001 CLARA ST	None	BELL GARDENS	CA	90201	4723	00	06000	33.96259296	-118.1593487	Los Angeles County
327039	Ordering, Referring, Prescribing	N/A	1285033209	0	0	ITA, RYAN K PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61506	N/A	N/A	N/A	N/A	N/A	1761 BROADWAY ST	209	VALLEJO	CA	94589	2226	00	06000	38.13049234	-122.2522422	Solano County
327110	Ordering, Referring, Prescribing	N/A	1285144113	0	0	IMBODEN, ABIGAIL S	10/6/2017	Taxonomy not applicable	NA	n/a	000	Unknown	55015	N/A	N/A	N/A	N/A	N/A	250 LOCUST ST	None	SANTA CRUZ	CA	95060	3813	00	06000	36.97493323	-122.028799	Santa Cruz County
327150	Ordering, Referring, Prescribing	N/A	1285209882	0	0	IRANI, MEHER MD	4/25/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A195350	N/A	N/A	N/A	N/A	N/A	9009 BARTON ROAD	None	REDLANDS	CA	92354	1001	00	06000	34.048269	-117.2161816	San Bernardino County
327276	Ordering, Referring, Prescribing	N/A	1285733840	0	0	IGARTA, MAGDELINE LCSW	3/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	21115	N/A	N/A	N/A	N/A	N/A	301 THE CITY DRIVE	None	ORANGE	CA	92868	3205	00	06000	33.78547994	-117.8888036	Orange County
327351	Ordering, Referring, Prescribing	N/A	1285886440	0	0	ISACSON, JASON K	2/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48847	N/A	N/A	N/A	N/A	N/A	2750 SUTTERVILLE RD	None	SACRAMENTO	CA	95820	1093	00	06000	38.540124	-121.4786745	Sacramento County
327758	Ordering, Referring, Prescribing	N/A	1295978229	0	0	IJEAKU, IJEOMA MD MPH	5/6/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A118450	N/A	N/A	N/A	N/A	N/A	950 N RAMONA BLVD	STE 2	SAN JACINTO	CA	92582	2567	00	06000	33.79559324	-116.9731495	Riverside County
328046	Ordering, Referring, Prescribing	N/A	1306506126	0	0	INOKHODOV, ALEKSEY O	7/3/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018879	N/A	N/A	N/A	N/A	N/A	614 W PALM AVE	None	MONROVIA	CA	91016	2635	00	06000	34.14899339	-118.0118782	Los Angeles County
328095	Ordering, Referring, Prescribing	N/A	1306852934	0	0	IBRAHIM, MAGED F MD	11/28/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C141296	N/A	N/A	N/A	N/A	N/A	16465 SIERRA LAKES PKWY	None	FONTANA	CA	92336	1242	00	06000	34.13805177	-117.4457839	San Bernardino County
328197	Ordering, Referring, Prescribing	N/A	1316066327	0	0	IRWIN, ROXANNE LMFT	7/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT31324	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PARK	None	SANTA CLARITA	CA	91350	2948	00	06000	34.41078438	-118.510775	Los Angeles County
328247	Ordering, Referring, Prescribing	N/A	1316210537	0	0	IHEKWOEME, IJEOMA	9/3/2022	Taxonomy not applicable	NA	n/a	000	Unknown	CA66684	N/A	N/A	N/A	N/A	N/A	1366 EAST AVE	None	CHICO	CA	95926	7336	00	06000	39.76111951	-121.8226455	Butte County
328369	Ordering, Referring, Prescribing	N/A	1316396823	0	0	INTWALA, SHAUNAK J PHARMD	2/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70370	N/A	N/A	N/A	N/A	N/A	330 N BRAND BLVD	STE 155	GLENDALE	CA	91203	0000	00	06000	34.15116156	-118.2549512	Los Angeles County
328509	Ordering, Referring, Prescribing	N/A	1316627151	0	0	ILICH, TATJANA NP	7/17/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026030	N/A	N/A	N/A	N/A	N/A	1964 VIA CTR	None	VISTA	CA	92081	6056	00	06000	33.18400138	-117.283827	San Diego County
328861	Ordering, Referring, Prescribing	N/A	1326503905	0	0	IZMIRIAN, MAGGIE M LCSW	3/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86500	N/A	N/A	N/A	N/A	N/A	695 S VERMONT	8TH FLOOR	LOS ANGELES	CA	90005	1349	00	06000	34.06078495	-118.2916863	Los Angeles County
328885	Ordering, Referring, Prescribing	N/A	1326588344	0	0	IVERSON, DAYNA CNP	5/23/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011857	N/A	N/A	N/A	N/A	N/A	190 S OAK AVE	BLDG. 2 / STE 1	OAKDALE	CA	95361	3528	00	06000	37.75958945	-120.8613916	Stanislaus County
329209	Ordering, Referring, Prescribing	N/A	1336560739	0	0	ISARRARAS, CLAUDIA LCSW	3/30/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW98169	N/A	N/A	N/A	N/A	N/A	10417 MAIN ST	None	LAMONT	CA	93241	1726	00	06000	35.2601067	-118.9142703	Kern County
329279	Ordering, Referring, Prescribing	N/A	1336670645	0	0	INGRAM, ASHLEY S	5/22/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	102937	N/A	N/A	N/A	N/A	N/A	133 W MAIN ST	STE 100	EL CAJON	CA	92020	3325	00	06000	32.79492453	-116.9627861	San Diego County
329358	Ordering, Referring, Prescribing	N/A	1336885128	0	0	IWUALA, ANGELA NP	8/22/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020496	N/A	N/A	N/A	N/A	N/A	13400 DOTY AVE	None	HAWTHORNE	CA	90250	6272	00	06000	33.910821	-118.3395325	Los Angeles County
329373	Ordering, Referring, Prescribing	N/A	1336979590	0	0	INIGUEZ, KIMBERLY	7/9/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030981	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
329527	Ordering, Referring, Prescribing	N/A	1346536919	0	0	ISLAS, AMERICA M LMFT	12/30/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT106121	N/A	N/A	N/A	N/A	N/A	4281 KATELLA AVE.	201	LOS ALAMITOS	CA	90720	6509	00	06000	33.80315853	-118.058328	Orange County
329733	Ordering, Referring, Prescribing	N/A	1346879731	0	0	IRVINE, JENNIFER DO	6/6/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21259	N/A	N/A	N/A	N/A	N/A	685 MORRO AVE	STE C	MORRO BAY	CA	93442	2233	00	06000	35.364564	-120.8511755	San Luis Obispo County
329736	Ordering, Referring, Prescribing	N/A	1346888104	0	0	IBRAHIM, HAJER G PHARMD	4/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80907	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PKWY	STE 625	SAN JOSE	CA	95119	1106	00	06000	37.23951066	-121.8013511	Santa Clara County
329835	Ordering, Referring, Prescribing	N/A	1356411243	0	0	ISHTOYAN, ARMINE PHARMD	3/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52122	N/A	N/A	N/A	N/A	N/A	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	00	06000	34.17030266	-118.5881699	Los Angeles County
329918	Ordering, Referring, Prescribing	N/A	1356609846	0	0	IKNER, FARISA M LMFT	3/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	97751	N/A	N/A	N/A	N/A	N/A	4441 E KINGS CANYON RD	None	FRESNO	CA	93702	3604	00	06000	36.738144	-119.753361	Fresno County
330078	Ordering, Referring, Prescribing	N/A	1356841514	0	0	IKETUBOSIN, ABIMBOLA D	7/20/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011284	N/A	N/A	N/A	N/A	N/A	2133 WINTERHAVE DR	None	WINTERHAVEN	CA	92253	9609	00	06000	32.73859108	-114.6357818	Imperial County
330421	Ordering, Referring, Prescribing	N/A	1366838211	0	0	INGLE, MATTHEW L MD	6/11/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	MD189233	N/A	N/A	N/A	N/A	N/A	940 E 5TH STREET	None	COQUILLE	OR	94723	1000	00	06000	43.17908426	-124.1788744	Coos County
330680	Ordering, Referring, Prescribing	N/A	1376613778	0	0	IULI, APRIL Y PSYD	6/25/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY21060	N/A	N/A	N/A	N/A	N/A	1605 EASTLAKE AVE.	None	LOS ANGELES	CA	90033	1009	00	06000	34.06300636	-118.2054784	Los Angeles County
330688	Ordering, Referring, Prescribing	N/A	1376547752	0	0	IWAMURA, HANH A	5/26/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D53039	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
330882	Ordering, Referring, Prescribing	N/A	1376986349	0	0	IRIZARRY, DRE M	4/29/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A152899	N/A	N/A	N/A	N/A	N/A	438 N WHITE RD	None	SAN JOSE	CA	95127	1439	00	06000	37.3776149	-121.8374887	Santa Clara County
330897	Ordering, Referring, Prescribing	N/A	1386007367	0	0	IOANNIDES, PERICLES MD	10/16/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A154867	N/A	N/A	N/A	N/A	N/A	900 MONO WAY	None	SONORA	CA	95370	5229	00	06000	37.97560986	-120.3677839	Tuolumne County
330945	Ordering, Referring, Prescribing	N/A	1386057024	0	0	IVEY, MATTHEW R LMFT	4/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	104416	N/A	N/A	N/A	N/A	N/A	3450 3RD ST.	UNIT 1C	SAN FRANCISCO	CA	94124	0000	00	06000	37.74535239	-122.387252	San Francisco County
331328	Ordering, Referring, Prescribing	N/A	1396029500	0	0	IM, MEA M PHARMD	7/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH62927	N/A	N/A	N/A	N/A	N/A	2690 PACIFIC COAST HWY	None	TORRANCE	CA	90505	7038	00	06000	33.79160861	-118.3328475	Los Angeles County
331699	Ordering, Referring, Prescribing	N/A	1396948576	0	0	IACUANIELLO, BYRON S LCSW	2/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	80159	N/A	N/A	N/A	N/A	N/A	3480 BUSKIRK AVE	None	PLEASANT HILL	CA	94523	4341	00	06000	37.94004473	-122.0590134	Contra Costa County
331883	Ordering, Referring, Prescribing	N/A	1407325681	0	0	IACOVELLI, SUZANNE L	8/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84892	N/A	N/A	N/A	N/A	N/A	12110 INDUSTRY BLVD	None	JACKSON	CA	95642	0000	00	06000	38.36981229	-120.8002806	Amador County
331977	Ordering, Referring, Prescribing	N/A	1407502164	0	0	ISAACS, CARLY L PA-C	6/27/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60761	N/A	N/A	N/A	N/A	N/A	442 S SAN PEDRO ST	None	LOS ANGELES	CA	90013	2132	00	06000	34.04476398	-118.2435593	Los Angeles County
332006	Ordering, Referring, Prescribing	N/A	1407618937	0	0	IRAHETA CASTELLON, KARLA FERNANDA DDS	11/15/2023	Taxonomy not applicable	NA	n/a	000	Unknown	109691	N/A	N/A	N/A	N/A	N/A	351 FELICE DR	None	HOLLISTER	CA	95023	3361	00	06000	36.85325269	-121.4170104	San Benito County
332127	Ordering, Referring, Prescribing	N/A	1417082041	0	0	ICHIMURA, DAVID M	8/14/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D40248	N/A	N/A	N/A	N/A	N/A	2710 MIDDLEFIELD RD	None	REDWOOD CITY	CA	94063	3404	00	06000	37.47644946	-122.2110919	San Mateo County
332287	Ordering, Referring, Prescribing	N/A	1417375528	0	0	ITSARA, MELISSA MD	7/19/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A140042	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
332488	Ordering, Referring, Prescribing	N/A	1427079573	0	0	IBOLD, LORRAINE LCSW	7/14/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW22378	N/A	N/A	N/A	N/A	N/A	505 N. TUSTIN AVENUE	134	SANTA ANA	CA	92705	3712	00	06000	33.74962094	-117.8341227	Orange County
332517	Ordering, Referring, Prescribing	N/A	1427132299	0	0	ISLAND, ROSENDO LMFT	7/1/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53985	N/A	N/A	N/A	N/A	N/A	3300 WEBSTER ST	SUITE 804	OAKLAND	CA	94609	3117	00	06000	37.82132826	-122.2621843	Alameda County
332542	Ordering, Referring, Prescribing	N/A	1427193770	0	0	IBARRA, EFRAIN LMFT	11/12/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49582	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
332584	Ordering, Referring, Prescribing	N/A	1427276013	0	0	ISIDRO, FIDES LCSW	5/3/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110005	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
332744	Ordering, Referring, Prescribing	N/A	1427558949	0	0	IGBINOSUN, FOLLEY NP	3/23/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008632	N/A	N/A	N/A	N/A	N/A	1521 CUMBERLAND CT	None	PERRIS	CA	92571	3723	00	06000	33.8057656	-117.1929842	Riverside County
332999	Ordering, Referring, Prescribing	N/A	1437414380	0	0	IMAM, FARAH N MD	3/4/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132422	N/A	N/A	N/A	N/A	N/A	7821 S. AVALON BLVD	None	LOS ANGELES	CA	90003	2358	00	06000	33.969393	-118.265197	Los Angeles County
333012	Ordering, Referring, Prescribing	N/A	1437435724	0	0	ISAAC, COURTNEY S LMFT	7/6/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT133567	N/A	N/A	N/A	N/A	N/A	5121 STOCKDALE HWY	None	BAKERSFIELD	CA	93302	1000	00	06000	35.35413152	-119.058471	Kern County
333145	Ordering, Referring, Prescribing	N/A	1437635950	0	0	ING, KEVIN J MD	7/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164742	N/A	N/A	N/A	N/A	N/A	3800 W CHAPMAN AVE	5TH FLOOR	ORANGE	CA	92868	1638	00	06000	33.78885849	-117.8950802	Orange County
333264	Ordering, Referring, Prescribing	N/A	1437872447	0	0	ISHA, ONEL J PHARMD	9/21/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86924	N/A	N/A	N/A	N/A	N/A	2001 MCHENRY AVE	SUITE C	MODESTO	CA	95350	3245	00	06000	37.67338576	-120.9942007	Stanislaus County
333642	Ordering, Referring, Prescribing	N/A	1447957964	0	0	IGBOERIKA, ESTHER NP	2/14/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024281	N/A	N/A	N/A	N/A	N/A	250 W 5TH ST	None	HANFORD	CA	93230	5029	00	06000	36.32439821	-119.6472235	Kings County
333773	Ordering, Referring, Prescribing	N/A	1457550949	0	0	IP, ERIC J PHARMD	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58424	N/A	N/A	N/A	N/A	N/A	555 CASTRO STREET	None	MOUNTAIN VIEW	CA	94041	2009	00	06000	37.38946454	-122.0815711	Santa Clara County
333842	Ordering, Referring, Prescribing	N/A	1457684870	0	0	IM, JANE NP	5/3/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	18546	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
333885	Ordering, Referring, Prescribing	N/A	1457770463	0	0	IZENBERG, JACOB M	5/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A138976	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
333994	Ordering, Referring, Prescribing	N/A	1457858151	0	0	ISLAM, FAHAD PHARMD	9/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76582	N/A	N/A	N/A	N/A	N/A	1634 E HIGHLAND AVE	None	SAN BERNARDINO	CA	92404	4616	00	06000	34.13588549	-117.2518245	San Bernardino County
334277	Ordering, Referring, Prescribing	N/A	1467778696	0	0	ITO, DIANNE M NP	2/22/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN457020	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD	MAIL STOP #81	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
335045	Ordering, Referring, Prescribing	N/A	1487348876	0	0	IRANI, SHAHRZAD NP	6/20/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025678	N/A	N/A	N/A	N/A	N/A	1317 OAKDALE RD	800	MODESTO	CA	95355	3361	00	06000	37.662489	-120.957588	Stanislaus County
335162	Ordering, Referring, Prescribing	N/A	1487831608	0	0	INGRAM, KAREN NP	7/19/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	13971	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
335181	Ordering, Referring, Prescribing	N/A	1487884367	0	0	IDOS, LESLIE V PHARMD	4/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH62117	N/A	N/A	N/A	N/A	N/A	1526 N EDGEMONT ST	2ND FLOOR- CARDIOLOGY	LOS ANGELES	CA	90027	5260	00	06000	34.098921	-118.2961105	Los Angeles County
335229	Ordering, Referring, Prescribing	N/A	1487974523	0	0	IZUHARA, KANDIS	7/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49872	N/A	N/A	N/A	N/A	N/A	5961 LA PALMA AVE	None	LA PALMA	CA	90623	2134	00	06000	33.84649747	-118.029168	Orange County
335406	Ordering, Referring, Prescribing	N/A	1497257273	0	0	INIGUEZ, MIRIAM S LCSW	10/22/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW104946	N/A	N/A	N/A	N/A	N/A	2620 INDUSTRY WAY	C	LYNWOOD	CA	90262	4024	00	06000	33.92360701	-118.2254995	Los Angeles County
335789	Ordering, Referring, Prescribing	N/A	1508294844	0	0	IACCINO, JOSEPH P DC	7/13/2021	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	32571	N/A	N/A	N/A	N/A	N/A	801 11TH ST	None	LAKEPORT	CA	95453	4100	00	06000	39.04898862	-122.9217691	Lake County
336019	Ordering, Referring, Prescribing	N/A	1518009554	0	0	IONG-SZETO, ALISON PHD	11/25/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY17544	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
336327	Ordering, Referring, Prescribing	N/A	1518593052	0	0	ISRAIL, ANDREW PHARMD	8/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH81378	N/A	N/A	N/A	N/A	N/A	7201 BOULDER AVE	None	HIGHLAND	CA	92346	3313	00	06000	34.123842	-117.1953945	San Bernardino County
336438	Ordering, Referring, Prescribing	N/A	1528192572	0	0	IXCAMEY, LOURDES M LCSW	2/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	65907	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
336748	Ordering, Referring, Prescribing	N/A	1528782489	0	0	ILIUTA, ANDREW PA-C	12/1/2023	Taxonomy not applicable	NA	n/a	000	Unknown	63778	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
337157	Ordering, Referring, Prescribing	N/A	1548025570	0	0	IBARRA, OMAR PA	6/6/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA64594	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
337213	Ordering, Referring, Prescribing	N/A	1548349509	0	0	INOUE, SACHI PHD	2/4/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY16879	N/A	N/A	N/A	N/A	N/A	3626 BALBOA STREET	None	SAN FRANCISCO	CA	94121	2604	00	06000	37.77571711	-122.4980286	San Francisco County
337626	Ordering, Referring, Prescribing	N/A	1558557561	0	0	IBARRA, NANCY LCSW	5/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74881	N/A	N/A	N/A	N/A	N/A	1701 OCEAN AVENUE	None	SAN FRANCISCO	CA	94112	3048	00	06000	37.72476918	-122.4604495	San Francisco County
338119	Ordering, Referring, Prescribing	N/A	1568779536	0	0	IYPE, SHERIN P LCSW	5/25/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75529	N/A	N/A	N/A	N/A	N/A	3545 LONG BEACH BLVD	None	LONG BEACH	CA	90807	3941	00	06000	33.82086796	-118.18938	Los Angeles County
338422	Ordering, Referring, Prescribing	N/A	1578507604	0	0	IGNACIO, ELMER P MD	12/19/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A42103	N/A	N/A	N/A	N/A	N/A	500 N. 9 TH ST.	A	MODESTO	CA	95350	5814	00	06000	37.65145793	-121.0156971	Stanislaus County
338505	Ordering, Referring, Prescribing	N/A	1578718607	0	0	ISLA, ESTELA LMFT	12/7/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	94030	N/A	N/A	N/A	N/A	N/A	619 E 5TH ST	None	LOS ANGELES	CA	90013	2109	00	06000	34.0432666	-118.2422934	Los Angeles County
338553	Ordering, Referring, Prescribing	N/A	1578797734	0	0	ISADORE, ADAM H MD	4/22/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A141267	N/A	N/A	N/A	N/A	N/A	2125 S EL CAMINO REAL	210	OCEANSIDE	CA	92054	9002	00	06000	33.18895278	-117.3283467	San Diego County
338685	Ordering, Referring, Prescribing	N/A	1578986832	0	0	IACONO, ALYSSA LCSW	12/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	96149	N/A	N/A	N/A	N/A	N/A	1019 GAYLEY AVE FL 2	FL 2	LOS ANGELES	CA	90024	3437	00	06000	34.06153366	-118.4476278	Los Angeles County
338732	Ordering, Referring, Prescribing	N/A	1588043814	0	0	INBAR, TAMI MD	10/25/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A147246	N/A	N/A	N/A	N/A	N/A	1401 AVOCADO AVE	709	NEWPORT BEACH	CA	92660	7710	00	06000	33.61235015	-117.8704573	Orange County
338768	Ordering, Referring, Prescribing	N/A	1588069165	0	0	ISHAK, OLIVIA LMFT	3/9/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108287	N/A	N/A	N/A	N/A	N/A	1350 3RD STREET	None	LA VERNE	CA	91750	5201	00	06000	34.10427088	-117.7847615	Los Angeles County
339358	Ordering, Referring, Prescribing	N/A	1598439036	0	0	ITANI, NOUR PHARMD	10/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85446	N/A	N/A	N/A	N/A	N/A	200 MUIR RD	None	MARTINEZ	CA	94553	4614	00	06000	37.99430233	-122.1107194	Contra Costa County
339450	Ordering, Referring, Prescribing	N/A	1598921850	0	0	INDERMILL, KRISTEN L LMFT	6/21/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT105839	N/A	N/A	N/A	N/A	N/A	5168 HONPIE ROAD	None	PLACERVILLE	CA	95667	8682	00	06000	38.6943603	-120.9018271	El Dorado County
339665	Ordering, Referring, Prescribing	N/A	1609315316	0	0	IGNONT, TARA LCSW	6/12/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88309	N/A	N/A	N/A	N/A	N/A	3301 E. 12TH STREET,	SUITE. 259	OAKLAND	CA	94601	2940	00	06000	37.77617499	-122.2247899	Alameda County
339666	Ordering, Referring, Prescribing	N/A	1609314905	0	0	IBRAHIM, ADEL MD	7/27/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A169484	N/A	N/A	N/A	N/A	N/A	6339 MACK RD	None	SACRAMENTO	CA	95823	4655	00	06000	38.475585	-121.4285265	Sacramento County
339717	Ordering, Referring, Prescribing	N/A	1609407402	0	0	INTERIANO, ALEXANDER L NP	1/24/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013791	N/A	N/A	N/A	N/A	N/A	4448 YORK BLVD	None	LOS ANGELES	CA	90041	3328	00	06000	34.12374025	-118.2188529	Los Angeles County
340032	Ordering, Referring, Prescribing	N/A	1619290442	0	0	IKEMEFUNA, VALERIE NP	5/9/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP19435	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
340116	Ordering, Referring, Prescribing	N/A	1619427432	0	0	IM, JENNIFER PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75145	N/A	N/A	N/A	N/A	N/A	13652 CANTARA STREET	MOB4 AREA 105	PANORAMA CITY	CA	91402	5423	00	06000	34.21980849	-118.4301135	Los Angeles County
340167	Ordering, Referring, Prescribing	N/A	1619519568	0	0	IKEH, ADEBIMPE	7/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65579	N/A	N/A	N/A	N/A	N/A	1138 W TENNYSON RD	None	HAYWARD	CA	94544	4422	00	06000	37.63123947	-122.076639	Alameda County
340413	Ordering, Referring, Prescribing	N/A	1629373980	0	0	IEONG, LAI LMFT	12/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT105444	N/A	N/A	N/A	N/A	N/A	409 JACKSON ST.,	None	HAYWARD	CA	94544	1530	00	06000	37.66243575	-122.0841894	Alameda County
340520	Ordering, Referring, Prescribing	N/A	1629564596	0	0	ING, ALICE M MD	6/8/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165149	N/A	N/A	N/A	N/A	N/A	3800 W CHAPMAN AVE	500	ORANGE	CA	92868	1638	00	06000	33.78885849	-117.8950802	Orange County
340592	Ordering, Referring, Prescribing	N/A	1629668306	0	0	INIGUEZ, JESSICA A LCSW	5/15/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115287	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	None	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
340724	Ordering, Referring, Prescribing	N/A	1639373731	0	0	IBAZEBO, EHIREME A MD	6/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C15663	N/A	N/A	N/A	N/A	N/A	29325 KIMBERLINA RD	None	WASCO	CA	93280	7617	00	06000	35.55797351	-119.3289345	Kern County
341436	Ordering, Referring, Prescribing	N/A	1659020675	0	0	IRONS, MATTHEW PA	7/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA60837	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
341492	Ordering, Referring, Prescribing	N/A	1659415875	0	0	IRANY, EVA K LMFT	4/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47218	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
341510	Ordering, Referring, Prescribing	N/A	1659411841	0	0	IEVLEVA, YULIA O LMFT	8/13/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48839	N/A	N/A	N/A	N/A	N/A	850 W TOWN AND COUNTRY R	416	ORANGE	CA	92868	4789	00	06000	33.77650924	-117.8609936	Orange County
341606	Ordering, Referring, Prescribing	N/A	1659651396	0	0	IZUMI, JON K PHARMD	7/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH51892	N/A	N/A	N/A	N/A	N/A	3521 DEL PASO RD	None	SACRAMENTO	CA	95835	2800	00	06000	38.65608	-121.541625	Sacramento County
341667	Ordering, Referring, Prescribing	N/A	1659740520	0	0	IZQUIERDO-GALLEGOS, MARK A LCSW	11/26/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93163	N/A	N/A	N/A	N/A	N/A	1359 N GRAND AVE	None	COVINA	CA	91724	1016	00	06000	34.104681	-117.872706	Los Angeles County
341773	Ordering, Referring, Prescribing	N/A	1659903045	0	0	IDUN, JACQUELINE CNP	2/24/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014031	N/A	N/A	N/A	N/A	N/A	2213 BUCHANAN RD	103	ANTIOCH	CA	94509	4265	00	06000	37.99879828	-121.8360576	Contra Costa County
341783	Ordering, Referring, Prescribing	N/A	1659921062	0	0	IP CHEN, ANDRES PHARMD	10/2/2018	Taxonomy not applicable	NA	n/a	000	Unknown	78850	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
341784	Ordering, Referring, Prescribing	N/A	1659927093	0	0	IBRAHIM, MERNA R	1/14/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	104003	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
342187	Ordering, Referring, Prescribing	N/A	1679054076	0	0	IGNACIO, MALLORY PHARMD	1/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64253	N/A	N/A	N/A	N/A	N/A	211 QUARRY RD	SUITE 108	PALO ALTO	CA	94304	1416	00	06000	37.44198478	-122.1694088	Santa Clara County
342266	Ordering, Referring, Prescribing	N/A	1679192371	0	0	IGWE, AMARA	1/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82297	N/A	N/A	N/A	N/A	N/A	189 NIBLICK RD	None	PASO ROBLES	CA	93446	4845	00	06000	35.61505753	-120.6811935	San Luis Obispo County
342531	Ordering, Referring, Prescribing	N/A	1689008336	0	0	IZADI, BIJAN DDS PC	10/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62719	N/A	N/A	N/A	N/A	N/A	925 BEVINS CT	None	LAKEPORT	CA	95453	9754	00	06000	39.03772106	-122.9223338	Lake County
342749	Ordering, Referring, Prescribing	N/A	1689669962	0	0	IYER, RAJINI MD	3/20/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A41811	N/A	N/A	N/A	N/A	N/A	3834 S WESTERN AVE	None	LOS ANGELES	CA	90062	1104	00	06000	34.016157	-118.3088825	Los Angeles County
342889	Ordering, Referring, Prescribing	N/A	1689963878	0	0	ISOLA, ANDREW J	8/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49775	N/A	N/A	N/A	N/A	N/A	29632 HWY 299E	None	ROUND MOUNTAIN	CA	96084	0228	00	06000	40.80385331	-121.9397745	Shasta County
342991	Ordering, Referring, Prescribing	N/A	1699144592	0	0	ITO-DOLINKA, JENNIFER PHARMD	8/23/2023	Taxonomy not applicable	NA	n/a	000	Unknown	73481	N/A	N/A	N/A	N/A	N/A	27220 HEATHER RIDGE RD	None	LAGUNA NIGUEL	CA	92677	3418	00	06000	33.56677119	-117.7120863	Orange County
343062	Ordering, Referring, Prescribing	N/A	1699277293	0	0	IBRAHIM, JACKLYN M	10/14/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	104338	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
343063	Ordering, Referring, Prescribing	N/A	1699279166	0	0	ISIKBAY, MASIS MD	4/8/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165353	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
343267	Ordering, Referring, Prescribing	N/A	1699947051	0	0	ILANI, DORIT S PHD	12/6/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY22773	N/A	N/A	N/A	N/A	N/A	58383 29 PALMS HWY	SUITE 101	YUCCA VALLEY	CA	92284	5890	00	06000	34.13159539	-116.3901072	San Bernardino County
343307	Ordering, Referring, Prescribing	N/A	1700083128	0	0	IVINS, BARBARA PHD	4/23/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY10343	N/A	N/A	N/A	N/A	N/A	312 CLAY STREET	SUITE 150	OAKLAND	CA	94607	3510	00	06000	37.79802567	-122.2780981	Alameda County
343520	Ordering, Referring, Prescribing	N/A	1700383486	0	0	IGBINIGIE, MATTHEW O MD	3/28/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A195139	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
343667	Ordering, Referring, Prescribing	N/A	1700948510	0	0	IXCARAGUA, ISOLINA LMFT	7/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	46442	N/A	N/A	N/A	N/A	N/A	511 N BROOKHURST ST	200	ANAHEIM	CA	92801	5231	00	06000	33.839253	-117.959068	Orange County
343669	Ordering, Referring, Prescribing	N/A	1700961752	0	0	ILAGAN-AVERGONZ, JESSICA Z	9/28/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D49338	N/A	N/A	N/A	N/A	N/A	12360 FIRESTONE BLVD	None	NORWALK	CA	90650	4324	00	06000	33.90615795	-118.0698073	Los Angeles County
343973	Ordering, Referring, Prescribing	N/A	1710520671	0	0	IZADYAR, DIBA PA-C	10/23/2019	Taxonomy not applicable	NA	n/a	000	Unknown	57199	N/A	N/A	N/A	N/A	N/A	1781 W. ROMNEYA DR	# A	ANAHEIM	CA	92801	1818	00	06000	33.85067272	-117.9447342	Orange County
344420	Ordering, Referring, Prescribing	N/A	1720641400	0	0	IWAFUCHI, CAITLIN H LMFT	10/18/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128726	N/A	N/A	N/A	N/A	N/A	1131 STONEMAN AVE	None	PITTSBURG	CA	94565	5466	00	06000	38.00327323	-121.8748171	Contra Costa County
344497	Ordering, Referring, Prescribing	N/A	1730190745	0	0	IHLE, EVA C MD	5/27/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A76406	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
344562	Ordering, Referring, Prescribing	N/A	1730308149	0	0	INZUNZA, ELENA D LCSW	4/29/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW79294	N/A	N/A	N/A	N/A	N/A	3075 MYERS ST	None	RIVERSIDE	CA	92503	5525	00	06000	33.90872869	-117.4423238	Riverside County
344575	Ordering, Referring, Prescribing	N/A	1730341306	0	0	IYER, SANGEETA R MD	3/9/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C168166	N/A	N/A	N/A	N/A	N/A	36977 PARK AVE	None	BURNEY	CA	96013	4067	00	06000	40.87640189	-121.6730441	Shasta County
344608	Ordering, Referring, Prescribing	N/A	1730422916	0	0	IYER, SAPNA P MD	7/19/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A134992	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FLOOR, SUITE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
344690	Ordering, Referring, Prescribing	N/A	1730542515	0	0	IFTIKHAR, SYED F MD	1/7/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A160234	N/A	N/A	N/A	N/A	N/A	16453 BEAR VALLEY RD	None	HESPERIA	CA	92345	1752	00	06000	34.47081596	-117.3043788	San Bernardino County
344712	Ordering, Referring, Prescribing	N/A	1730597071	0	0	IM, DEBRA J	3/23/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D63753	N/A	N/A	N/A	N/A	N/A	1661 HANOVER RD	# 103	CITY OF INDUSTRY	CA	91748	1796	00	06000	33.99109665	-117.920988	Los Angeles County
345001	Ordering, Referring, Prescribing	N/A	1740560861	0	0	IBRAHIMI, SAID A MD	11/15/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A129171	N/A	N/A	N/A	N/A	N/A	4155 BLACKHAWK PLAZA CIR	SUITE 240	DANVILLE	CA	94506	4903	00	06000	37.80225444	-121.9179817	Contra Costa County
345146	Ordering, Referring, Prescribing	N/A	1740772383	0	0	ICASIANO, HERBERT D DO	4/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	OS020260	N/A	N/A	N/A	N/A	N/A	219 NORTH MAIN AVE	UNIT #140	SCRANTON	PA	18504	3307	00	06000	41.4139704	-75.67850541	Lackawanna County
345253	Ordering, Referring, Prescribing	N/A	1750041265	0	0	IWOBI, IESHA PA-C	7/21/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA61409	N/A	N/A	N/A	N/A	N/A	2540 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	00	06000	40.14893664	-122.2178101	Tehama County
345311	Ordering, Referring, Prescribing	N/A	1750410858	0	0	IVANOVA, TEMENUGA G LMFT	12/4/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT39120	N/A	N/A	N/A	N/A	N/A	54405 VILLAGE VIEW DR,	None	IDYLLWILD	CA	92459	2411	00	06000	33.73793798	-116.7133307	Riverside County
345389	Ordering, Referring, Prescribing	N/A	1750596730	0	0	INMAN, LISA R MD	5/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A85322	N/A	N/A	N/A	N/A	N/A	1525 SILVER AVENUE	2 ND FLOOR	SAN FRANCISCO	CA	94134	1229	00	06000	37.73224392	-122.4063707	San Francisco County
345496	Ordering, Referring, Prescribing	N/A	1750780516	0	0	ISLAM, JULIE R MD	2/19/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A149552	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
345670	Ordering, Referring, Prescribing	N/A	1760133375	0	0	IWIG, HAYLEY LCSW	1/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	120551	N/A	N/A	N/A	N/A	N/A	1301 PINE AVE	None	LONG BEACH	CA	90813	3124	00	06000	33.782913	-118.192417	Los Angeles County
345720	Ordering, Referring, Prescribing	N/A	1760416770	0	0	IMANDOUST, MOHAMMAD MD	4/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C50910	N/A	N/A	N/A	N/A	N/A	1328 S MISSION RD	None	FALLBROOK	CA	92028	4006	00	06000	33.36868654	-117.2507699	San Diego County
345964	Ordering, Referring, Prescribing	N/A	1760931406	0	0	ILEJAY, RAYMUND D	3/25/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	121722	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
346016	Ordering, Referring, Prescribing	N/A	1770032443	0	0	IM, ROBIN DDS	2/5/2024	Taxonomy not applicable	NA	n/a	000	Unknown	100897	N/A	N/A	N/A	N/A	N/A	701 S RAYMOND AVE	None	FULLERTON	CA	92831	5201	00	06000	33.863841	-117.9068965	Orange County
346198	Ordering, Referring, Prescribing	N/A	1770701708	0	0	IFEKWUNIGWE, CHRISTOPHER LCSW	8/8/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW19633	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
346504	Ordering, Referring, Prescribing	N/A	1780273425	0	0	IBRAHIM, JACQUELINE PHARMD	7/27/2022	Taxonomy not applicable	NA	n/a	000	Unknown	64589	N/A	N/A	N/A	N/A	N/A	770 MAGNOLIA AVE	SUITE 1-G	CORONA	CA	92879	3121	00	06000	33.85936872	-117.5534605	Riverside County
346695	Ordering, Referring, Prescribing	N/A	1780939157	0	0	IZQUIERDO, VANESSA NP	4/15/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	21892	N/A	N/A	N/A	N/A	N/A	5420 N. FIGUEROA ST.	None	LOS ANGELES	CA	90042	4118	00	06000	34.10779213	-118.196385	Los Angeles County
346792	Ordering, Referring, Prescribing	N/A	1790085728	0	0	ILLIG, NANCY A PHARMD	1/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH028292	N/A	N/A	N/A	N/A	N/A	989 SUNRISE AVE	None	ROSEVILLE	CA	95661	4506	00	06000	38.73110774	-121.272042	Placer County
347005	Ordering, Referring, Prescribing	N/A	1790453801	0	0	INAM, NAUREEN PHARMD	4/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	84513	N/A	N/A	N/A	N/A	N/A	26610 YNEZ RD	None	TEMECULA	CA	92591	4697	00	06000	33.52155695	-117.1568629	Riverside County
347024	Ordering, Referring, Prescribing	N/A	1790550440	0	0	IWUOHA, MAUREEN NP	11/1/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027929	N/A	N/A	N/A	N/A	N/A	12442 LIMONITE AVE	205	EASTVALE	CA	91752	2467	00	06000	33.97511454	-117.5531895	Riverside County
347075	Ordering, Referring, Prescribing	N/A	1790844637	0	0	ISLETA-FLORENTO, AILENE I MD	4/9/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A77383	N/A	N/A	N/A	N/A	N/A	137 N COTTONWOOD ST	1500	WOODLAND	CA	95695	6646	00	06000	38.68538399	-121.7933582	Yolo County
347151	Ordering, Referring, Prescribing	N/A	1801016555	0	0	IKEDA, ALLISON M LMFT	2/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFC50883	N/A	N/A	N/A	N/A	N/A	1521 UNIVERSITY AVENUE	None	BERKELEY	CA	94703	1422	00	06000	37.87060038	-122.2812128	Alameda County
347157	Ordering, Referring, Prescribing	N/A	1801025903	0	0	ISSAGHOLIAN-HAVAI, LAURA E PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61520	N/A	N/A	N/A	N/A	N/A	8110 WOODMAN AVENUE	None	PANORAMA CITY	CA	91402	5423	00	06000	34.21850103	-118.4310944	Los Angeles County
347229	Ordering, Referring, Prescribing	N/A	1801163878	0	0	INSLEE, THERESA M LMFT	12/2/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT82424	N/A	N/A	N/A	N/A	N/A	2101 COURAGE DR	None	FAIRFIELD	CA	94533	6717	00	06000	38.23737478	-122.0676832	Solano County
347301	Ordering, Referring, Prescribing	N/A	1801261995	0	0	IVERSEN, RACHEL LAC	6/29/2020	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	A16921	N/A	N/A	N/A	N/A	N/A	2243 W. BALL ROAD	None	ANAHEIM	CA	92804	5314	00	06000	33.817798	-117.9610599	Orange County
347439	Ordering, Referring, Prescribing	N/A	1801493887	0	0	IBE, CHIDOZIE E NP	7/14/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014912	N/A	N/A	N/A	N/A	N/A	2620 26TH AVE	None	OAKLAND	CA	94601	1907	00	06000	37.79088756	-122.2231716	Alameda County
347520	Ordering, Referring, Prescribing	N/A	1801976907	0	0	INIGO, VIANKA C	3/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW21839	N/A	N/A	N/A	N/A	N/A	4000 W METROPOLITAN DR	SUITE 404	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
347721	Ordering, Referring, Prescribing	N/A	1811366065	0	0	IREY, LISA A	10/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128538	N/A	N/A	N/A	N/A	N/A	3200 E GUASTI RD	SUITE 100	ONTARIO	CA	91761	8660	00	06000	34.06518	-117.5822055	San Bernardino County
347810	Ordering, Referring, Prescribing	N/A	1811486947	0	0	IQBAL, TAHERA DO	3/21/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17720	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1445	00	06000	38.555181	-121.4566785	Sacramento County
347846	Ordering, Referring, Prescribing	N/A	1811550858	0	0	IXCOL, NORMA LMFT	5/24/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111212	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7906	00	06000	33.62516256	-117.7353393	Orange County
347905	Ordering, Referring, Prescribing	N/A	1811919731	0	0	IQBAL, SAYEED N MD	3/2/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G88426	N/A	N/A	N/A	N/A	N/A	43322 GINGHAM AVE	None	LANCASTER	CA	93535	4576	00	06000	34.67013731	-118.1222748	Los Angeles County
347915	Ordering, Referring, Prescribing	N/A	1811983232	0	0	IBRAHEEM, LAJA I MD	5/22/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A66124	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
348090	Ordering, Referring, Prescribing	N/A	1821398413	0	0	INOSHITA, ROBERT K PHARMD	1/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	42647	N/A	N/A	N/A	N/A	N/A	6445 PACIFIC AVE	None	STOCKTON	CA	95207	3715	00	06000	38.00885138	-121.3198384	San Joaquin County
348189	Ordering, Referring, Prescribing	N/A	1821539180	0	0	ISRAEL, JENNIFER R DO	3/16/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17135	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
348419	Ordering, Referring, Prescribing	N/A	1831431238	0	0	IBERICO LOZADA, MARIANO M MD	7/3/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132138	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
348625	Ordering, Referring, Prescribing	N/A	1831718683	0	0	IVANIS, JELENA MD	5/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL5026	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
348665	Ordering, Referring, Prescribing	N/A	1831830298	0	0	IACONIS, ANDREA LCSW	4/15/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW107672	N/A	N/A	N/A	N/A	N/A	871 ENBORG CT	None	SAN JOSE	CA	95128	2645	00	06000	37.311489	-121.933817	Santa Clara County
348680	Ordering, Referring, Prescribing	N/A	1831863331	0	0	IRVINE, KEELY S	10/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA60172	N/A	N/A	N/A	N/A	N/A	1873 COMMERCENTER W	None	SAN BERNARDINO	CA	92408	3303	00	06000	34.067781	-117.286122	San Bernardino County
348829	Ordering, Referring, Prescribing	N/A	1841469525	0	0	INESI, GINO LMFT	4/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48327	N/A	N/A	N/A	N/A	N/A	550 QUARRY RD	None	SAN CARLOS	CA	94070	6221	00	06000	37.51749579	-122.2670107	San Mateo County
349062	Ordering, Referring, Prescribing	N/A	1841831088	0	0	IBRAHIM, SAMAH N PHARMD	7/27/2024	Taxonomy not applicable	NA	n/a	000	Unknown	78645	N/A	N/A	N/A	N/A	N/A	105 W BASTANCHURY RD, ST	D	FULLERTON	CA	92835	2525	00	06000	33.89549201	-117.9294117	Orange County
349255	Ordering, Referring, Prescribing	N/A	1851567382	0	0	IHEKWOEME, FELIX U PHARMD	11/22/2018	Taxonomy not applicable	NA	n/a	000	Unknown	57675	N/A	N/A	N/A	N/A	N/A	965 HWY 99 W	SUITE 127	CORNING	CA	96021	2734	00	06000	39.92634593	-122.1974807	Tehama County
349326	Ordering, Referring, Prescribing	N/A	1851676720	0	0	IADAROLA, NICKOLE K LMFT	5/10/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT114141	N/A	N/A	N/A	N/A	N/A	2751 NAPA VALLEY CORPORA	None	NAPA	CA	94558	6216	00	06000	38.24829023	-122.2745626	Napa County
349635	Ordering, Referring, Prescribing	N/A	1861552291	0	0	IBRAHIM, RIM S MD	6/30/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A111466	N/A	N/A	N/A	N/A	N/A	2045 FAIRMONT CIRCLE	None	SAN LEANDRO	CA	94578	1088	00	06000	37.709892	-122.118966	Alameda County
349643	Ordering, Referring, Prescribing	N/A	1861571358	0	0	IWAMA, GAIL	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50516	N/A	N/A	N/A	N/A	N/A	3683 GREEN AVE	None	LOS ALAMITOS	CA	90720	3237	00	06000	33.80191461	-118.0685441	Orange County
349794	Ordering, Referring, Prescribing	N/A	1861857344	0	0	INGRAM-FLORES, ANASTASIA R LCSW	11/4/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW110239	N/A	N/A	N/A	N/A	N/A	40 DIAMOND VALLEY ROAD	None	MARKLEEVILLE	CA	96120	9322	00	06000	38.76981249	-119.8167806	Alpine County
349986	Ordering, Referring, Prescribing	N/A	1871163360	0	0	IORDAN, CRISTIAN M LMFT	2/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103968	N/A	N/A	N/A	N/A	N/A	11057 HILL DRIVE	None	LOMA LINDA	CA	92354	3854	00	06000	34.05273578	-117.261456	San Bernardino County
350231	Ordering, Referring, Prescribing	N/A	1871876664	0	0	ISUSQUIZA, MARISOL PHARMD	4/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	58698	N/A	N/A	N/A	N/A	N/A	11800 4TH ST	None	RANCHO CUCAMONGA	CA	91730	6129	00	06000	34.07733948	-117.548154	San Bernardino County
350243	Ordering, Referring, Prescribing	N/A	1871906545	0	0	ITEN, ANA E MD	8/21/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A139493	N/A	N/A	N/A	N/A	N/A	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
350256	Ordering, Referring, Prescribing	N/A	1871920819	0	0	ISSARAPANICHKIT, TAWNY PHARMD	4/3/2022	Taxonomy not applicable	NA	n/a	000	Unknown	69897	N/A	N/A	N/A	N/A	N/A	2901 LOS FELIZ BLVD	None	LOS ANGELES	CA	90039	1502	00	06000	34.129008	-118.263933	Los Angeles County
350505	Ordering, Referring, Prescribing	N/A	1881331627	0	0	IRIS, TARA J RN MA	1/13/2024	Taxonomy not applicable	NA	n/a	000	Unknown	632072	N/A	N/A	N/A	N/A	N/A	2922 TRANSWORLD DR	None	STOCKTON	CA	95206	3974	00	06000	37.90687986	-121.2291511	San Joaquin County
351196	Ordering, Referring, Prescribing	N/A	1902208051	0	0	IRLANDO, JEANETTE LMFT	7/2/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133533	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY	207	SANTA ROSA	CA	95407	5486	00	06000	38.425266	-122.749875	Sonoma County
351601	Ordering, Referring, Prescribing	N/A	1912279175	0	0	IBARRA, BRENDA L LMFT	12/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123669	N/A	N/A	N/A	N/A	N/A	1908 S BUSINESS CENTER D	None	SAN BERNARDINO	CA	92408	3436	00	06000	34.06732096	-117.2801085	San Bernardino County
351674	Ordering, Referring, Prescribing	N/A	1912397605	0	0	IRELAND, JANE K LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53542	N/A	N/A	N/A	N/A	N/A	1682 NOVATO BLVD	None	NOVATO	CA	94947	7000	00	06000	38.10598003	-122.5782662	Marin County
351719	Ordering, Referring, Prescribing	N/A	1912465626	0	0	IYER, GAYATHRI P	6/6/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	103579	N/A	N/A	N/A	N/A	N/A	121 BARBOZA ST	None	MENDOTA	CA	93640	1901	00	06000	36.76619136	-120.3839072	Fresno County
351807	Ordering, Referring, Prescribing	N/A	1912663667	0	0	IQBAL, MOHAMMAD T	8/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84874	N/A	N/A	N/A	N/A	N/A	2703 ORO DAM BLVD E	None	OROVILLE	CA	95966	5116	00	06000	39.50709449	-121.5453316	Butte County
352215	Ordering, Referring, Prescribing	N/A	1932112455	0	0	ISKENDERIAN, KEVORK MD	5/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C50646	N/A	N/A	N/A	N/A	N/A	2500 S. C STREET	C	OXNARD	CA	93033	5340	00	06000	34.17646093	-119.1812737	Ventura County
352294	Ordering, Referring, Prescribing	N/A	1932338175	0	0	INES, MARLO L LMFT	5/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98715	N/A	N/A	N/A	N/A	N/A	370 W CRENSHAW BLVD. E-	None	TORRANCE	CA	90503	1727	00	06000	33.84549	-118.3287415	Los Angeles County
352529	Ordering, Referring, Prescribing	N/A	1932741139	0	0	INTHAVONG, VIRGINIA V NP	2/9/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013866	N/A	N/A	N/A	N/A	N/A	1717 LAS VEGAS STREET	None	MODESTO	CA	95358	5500	00	06000	37.6052798	-121.0027523	Stanislaus County
353039	Ordering, Referring, Prescribing	N/A	1952428492	0	0	IGNATOWICZ, OLGA MD	2/18/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A69587	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
353367	Ordering, Referring, Prescribing	N/A	1962053470	0	0	INNES-GOMBERG, DEBORAH PHD	10/5/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY13705	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	None	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
353470	Ordering, Referring, Prescribing	N/A	1962564500	0	0	IHINGER, JO E LMFT	5/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT42286	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
353686	Ordering, Referring, Prescribing	N/A	1962897520	0	0	ISALES, MARIA C MD	11/9/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A160479	N/A	N/A	N/A	N/A	N/A	2420 SAMARITAN DRIVE	None	SAN JOSE	CA	95124	3907	00	06000	37.25107191	-121.946105	Santa Clara County
353801	Ordering, Referring, Prescribing	N/A	1972096709	0	0	ISHAK, RIOSALINE A	8/17/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	102468	N/A	N/A	N/A	N/A	N/A	525 ROBERTS LANE	None	BAKERSFIELD	CA	93308	4799	00	06000	35.40860151	-119.0317455	Kern County
353817	Ordering, Referring, Prescribing	N/A	1972130722	0	0	IQBAL, DANIYAL N DO	11/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A22313	N/A	N/A	N/A	N/A	N/A	11670 ATWOOD ROAD	None	AUBURN	CA	95603	9522	00	06000	38.93485327	-121.0988193	Placer County
354340	Ordering, Referring, Prescribing	N/A	1982375697	0	0	IWAMOTO, THOMAS PHARMD	4/28/2023	Taxonomy not applicable	NA	n/a	000	Unknown	85105	N/A	N/A	N/A	N/A	N/A	481 OLD MAMMOTH ROAD	None	MAMMOTH LAKES	CA	93546	0406	00	06000	37.63851578	-118.9666226	Mono County
354465	Ordering, Referring, Prescribing	N/A	1982885430	0	0	IVERS, BONNIE J PSYD	2/26/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	21391	N/A	N/A	N/A	N/A	N/A	6201 BRIARCLIFF DR	N/A	HUNTINGTON BEACH	CA	92647	2207	00	06000	33.75141697	-118.0209043	Orange County
354534	Ordering, Referring, Prescribing	N/A	1982991394	0	0	IGLESIA, PATRICIA LCSW	9/29/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	104420	N/A	N/A	N/A	N/A	N/A	401 W CIVIC CENTER DR	STE. 700	SANTA ANA	CA	92701	4515	00	06000	33.75157353	-117.870921	Orange County
354655	Ordering, Referring, Prescribing	N/A	1992188502	0	0	IRAHETA, XIOMARA LMFT	12/27/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130227	N/A	N/A	N/A	N/A	N/A	2280 N VALENTINE AVE	None	FRESNO	CA	93722	5553	00	06000	36.76966023	-119.8532997	Fresno County
354685	Ordering, Referring, Prescribing	N/A	1992242846	0	0	INMAN, ANNIE CNP	12/17/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95033342	N/A	N/A	N/A	N/A	N/A	400 CONCAR DRIVE	None	SAN MATEO	CA	32065	0000	00	06000	37.55338259	-122.3076528	San Mateo County
354721	Ordering, Referring, Prescribing	N/A	1992327977	0	0	IBRAHIM, YAZEED	8/18/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A20185	N/A	N/A	N/A	N/A	N/A	2001 THE ALAMEDA	None	SAN JOSE	CA	95126	1136	00	06000	37.34293689	-121.9270392	Santa Clara County
354731	Ordering, Referring, Prescribing	N/A	1992335442	0	0	IDIONG, KUFREABASI LCSW	2/2/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106732	N/A	N/A	N/A	N/A	N/A	39990 FAURE RD	None	HEMET	CA	92544	9408	00	06000	33.54540303	-116.8982524	Riverside County
354868	Ordering, Referring, Prescribing	N/A	1992875470	0	0	INABA, NAHOKO	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH56245	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County